Significance of DRE findings

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mjluke
Regular Member


Date Joined Jan 2009
Total Posts : 189
   Posted 2/20/2009 9:00 AM (GMT -6)   
 
A friend of mine has been diagnosed with prostate cancer. His PSA and  gleasons are similar to mine- similar biopsy results although a couple of my samples indicated a higher percentage than his.
 
The main difference is that my DRE indicated a significant tumor on the right side  whereas his DRE showed normal- PSA increase gave rise to his biopsy.
 
We are both investigating the available treatments ( or not ).
 
My question is this. All other things being fairly equal ,what is the significance of postive V. negative DRE findings. In other words is it likely that I am in more trouble given the DRE findings.
 
63 years old-tumor discovered on digital exam- biopsy December 2008-
4 of 12 samples positive-all on right side
Gleason 3+3=6
PSA-3
Otherwise excellent health.
 
  "There may come a day when the courage of men will fail, but it will not be this day."


Ziggy9
Veteran Member


Date Joined Jul 2008
Total Posts : 981
   Posted 2/20/2009 9:22 AM (GMT -6)   
mjluke said...
A friend of mine has been diagnosed with prostate cancer. His PSA and gleasons are similar to mine- similar biopsy results although a couple of my samples indicated a higher percentage than his.



The main difference is that my DRE indicated a significant tumor on the right side whereas his DRE showed normal- PSA increase gave rise to his biopsy.



We are both investigating the available treatments ( or not ).



My question is this. All other things being fairly equal ,what is the significance of postive V. negative DRE findings. In other words is it likely that I am in more trouble given the DRE findings.


Not necessarily. A DRE is only as good as the doctor giving it. My Pca was initially found by a DRE and a couple of urologists I saw afterward told me to commend my primary care doctor for a good find. Many others wouldn't have felt it. That said after a normal and a 3d mapping biopsy my Pca was found to be early stage and I was designated as a good candidate for TFT (targeted focal therapy) which the last I saw only about 57% who go through a 3d mapping biopsy remain eligible for. The other 43% go on to more aggressive radical treatments. I don't know exactly how that compares to post surgical upgrades but I bet it's fairly close. Of course with your dx how really significant is your significant tumor? But as I said to begin with not necessarily so don't automatically think the worse.
Diagnosed 11/08/07 - 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 - 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 - Not unexpected bounce after the 80% drop the quarter earlier. Along with urine flow readings, an acceptable amount left in bladder measured by sonic. Results warrant skipping third quarter tests, and to return April, 2009 for final biopsy scheduled to
complete clinical research study 
 
 
 


mjluke
Regular Member


Date Joined Jan 2009
Total Posts : 189
   Posted 2/20/2009 9:37 AM (GMT -6)   
Hey Real:

Thanks for your response- trying always to stay positive and your reply is encouraging.
 
63 years old-tumor discovered on digital exam- biopsy December 2008-
4 of 12 samples positive-all on right side
Gleason 3+3=6
PSA-3
Otherwise excellent health.
 
  "There may come a day when the courage of men will fail, but it will not be this day."


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4828
   Posted 2/20/2009 10:37 AM (GMT -6)   

My PSA never got over 1.3

But it was the finding of the nodules via DRE that started my whole process.


Age 53   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
 
06/25/08 - Da Vinci robotic laparoscopy
Catheter in for five weeks.
Dry after 3 months.
 
10/03/08 - 1st Quarter PSA -> less then .01
01/16/09 - 2nd Quarter PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.
 


JerseyG
Regular Member


Date Joined Feb 2009
Total Posts : 65
   Posted 2/20/2009 2:02 PM (GMT -6)   
My PSA was also very low. My PC was discovered by DRE. I think the only difference in finding PC by PSA or DRE is the stage and grade of the PC.  The earlier the stage and the lower the grade the better.
 

Age now 44 (43 when dx)
 
Pre-op PSA:  0.9
Biopsy: 3/12 cores pos  20% 30% 50%
Gleason 3+3=6
Robotic RP:   Aug 08 1 day hospital stay, cath out on 8th day.
Post Surgery Pathology Report: Gleason 6, pT2c, tumor 10% contained in prostate gland, all margins negative. Negative lymph nodes
Post Op PSA: Dec 08 <0.1


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25372
   Posted 2/20/2009 2:04 PM (GMT -6)   
And Jersey, mine was the opposite, 6 years of normal DRE's but steadily rising PSA.
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Right nerves saved, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05
 
 

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