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  • #1

    NCCN Patient Guidelines

    From our fellow user Mark:

    The NCCN patient guidelines can be downloaded as a PDF here:


    Early stage: https://www.nccn.org/patients/guidel...ly-patient.pdf

    Advanced stage: https://www.nccn.org/patients/guidel...ed-patient.pdf

    All stages: https://www.pcf.org/guide/prostate-c...patient-guide/



    Age Dx: 57
    PCa History: Father, Grandfathers, Uncles
    Oct16 Bx: Gleason 4+3 Grade Group 3 w/PNI, LB: 4+3 (60% pattern 4), RA: 3+3, RLM: 3+3, RLA: 3+3
    Jan17 RALP - Pathology = pT3a; Gleason 4+3; Weight: 42g - Dr. Grant Taylor
    AMS800 Dr. David Rapp @ UVA:
    Jun19 Installed; Jul19 Activated; Sep22 Failed; May23 Revision
    PSA_TESTS: Apr16-5.10, Jul16-4.70, Aug16-5.13, Mar17<0.01, Jul17<0.01, Oct17<0.01, Jan18<0.01, May18<0.01, Nov18<0.01, Jan19<0.01, Jun19<0.02, Nov20<0.10, May21<0.10, Apr22<0.10, Sep22<0.10​
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  • #2
    For those who like to delve further into how treatment paths are determined, the physician guidelines with evidence blocks are a useful resource. A free login is needed to access them. Info at:
    Guidelines With Evidence Blocks
    https://www.nccn.org
    PSA hadn't been checked for a few years (damned USPSTF) until . . .
    PSA 11.5 - 6/18 gets me referral to URO
    PSA 12.4 - 9/18 before biopsy

    12 core TRUS biopsy 10/18, two cores positive
    Left Apex Gleason 3+3=6, <5% of core
    Right Apex Gleason 3+4=7 (almost 50% is pattern 4), 5% of core
    Decipher biopsy score 0.94

    RARP 12/18, pathology: pT3a,pNX
    Acinar adenocarcinoma, Gleason score 4+3=7, tumor 10-15% of prostate
    IDC-, EPE+, BNI+, SVI-, LVI-, PNI+, multifocal SM+ with pattern 4

    4/19 Second opinion on pathology:
    biopsy:
    Left Apex Gleason 3+3=6, <5% of core
    Right Apex Gleason 4+3=7 (80% pattern 4), 5% of core, cribriform
    RARP: pT3a,pNX
    Acinar adenocarcinoma, Gleason score 4+4=8, 1% pattern 5, tumor 10-15% of prostate
    cribriform, IDC+, EPE+, BNI+, SVI-, LVI-, PNI+, multifocal SM+ with pattern 4 at margin

    Adjuvant RT to prostatic fossa 7/19-9/19 with six months ADT

    PSA <0.1 - 1/19 through 8/21

    PSA 0.21 - 1/27/22 yikes!

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