Just came back from Dr. visit. Need opinions.

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ChrisR
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Date Joined Apr 2008
Total Posts : 812
   Posted 4/16/2008 10:06 AM (GMT -7)   
I just had a consultation with a new doctor at Ohio State Univ.  He said that my cancer was very low volume 2%-5%.  6 cores out of 50 positive.  Cancer seems to be all around the prostate.  Gleason 3+3=6.  PSA 2.75.  He feels a good chance cancer is still contained.  0% chance of lymph node involvement.  Of course we won't know until it is taken out.
 
My big question is that if it is contained what is the chance of recurrence?  Does this happen a lot?  Can you be pretty hopeful if it is contained or will it always come back some day?  He used the word "cure" if it is contained based on my stats.  I know he is just guessing.
 
Opinions......
 
Age 42
PSA 2.75
Glease 3+3=6
6 of 50 cores contain 2% to 5%
Gland size 35cc  (Dr. not concerned)  I don't know.
 

Post Edited (ChrisR) : 4/16/2008 11:37:22 AM (GMT-6)


Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1210
   Posted 4/16/2008 10:47 AM (GMT -7)   
Hi ChrisR,
I'm certainly not a medical professional, just a cancer patient, but from what I have learned in my journey thus far, if your numbers still look this good after a pathologist examination of your prostate, your chances of  a full recovery seam very good. All of us here are hoping that our cancer will not return, but only time will tell.
More knowledgeable people will chime in soon with more and better help. 
All the best to you in your journey and please keep in touch to let us all know how you're doing.
 
Magaboo

Born Sept., 1936
PSA 7.9
Stage T1C
-ve DRE
Gleason's Score 3+4=7
2 of 8 positive
Open RP 28 Nov 06
Post op staging T3
Gleasons still 3+4=7
Seminal vesicles and lymph nodes clear
Catheter out 15 Dec 06
Dry since 11 Feb 07
All PSA tests in 2007 (4) <.04
PSA test Mar., 08 =.04 
 
 


elofdahl
New Member


Date Joined Mar 2008
Total Posts : 19
   Posted 4/16/2008 11:08 AM (GMT -7)   

The Johns Hopkins website has an interactive "Hans table" that will predict probabilities of biochemical recurrance given various circumstances.  Check it out at http://urology.jhu.edu/prostate/hanTables.php

Based upon the Hans tables...If your cancer is organ confined it appears as though there is a 3% chance of biochemical recurrance at 10 years



  
Eddie
Age 55
PSA 6.7
T1c Gleason 3+4=7...2 of 10 cores
Non-Robotic laparoscopic RP on 3/4/2008
Specimen pathology: T2C organ confined with clear margins. GS lowered to 6!
100% urinary continence since cath removal on 3/11/2008
ED resolution promising.  Levitra is necessary, but working well for now
 

Post Edited (elofdahl) : 4/16/2008 12:16:37 PM (GMT-6)


Izzyblizzy
Regular Member


Date Joined Oct 2006
Total Posts : 411
   Posted 4/16/2008 11:09 AM (GMT -7)   
If it is contained upon final pathology (after they get it out). You have a very HIGH chance of full recovery and yes, being cured.

It is not often that a fully contained cancer within the prostate (no spread to margins, etc.) turns out to be recurrent. That is why prostate cancer is one of the most curable cancers out there. As long as you catch it early, which it sounds like you have.

I would say you have a VERY good prognosis, but like your doctor says there is always that chance that it has spread and they don't know it. But I would be cautiously optimistic about your prognosis.

Just a P.S. ... 50 biopsy punches ... wow!!

Best wishes and keep us all updated :)

Tanya
Age: 63
Diagnosed: 10/30/06
PSA: 3.7 (2005: 3.4, 2004: 4.0)
Biopsy: 1/10 cancerous, 5% of one core, right apex.
Gleason: 3+3=6
Da Vinci: April 10, 2007, Denver CO
Path results: 1% of prostate involved. Very small tumors on both right and left apex. Negative margins, negative seminal vessicles, lymph nodes left intact. Gleason upgraded 3+4=7.
1st PSA Results: May 11, 2007 <.01
 


ChrisR
Veteran Member


Date Joined Apr 2008
Total Posts : 812
   Posted 4/16/2008 11:25 AM (GMT -7)   
So, I can almost bet that I will be upgraded to a higher Gleason score.  It seems a lot of things change after surgery.  It seems there is no way to predict what is actually going on with a biopsy. 
 
Best to everyone...

phillysub
Regular Member


Date Joined Nov 2007
Total Posts : 64
   Posted 4/16/2008 11:55 AM (GMT -7)   

You need to realize that it is a "numbers" game and you're really relying on statistics and percentages.

Nothing will be "relatively" certain until the final pathology report and PSA follow-up visits.

In your situation, the numbers, and what your doctor told you, are VERY promising. Look at this from the positive viewpoint that you have a good chance of being "cured".


Phillysub.

Age: 51
Last PSA before diagnosis: 2.9

Diagnosed: Oct 2007

Gleason: 3+3=6

RALP surgery: Jan 23, 2008 (Dr Costas Lallas @ Thomas Jefferson Hospital in Philadelphia)

1st Post-op appt: Feb 1, 2008 (negative margins, cancer contained within the capsule)


Johnny Canuck
Regular Member


Date Joined Jan 2008
Total Posts : 88
   Posted 4/16/2008 12:31 PM (GMT -7)   
Hi Chris,
At the risk of sounding like a cheerleader, I would encourage you to investigate brachytherapy as a treatment option. Have a chat with a radiation oncologist and ask him whether or not you might be a candidate. Surgeons prefer surgery. Good luck, though, whatever your choice.
Age: 54
Gleason Score: 3+3=6
PSA: 3.33
Biopsy:7/8 Positive
Stage: "Bulky" T1c
Prostate Size: 27cc
 
Diagnosed: December 05, 2007
Brachytherapy: on February 26, 2008
  68 seeds, (Iodine 125). 
 
 


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 4/16/2008 1:44 PM (GMT -7)   
Chris,

Doc's right and at your tender age, this may be your only chance for a cure. Paul has been clean for 3 years now. His PSA was a little higher (3.6) and by volume, the cancer probably a bit larger. His prostate size with the biopsy measurement was the same. Paul done very well....so will you! Do whatcha gotta do Chris. treat this while its curable.

PS: Check this out for some decent information. Hope it helps.

http://www.cancer.prostate-help.org/download/jhnomo.pdf

Good Luck, Swim
 


biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1464
   Posted 4/16/2008 2:29 PM (GMT -7)   
Hey Chris,

As others have said, the only way to know the true extent of the cancer in your prostate is to get it out and look at it. You have many years left so why risk missing some of it that could cause problems later. For most of us that have had surgery the side effects are manageable and seeing those zeros on all the PSA tests sure feels good.

Jim
Age 73. Diagnosed 11/03/06. PSA 7.05. Stage T2C Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Catheter out on 12/13/06.  Dry on 12/14/06.
Pathological stage: T2C N0 MX. Gleason 3+4.
50 mg Viagra + 1000 mg L-Arginine + .03 cc Trimix = Excellent Results
PSAs from  1/3/07 - 1/17/08 0.00. 
Next PSA test on 7/17/08
"Patience is essential, attitude is everything."
 
 


Tim G
Veteran Member


Date Joined Jul 2006
Total Posts : 2268
   Posted 4/16/2008 3:21 PM (GMT -7)   
You are a lucky unlucky man, Chris!  Unlucky that you got prostate cancer and at a young age.  Lucky in that it appears to have been caught at an early stage and is essentially curable.
 
All three of the well-established treatments--radioactive seed implants, surgery  and external-beam radiation--have excellent cure rates and long-term survival.  The newer treatments look very promising but don't yet have an established track record.  It's your choice, so do the research (this web site is an excellent place for information and support) and make your decision.
 
After extensive research, my wife and I decided on surgery for reasons that were important to us:  (1) pathological staging where the extent of the tumor and margins can be accurately determined  (2) The PSA goes immediately to zero  (3) The availability of options like salvage radiation if the cancer recurs  (4) Incontinence and impotence tend to get better with time  (5) Less likely to get diarrhea and painful urination.
 
I, too, am a lucky unlucky man, but am thankful that due to an alert family doctor, my cancer was found at a very early stage and the statistical probability  for recurrence nearly two years after its removal is 1%. 
 
Take care and hang in there...Tim

Age 59  PSA quadrupled in 1 yr (0.6 to 2.5) 
DRE neg  1 of 12 biopsies pos (5%) 
Open surgery June 2006 
Cancer confined to one small area of prostate
Gleason 5 (3+2)  PSA's < 0.1  


Frank1205
Regular Member


Date Joined Feb 2008
Total Posts : 308
   Posted 4/16/2008 4:58 PM (GMT -7)   
Hi Chris,
 
Sorry your here but glad you came.  I am about 20 days post surgery.  I can not speak or advise but only share with you how I made my decision.  I had three basic choices, wait, do some form of radiation or do surgery.  I saw three surgeons, hind site I would have seen at least a radiation doctor.  When a Doc said this treatment is the only way you can get a cure and your 95% of getting that with your early symptoms I could not hear anything else. I could not see the trees through the Forest.
 
With surgery even if I did not get the expected results at least the I knew we would cut off the head of the snake.  It seemed surgery offered plan B (radiation) and plan C (hormone therapy) if surgery failed.  And very important to me was that we would know what, where and how much we are dealing with.
 
With that said I choose the DaVinci robotic method.  Less bleeding, faster recovery.  I was told to choose a surgeon that has done 400 minimum procedures.  Being still sexually active I choose nerve sparing as well.
 
Now hind site,  After pathology I went from a T1C, Gleason 6, 1% involved (95%) cure ratio to a Gleason 7, T2C, 10% involved one bad margin and cancer found in a unusual location.  Will that happen to you,  who knows hope not indeed.   I still have a 86% of being cured according to Doc.  One PSA above .1 and I go to 20% chance.  I am still in very good shape and have an excellant chance of beating this disease and I will.   
 
My sexual function is pretty close to being back to normal while my continence is typical and slow.  I did work at home 4 days after surgery and back part time in 11 days and full time with limitations 18 days after. Little pain,30 hours in hospital.
 
Stay with us, this site has an unlimited amount of knowledge, support, experience and an endless supply of love and compassion.  What ever you choose we will be with you all the way.
 
Frank
Diagnosed 01-08-08 @ 53 years old 
DRE normal - High PSA for 5 or more years
2004 Biospy negative - 2008 Biopsy positive (01-08-08)
10 cores, 1 positive and at 1% of that one core
Current PSA 6 - Bone and Ct scans negative
clinicalg Staged at T1C - Gleason 3+3 = 6
Robotic Da Vinci performed March 27th, 2008
University of Chicago,5 hour surgery , 3 hour recovery
Unexpected Cardiac issues appear and disappear?
Hospital stay 30 hours - Catheter out in 7 days  normaly expected leakage - Erectile funtion back on line 9 days 
Post Pathology T2C, Gleason 7, 10 % of both portions of prostate, Seminal vessels clear, fat tissue clear,Tumor on bottom of prostate, 1 positve margin  going to meet with oncologist to discuss treatment options if any at this time.
 


mvesr
Veteran Member


Date Joined Apr 2007
Total Posts : 823
   Posted 4/16/2008 5:04 PM (GMT -7)   
Hi Chris.

Sorry you had to join our club but glad you found us. Your numbers sound pretty good and as some members of the forum have already stated, you have some real decisions to make as to treatment of PC. Look at all your options, get as much information about the treatments, make your decision and don't look back. We are all here for you. Take care and God bless you on your journey.

Mika
age at dx 54 now 55
psa at dx 4.3
got the bad news 1/29/07
open surgery Duke Medical Center 5-29-07
never more than 2 pads
wear one for insurance now
ED still a problem
last PSA undetectable
 


Tamu
Veteran Member


Date Joined Oct 2006
Total Posts : 626
   Posted 4/16/2008 6:33 PM (GMT -7)   
Chris,

The number one reason I chose surgery was because I would know about the chance of reoccurence after the post op path report. In my case the tumor was a single focal tumor representing about 5% of the total prostate volume and located almost right in the middle of the prostate. Due to the location and size I feel 100% that my cancer will not reoccur and so does my surgeon. It really comes down to the confidence you have after the post op path report.

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, 6/25/07, 1/8/08
No more pads as of 1/13/07
Began injections in April '07
 


smilingoldcoot
Regular Member


Date Joined Jan 2008
Total Posts : 338
   Posted 4/16/2008 8:18 PM (GMT -7)   

Chris

There are so many different situations we each face.  Each of us has a different set of numbers, stages, scores.  I personally know that this thing called PCa can and will make your mind ask numerous questions and I think even second guess ourselves at times.  My urologist almost guaranteed me I did not have cancer but my biopsy came back positive with a high gleason score.  At the  initial consultation at MD Anderson my doctor initially had me believing that my PCa had already metastisized before the Pelvic CT proved him wrong.  I don't know the exact results but I am confindent my PET and Prostascint Scans were clear. I base this on the fact I have been scheduled for my workup at the U of Florida Proton Therapy Institute to prepare for Proton Radiation.

I tell you all of that because I know this road we are on is not smooth and without some possible bumps.  So, please stay positive and don't give yourself something to worry about that may never materialize.

God Bless

Richard

 


Retired USAF Richard & Debbie on The Shores of Toledo Bend Lake Louisiana
Neg Bios 1997 & 2000 PSA within considered normal range
11/06 PSA 1.9 PSA 11/07 was 4.9 PSA 12/07 was 7.7 MDA 2/12/08 3.3 On Proscar so shud be doubled
Biospy 1/10/08 Gleason 10, Stage T1C  8 of 12 samples positive all Less Than 5% 
Bone scan 1/17/08 hot spot on ribs, CT shows rib enjury CT CHest 1/30/08 Clear
M.D. Anderson 2/12/08 Gleason 9 - CT Abdomin & Pelvis Clear Recommended Hormone&Radiation
2/19/08 Dr Fagin, Austin, TX did not recommend surgery based on medical history
2/22/08 Contacted U of Florida Proton Therapy Institute - Appt 3/13/08 
3/24/08 PET Scan await results - 4/1/08 Prostascint Scan await results
Appointment UFPTI for 3 day workup April 29th and 30th and May 1st.
Radiation to start 4-5 weeks later
Turn Stumbling Blocks into Steping Stones and Keep Smiling

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