Just diagnosed with 9 out of 14 biopsy cores positive

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Ivory63
New Member


Date Joined Nov 2008
Total Posts : 13
   Posted 11/16/2008 12:45 PM (GMT -6)   
Since being diagnosed on Tuesday, November 7 I am faced with my biggest nightmare.  .
 
I had three PSA test this year starting in April with a 3, one in July at 3.1, and a final in October at 3.3.  I almost didn't do the biopsy since I thought the scores were so low and their was no digital evidence, but since I have a family history of prostate cancer I did do it on November 6.  As I mentioned in the forum yesterday 14 cores were taken and the results were seven cores with Gleason scores of 7, two with scores of 6, and the others were benign.
 
What scares me the most is that so many samples were positive (9 out of 14) with a mid core sample showing a focal perineaural invasion.  I guess my PSA score is a positive and my doctor says this was caught early and although the cancer is their it is still small in terms of the size I guess he met the tumors .  I had a bone scan on Friday and will find out the results on Monday.  I am also seeing a surgeon on Monday named James Karol of Norcal Urology who specializes in the Divinci procedure.
 
I just can't seem to think about anything else day or night since I was told I had the disease.  Since so much of the prostate seems to have cancer present my wife who is in charge of a hospitals rehab unit thinks we should move fast.
 
What are your thoughts?

coxjajb
Regular Member


Date Joined Nov 2008
Total Posts : 184
   Posted 11/16/2008 2:26 PM (GMT -6)   
I made a comment in your thread yesterday. When I first met with my surgeon he said " I know you have a lot to think about, but I don't want you to wait too long". I did not ask how long he thought I should or could wait because it didn't matter. As soon as I knew I had cancer, I knew I wanted it out. Knowing I had cancer was like a dagger hanging over my head. I work for a large health plan. I spoke to the medical director there and was told I had plenty of time to made a decision. He told me that prostatr cancer is typically slow growing. Still, it was eating at me to know I had cancer. I wanted to move as fast as I could to get it out. When my surgeon told me to think about my options, but not wait too long, I responded with " I'm not doing anything this afternoon, my decision is made, you can perform the surgery today". He said that if I was serious, he had an cancellation and he could do it Friday, which was three days away. I said yes and have no regrets. My surgeon performs about 10 prostatectomy procedures, using the da Vinci robot, per week and over 1,000 in the past few years. I had complete trust in his skill. You will hear pros an cons to the various options. The urologist that diagnosed my cancer, spelled out all of my options. I told him I wanted to opt for the da Vinci robot. He said he thought that was my best option, and referred me to the physician that performed my prostatectomy. It's your decision to make. I wish you the best in your decision.
Age 50
Pre - Op PSA, 4.3
Gleason 3+4=7
Stage T1C
da Vinci Prostatectomy 8/1/08
No issues with incontinence or ED since day 1 after catheter removal
First post op PSA 11/11/08, 0.00


Ivory63
New Member


Date Joined Nov 2008
Total Posts : 13
   Posted 11/16/2008 2:35 PM (GMT -6)   
Thanks for your coments coxjajb.

Ivory

Jerry1
Regular Member


Date Joined Mar 2007
Total Posts : 460
   Posted 11/16/2008 4:02 PM (GMT -6)   
 
Ivory,
 
I know only to well what you are feelings, from the time I heard the words you have prostate cancer in August nothing was the same.  This forum helped me gain perspective and to take a breath and realize there is the other side of this nightmare.  After my biopsy they told me that only one out of 14 cores was positive but it was a gleason 8 which meant it was a very aggressive cancer.  My doctor recommended surgery the Da Vinci and recommend a doctor in Orlando Fl who was top in his field  He also said to look into other options but felt since it was aggressive the only way to be sure they it was contained was the surgery.  After much research by my wife and I we decided on the surgery.  Then I was told by the surgeon that he would not operated until 8 weeks after the biopsy to be sure it was healed since the prostate is then easier to remove I almost lost it once I made the decision I want it out now.  Those weeks were the hardest but now I realize that I had time to relax and a few more weeks does not make that much of a difference.  After my surgery my cancer was downgraded to a gleason 6 and was contained in the prostate, for the most part I am doing great no incontinence some minor dripping and just a couple of minor complications but nothing major.  I am so happy it is behind me, and you will find that just reading and communicating on this site is very helpful we have all been where you are and care very much about what you are going through.  Read and research as much as you can and make your decision.  Soon you will be on the otherside of this operation and moving on with your life.
 
Jerry    
Age 69
DX 8/13/08 , PSA 4.0, Biopsy 14 samples 1 positive for Prostate Cancer 12% of sample, Second option of biopsy from Methodist Hospital Houston same DX
Gleason Score 4+4 =8
Bone scan and MRI negative
Da Vince surgery on Oct 17, 08 Florida Hospital Dr Vipul Patel
Tumor size 2.9 x0.8 x 0.8 cm
Location: single focus, left posterior peripheral zone (pt2a)
Post Gleason report  3+3= 6
Lymph nodes on both sides negative
Angiolymphatic invasion: Positive
Perineural invasion: Positive
Extraprostativ extension: Negative for periprostatic or seminal vesile invasion
Surical margins Negative 
Stage II (pt2a) 
Cath out on October 29th. 


Ivory63
New Member


Date Joined Nov 2008
Total Posts : 13
   Posted 11/16/2008 4:49 PM (GMT -6)   
Thanks Jerry for your understanding.

kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 11/16/2008 9:14 PM (GMT -6)   
Sorry to Welcome you to our club Ivory. How bout posting some stats? Good Luck on your treatment.
KW
    43 at Dx and Surgery (RRP)
    PSA 5.7, Biopsy 3 of 12 positive (up to 75%) all on left side of prostate, Gleason 7
    RRP on Oct. 17, 2006 - Nerves on right side saved. All Lab's clear. 
    Cathiter in for 28 days due to complications in healing. Removed Nov. 9, 2006
    First Post op PSA on Dec. 11, 2006  Undetectable 0.00.
    ED workable and usable with Viagra.
    Feb. 20th, 2007 - Feb. 4th, 2008  Cystoscope, Two Collagen injections,Second Opinion Consultation for Incontinance at OU Medical Center, Bio-Feedback training, Chiropractic, Accupuncture  to try to resolve ongoing incontinance (4-6 pads a day)  All PSA's 0.00.
    Feb. 22nd, 2008 - Surgery to install the AMS AdVance Male Sling.
    March 27th, 2008 - Sling not working, Little or no improvement.
    April 18, 2008 - Collagen injection.  Back to using 4-6 full pads a day within a week.
    May 14, 2008 - Another collagen injection to try to Band-Aid the leaking for our June cruise.  Will start making conusultation appiontments for AUS after we return.
    July 14th, 2008 - AUS consultation with Dr. Morey at UT Southwestern (Dallas).
    July 30, PSA 0.00.
    Aug. 22nd, 2008 - AUS Surgery by Dr. Morey
    Oct. 6th, 2008 - AUS Activation by Dr. Morey
     


Ziggy9
Veteran Member


Date Joined Jul 2008
Total Posts : 981
   Posted 11/16/2008 9:29 PM (GMT -6)   
First of all you have only been diagnosed a week ago. Calm down!!!!

Near all men survive this disease. For most it's slow growing so one doesn't need to panic or react to an urgent need to get it out right now!!!!!

For one thing most reputable urologists will want at least 6 weeks after a biopsy to proceed with any kind of treatment. That's to reduce the after biopsy swelling and trauma. Second you are giving way to much credibility to a 14 core biopsy. Most 10-14 core biopsies are to just spot and find cancer. There accuracy in actually placing the tumor/s leaves a lot to be desired. They really don't tell how much over all. Look below at my normal biopsy shows 3 cores out of 12 while the much more accurate saturation mapping biopsy came up with one core out of 45 in a smaller gland. Those results are typical. The fact that you can't think of anything else but your cancer puts you exactly in the wrong frame of mind to make any decision especially not a major one. Weigh the possible side effects to for you could be living with them for a long time or forever. As bad as cancer was I didn't want to go in as a fairly active middle aged man and wake up elderly wearing diapers just to get the cancer out asap. Quality of life must be factored in too as well as possible risks. I advise you to go to my TFT redux thread and on the first post links, watch the 4 part video presentation. It's an excellent production of someone diagnosed with PCa and the treatments offered. As I stated in your other post I actually went with a third choice. If I had rushed to my first choice I know I'd be regretting it now. Or in other words take your time reflecting on this or at least more than you would buying a new car. I advise you to take a few days off go somewhere, RELAX! Try the best you can to put this out of your mind. Let your emotions calm down and come back to it like in a week,. Contrary to that other guy there's NO hurry to decide. A few months won't make any difference.
Diagnosed 10/08/07
Age: 58
3 of 12 @5%
Psa: 2.3
3+3=6
Size: 34g
T-2-A
 
2/22/08
3D Mapping Saturation Biopsy
1 of 45 @2%
Psa:2.1
3+3=6
28g after taking Avodart
Catheter for 1 day
Good Candidate for TFT
(Targeted Focal Therapy)
Cryosurgery(Ice Balls)
Clinical Research Study
 
4/22/08
TFT performed at University of Colorado
Medical Center at Denver Fitzsimons Campus
Catheter for 4 days
Slight soreness for 2 weeks but afterward
life returns as normal
 
7/30/08
Psa: .32
 
11/10/08
Psa.62
 
April, 2009
Final Biopsy scheduled to
complete clinical research study 
 
 
 


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4184
   Posted 11/16/2008 10:38 PM (GMT -6)   

Ivory, I encourage you to read the first two sentences of realziggy's post...then read them a couple of more times.

If your doc says it was caught early, then there is a very like probability that you will be cured.  None of us here can tell you the right treatment for your situation, but most of us will suggest that you get multiple opinions from different practioners and to pick someone with great experience.

There are tons of links on this forum that will take you to informational sites.  Take some time to read about this disease and make an informed decision, not a knee-jerk reaction.

Good luck.  I'm sure we all feel for you as we all remember "getting the news".  But, please get yourself educated on this so you can feel at peace with your decision...


Age 62
Gleason 4 +3 = 7
T1C
PSA 4.2
27cc
Brachytheraply volume study done on 11/14/08
Brachytherapy scheduled in early December


biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1464
   Posted 11/16/2008 11:15 PM (GMT -6)   
Hey Ivory,

Sorry you have to be here but glad you found us. I understand your concern over knowing you have cancer, we all go through that and I felt exactly as you do.

Two things are required to beat this disease - early detection and agressive treatment.

Cancer is not something to play around with and even though you hear that PCa is slow growing and you have time, there are those here that thought that only to find out they have stage III or IV disease. The problem is that you won't know that for sure until you get a post-op pathologiy report.

Got cancer? Get rid of it!!!

Jim


Age 74. 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 - 7/17/08 0.00. 
Next PSA test on 1/28/09
Lung cancer dxed on 5/16/08.  Surgery on 6/25/08  T1N1M0 - Stage IIA  Finished 4 cycles of chemo on 11/7/08.
First CT scan on 12/2/08.
"Patience is essential, attitude is everything."


califguy
Regular Member


Date Joined Sep 2008
Total Posts : 72
   Posted 11/16/2008 11:39 PM (GMT -6)   
Good statements. As you can see, it is good to act on, but not simply react. I sent you a couple of emails of ideas.
 
Bill
Don't get discouraged!!
CalifGuy
 
Diagnosed Feb 2008  54 years old
3+4=7 gleason
7.5 PSA
4 out of 20 biopsies were cancerous
daVinci Robotic surgery July 24, 2008
Univ of Calif San Francisco Med Center  Dr Peter Carroll
In hospital 2 nights altho I had option of leaving the next day but stayed due to distance home.
Contained in prostate, not spread
Six weeks post surgery PSA less than .01


kcragman
Regular Member


Date Joined May 2008
Total Posts : 240
   Posted 11/17/2008 9:54 AM (GMT -6)   
Ivory63:

I had 12 cores taken, 5 were cancerous and a 6th was suspect. I was initially a Gleason 7. I had 3 doctors tell me not to wait more than 60 days to do something. By the time I saw the 3rd doctor, he said if it were a family member of his, he would clear his schedule and do me in 2 or 3 weeks (which he did). I had surgery about 52 days after my initial diagnosis. The post-op analysis determined that I was actually a Gleaon 9 with a T3a tumor - which means it had bulged out, but not quite broken out of the prostate. The point is, they cannot always tell exactly what is going on in there.

My impression is that if you have a Gleason 7 or higher, you should not wait more than about 2 months to do something - whatever your treatment choice may be.

I would recommend that you gather as much info as possible, talk to as many doctors as possible, and move as quickly and calmly as you can to a decision that you are comfortable with. I am not saying rush into something, but I am saying don't drag your feet.

Good luck,
kcragman
Age: 52
March 2006: PSA 2.5

Dec 2007: PSA taken for insurance application. I did not see the results until late Jan '08 - after I was rejected. Their lab said PSA 4.5. PSA again in Feb '08: 3.7.

March 2008: Biopsy. Gleason 7 (4+3) 12 cores taken. 5 on the left side were cancerous and the 6th was suspect.  

May 5, 2008: Da Vinci robotic laparoscopy at GW Hospital, Washington DC.

Post op: Gleason 9 (4+5). 15% of prostate involved. Stage: pT3a. Negative margins. Lymph nodes and associated glands all appear to be cancer free.

July 2008: PSA at 7 weeks was undetectable.
August 2008: PSA at 14 weeks (3 months) was undetectable.
Nov 2008: PSA at 6 months was undetectable.


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 11/17/2008 1:02 PM (GMT -6)   
Hi Ivory63,
First welcome to the best site on the web for compassionate and caring support. We have a bit in common. I was 44 when I found my cancer, and I decided to be aggressive with it because at my age I didn't feel like a 40 year survival rate required anything less. But things might have been different if I was 64 when diagnosed. You have some other options that are less intrusive in the early going like radiation. What I think you do want to do before you select a treatment is study up on the disease a bit. You have time for that at least. Knowledge will help quell the fear. Also, PNI is present in most biopsies, but it's importance is slight. In fact some centers don't consider it at all when discussing treatment options. But learn your options and select one, then don't look back. Having full confidence moving forward will be of great assistance.

My DaVinci experience was uneventful. My plumbing works and I am satisfied with the great team that did the work. I have a recommendation though. I don't know of others using Dr. James Karol ~ but I do know that Dr. Peter Carroll at USF is one of the best in in the US. Remember Doctor DOES matter in the outcome. This is a quick but delicate operation. Good hands and lots of experience are required. My doctor has performed over 1500 procedures and that center over 4000.

One more very important thing ~ stay positive!

Tony
Age 46 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007 @ The City of Hope
Post-Op Pathology: Gleason 4+3=7, positive margins, Extra Prostatic Extension (EPE)
Bilateral seminal vesicle invasion (SVI); Stage pT3b, N0, Mx
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (September 17 '08): <0.1 ~ Undetectable!
 
You can visit my Journey at:
 
STAY POSITIVE!
 
 

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