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Just came back from Dr. visit. Need opinions.

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Prostate Cancer
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Posted 4/16/2008 11:06 AM (GMT -6)
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)

Posted 4/16/2008 11:47 AM (GMT -6)
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

Posted 4/16/2008 12:08 PM (GMT -6)

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


Posted 4/16/2008 12:09 PM (GMT -6)
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
Posted 4/16/2008 12:25 PM (GMT -6)
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...

Posted 4/16/2008 12:55 PM (GMT -6)

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".

Posted 4/16/2008 1:31 PM (GMT -6)
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.
Posted 4/16/2008 2:44 PM (GMT -6)
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
Posted 4/16/2008 3:29 PM (GMT -6)
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
Posted 4/16/2008 4:21 PM (GMT -6)

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

Posted 4/16/2008 5:58 PM (GMT -6)
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

Posted 4/16/2008 6:04 PM (GMT -6)
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
Posted 4/16/2008 7:33 PM (GMT -6)
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
Posted 4/16/2008 9:18 PM (GMT -6)

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

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