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prostate cancer

Hi was diagnosed with prostate cancer t3 and seminal vesicle involvement. What would my best tmt options be and is it poss there is lymph involvement. What sort of questions shoul i be asking. i had gleason 7 . is this an aggressive cancer. surgery if recommended not for 6 weeks. Is it likely to follow on with recurrence. Also what stage am i likely. only told gleason 7  and t3. Is t3 considered metastatic or is it just a locally advanced cancer if seminal vesicles. many thanks. excuse the haphazard questions but any direction of thought would be appreciated. is surgery enough or does it follow with hormones or radio tmt. I am 50 yr old.
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242579 tn?1252114771
Thank you for your question. When cancer involves the Seminal vesicles (SVs) it is classified as T3b (vs.T3a when the cancer extends out from the glands without involvement of the SVs). T3b is advanced localized cancer just like T3a. In the literature, urologists report up to 20% of the operated prostate cancers to be T3. A
Gleason 7 is an intermediate cancer. The need for adjuvant therapy (hormonal or radiation) will be decided post-operatively  according to the pathology and the post-operative PSA values. That is to say, if surgical margins are positive (cancer left in the body) and/or the PSA levels do not normalize, adjuvant therapy would be recommended.


Ash Tewari, MD


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