Hi All,

I would like to get some guidance or advice on my situation.

Six years ago aged 59, because of an elevated PSA (4.4 ng/ml), I had a TRUS biopsy of my prostate to test for possible prostate cancer. Fortunately the results were negative. However I was treated for BPH urinary symptoms (Tamsulosin) and Finasteride to bring down PSA. 

Urinary symptoms continued to deteriorate and in July 2019 I had a sucessful TURP (Trans Urethral Resection of Prostate) to improve urinary problems.

Histology of the prostate tissue revealed the presence of Gleason Grade 8 (4+4) prostate cancer in <5% of the tissue samples. Subsequent MRI and bone scan indicated no  evidence of disease spread beyond the capsule or metastatic spread. I assume this indicates a T1a N0 M0 staging with Gleason 8.

My problem is that the TURP biopsy was taken in July. The MRI and bone scan were done in September. It is now November and I have not been offered a treatment option other than another TRUS biopsy. The waiting list for my preferred treatment option (radical prostatectomy) is at least 4 months and I still have not received an appointment to discuss this possibility with a urologist. The most optimistic time estimate for potential treatment is ~10 months to a year  from positive biopsy  but probably longer.

Is it ususal or acceptable to wait this long for treatment of Gleason grade 8  confirmed prostate cancer? From what I have read it certainly does not seem to be. Gleason 8 is regarded as highly likely to spread and I feel like I am just waiting for this to happen.

Has anybody else had a Geason 8 finding and not been treated?