Any chance of Remission with Prostate cancer?

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same_as_u
Regular Member


Date Joined Mar 2007
Total Posts : 76
   Posted 6/14/2007 10:00 PM (GMT -6)   
     I just got word that one out of twelve samples of my biopsy showed positive for cancer.  I have not met with my Urologist for a follow-up yet.
 
     By phone he told me that my Gleason was 4 + 4 (I think that is how he said it).  My PSA was 6.8 and 2 months later 6.2.
 
     How about a "Home run" question.  Is there ever any chance of remission with this?
 
 

Walt


Tamu
Veteran Member


Date Joined Oct 2006
Total Posts : 626
   Posted 6/14/2007 10:28 PM (GMT -6)   
Walt,

First of all I am sorry that you had to post on this forum. In answer to your question let me say that prostate cancer is curable so you should be thinking along those lines and not remission. Your Gleason score indicates that your cancer is on the more aggressive side of the norm. The fact that only 1 in 12 of your biopsy samples had cancer would indicate that it is not wide spread. You should have your slides read by another pathlogist just to be sure of the reading. Was your biopsy prompted by your PSA reading or did your urologist feel anything on the DRE? If prompted by your PSA then this further indicates that the cancer can be eliminated through different treatments. There are surgical and different types of radiation treatments. You should research the possible treatments. There are previous posts on this forum from men that have had different types of treatment. Feel free to ask an you will get replies. Once you have followed up with your urologist let us know what he is recommending and we can provide insight into that treatment and others.

Tamu
Diagnosed 7/6/06, 1 of 10 core samples, 40%,Stage T1c, Gleason 3+3
Da Vinci on 11/01/06, Catheter out on 11/13/06
56 Years Old
Post Op Path, Gleason 3+3, Approx. 5% of prostate involved
Prostate Confined, margins clear
Undetectable PSA on 12/18/06
No more pads as of 1/13/07
Began injections in April '07


veteran1
Regular Member


Date Joined May 2007
Total Posts : 133
   Posted 6/14/2007 10:49 PM (GMT -6)   
Walt----
Regret you have prostate cancer. And you "hit one out of the park" by finding this site.
You're biopsy revealed a fairly low PSA---and if you heard your doctor correctly---a 4 + 4 = 8 is an agressive cancer. First, I would talk to my urologist to see if "phone in" Gleason is correct.
I do however appreciate your apprehension. With a new diagnosis a flurry of questions go through the mind.
Will I have a recurrence? Is it cureable
(depending on a multitude of factors, yes), but how about your cancer right now? What's your treatment plan? You are way AHEAD of yourself. Talk to your
urologist...ask him/her questions. Ask for
a recommendation to see a Oncologist. Or a radiation/oncologist.

Try (very difficult) to relaxe and make an informed decision regarding your next step. Use this site for support and info.

Best wishes...

Vet

Diag. 12/03/05
Biopsy: Gleason 10
Path. Diag. T3b Seminal Vesicle Involvement--- Gleason 5 + 4 = 9 both lobes
Current PSA---.01

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 7665
   Posted 6/14/2007 11:23 PM (GMT -6)   
As Tamu and Vet have stated. You have a chance for both a remission and a cure. In my opinion, get rid of that prostate. And even if someone says "inoperable"...take it out. 1 of 12 samples means "little"
and you just may be localized. But they can't predict the stage of this cancer with radiation or other therapies. My story is well documented here. I would love to have your opportunity to beat this. Simply put, it's not strike three by any means.

Tony

pasayten
Regular Member


Date Joined Mar 2007
Total Posts : 390
   Posted 6/14/2007 11:40 PM (GMT -6)   
Walt,

Tamu and Vet have both given you great advice and if I was in your shoes, I would follow it.

I had a psa of around 4.5 - 5.5 for 5-6 years before I saw a urologist. I had a negative DRE (digital rectal exam), and a free PSA running from 21-24% which points to if a problem, chances are it was benign. I had a twelve core biopsy, just for screening. 6 on each side. Left side all negative. Right side, 1 core of the 6 on the LAST 1mm of a 120mm core showed some cancer cells... Rated at a Gleason 3+3 or 6. They only caught it by a distance of a hair...

I researched the alternatives, also thinking in the back of my mind that the cancer must be very small and insignificant... And I would easily be well within the negative margin group where all the cancer was totally contained within the prostate. After research, for me, my current health, and my future life, I decided to go with the nerve sparing DaVinci robotic procedure. These decisions must be made by every individual themselves... That is why it is important to be as informed as you can get and ask as many questions as you want... I would write them down before a visit to the doctor(s) so I would not forget anything.

I had surgery 4/24 and catheter out 5/2... I am feeling very well and healthy... I am also on the "normal" side of recovering my continance and seem to be faster on the ED side. Yes at times I get frustrated about the time it takes to recover total continance and ED factors, but that is just because I am impatient. I would not change my decision at all. It was the best decision I made for ME.

And, by the way, the reason I gave you so much background about my minimal screen biopsy, as I interpreted it and I think the doctor was a little suprised also, was that the pathology of my prostate after it was removed was that it was 20% involved! and I had two areas where a couple of the cancer cells were touching the outside portion of the prostate. I am so glad I caught the cancer when I did... The Gleason stayed at 6 for the final pathology and did not get upgraded higher which sometimes happens to many patients. The doctor feels it all got removed and my final pathology "numbers" reflect on a nomogram that the "odds" are 95% that I will not have a recurrence of cancer for 7 years.... Nothing is ever 100% with cancer (and many other diseases) ... especially the longer time frame you look out. For me, these are GREAT numbers for cancer... I I fully expect to eventually die from something other than cancer.

Walt, take good care of yourself, research, inquire, ask many questions, get second opinions from doctors, keep on visiting this board (no question is dumb or too intimate!), follow the advice from the previous posters, and make the best decision for yourself and your particular circumstances.

God Bless!
pasayten
Age 59 y/o - Last 3-4 years of annual general health checkups - PSA 5-6 but Free PSA Ratio 21-24%, suggesting "benign"
3/7/2007 - Went to urologist -Neg DRE, but scheduled screening biopsy
3/13/2007 - 12 point biopsy - Left 6 OK  Right 1 of 6 had small hit.
Gleason 3+3 Diagnosed as T1c
4/24/2007 - DaVinci performed at Virginia Mason hospital in Seattle
5/2/2007 - Catheter Out! Got copy of pathology report:
Gleason 6  T2c Nx Mx   approx 20% of prostate involved
Positive margin, but 2 places where a focal point of only 2 cells were touching edge, the right apex and right posterior. Perineural Invasion present. Seminal Vesicle and Lymphatic/Vascular not identified. Final Diognosis of T2c "suggests" organ confined.  Stats for no re-occurance are 95% for 7 years. No further treatment other than PSA watch.


M. Kat
Veteran Member


Date Joined Jul 2006
Total Posts : 715
   Posted 6/15/2007 5:45 AM (GMT -6)   
Walt, I can only echo what others have said here. there are no definites when it comes to this disease and only you can make the decision on what to do. prostate cancer is curable! ask all the questions you want and you will get answers here. read a lot of threads, too, as there are a lot of journeys posted here. God bless, kat
Husband Jeff 56 years old diagnosed July 27, 2006
PSA 6.5, 2 positive areas in biopsy, Gleason 3+3=6
Radical Retropubic Prostatectomy August 30, 2006
pathology report - all clear - cancer gone
1st post-surgery PSA test <0.1, 2nd post-surgery PSA test <0.1, 3rd PSA <0.1
no more pads Oct 12, 2006
first "real" erection with use of pump 12/16/06
3/07 - occasional dribbles and erections with Cialis and pump


same_as_u
Regular Member


Date Joined Mar 2007
Total Posts : 76
   Posted 6/15/2007 7:28 AM (GMT -6)   
Many thanks to you all for your wise counsel.

As far as the question, "Was your biopsy prompted by your PSA reading or did your urologist feel anything on the DRE?" It was strictly PSA and three opinions said the DRE was normal.

I did get a second opinion reading of the slides. They were sent to Dr. Epstein at John Hopkins, and he (don't know if it was him personally) agreed with the original reading from UPMC Shadyside Hospital. Being from Pittsburgh, that is where I had the biopsy done.

My urologist is certified for DaVinci robotic so that may be what he will recommend. I meet with him on Tuesday 6/19. All he said to me by phone is that although I am 67, he is in favor of removing the cancer.
Walt


GreenAcres
Regular Member


Date Joined Jul 2006
Total Posts : 474
   Posted 6/15/2007 8:27 AM (GMT -6)   
Walt - your stats are similar. Our biopsy showed a 5% of one core positive out of 12 samples. The path report post-surgery was a different story. Those little needles can miss a lot! At the age of 66, we were still considered to be prime surgical candidates. Even though we may be facing a recurrence (and maybe not) - in hindsight we would do the same thing over again. Da Vinci meant for us less recuperation time and less blood loss. Not to mention knowing where we stood with an instant pathology report. We were already familiar with the wonderful abilities of robotics and trusted the process completely. Of course, it's the doc you have to trust first and foremost and you're very lucky - if you go that route - to have one nearby!

It's also wise to look at all the alternatives as many others here have chosen different routes that were right for them.

It is most definitely not an easy decision. Good luck.
Husband age 66
PSA on 5/1/06: 4.2 (had doubled in 13 mos. and rising monthly)
DaVinci Surgery 8/2/06 - Austin, TX w/Dr. Randy F.A.G.I.N.
T2a (at biopsy)
At pathology - cancer cell leakage into fatty tissue
Post-Surgical PSA on 10/3/06 - undetectable!
Update: 11/1/06 - perhaps bladder neck involvement; 30%-50% chance of recurrence
Future: PSA tests twice-yearly for now - Next one: 4/17/07
 

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