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New Member

Date Joined Feb 2009
Total Posts : 18
   Posted 3/15/2009 11:24 PM (GMT -6)   
Biopsy Results came yesterday. Letter stating have detected
low impact cancer cells and you have been scheduled for
discussion with doctors about your future treatments.  Have
read extensively about postrate cancer and was wondering
what questions I should be asking the doctors. I view this
as a journey and have been blessed with 62 years of perfect
health and am prepared for the worse but hope for the best.
Thanks for Any ideas....

Tony Crispino
Veteran Member

Date Joined Dec 2006
Total Posts : 8128
   Posted 3/15/2009 11:40 PM (GMT -6)   
Hi neg,
You need a copy of that biopsy report. Ask for it right away.
Ask what treatment he suggests and write it down. Better yet, if you can bring a tape recorder or other recorder like a hi-tech cell phone, record the session.
Ask if his suggestion is in line with your PSA and biopsy.
Ask about alternative treatments.
Ask if doing nothing and monitoring it is a good choice given he termed it as "low impact"

Also try not to be swayed by anything until you look further into the biopsy report. It will take you a little time to better understand it. So get that copy...

And negative...stay positive...that's my motto for a reason...:-)

Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (January 13, 2009): <0.1
My Journal is at Tony's Blog  

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 3/16/2009 5:40 AM (GMT -6)   
Ditto-demand an actual copy of pathology report so you and others can read it, and you can learn what it says. Caution you are about to enter the 'no spin zone', just the facts are what is important. Go to pathology website to get fast track education, maybe that could help you ask questions to them. Get the name of the doc whom did your pathology, probably found on the report anyway. Alot of people get second or more opinions even on pathology....and with good reasons, see (forums).

(These are the expert types on pathology)

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 3/16/2009 7:50 AM (GMT -6)   
If it really is "low impact", then you should have the full spectrum of treatment options before you. It would realy help to know what your gleason score is and any staging information at this point. You may be one of the rare ones where it might be safe to do "watchful waiting". Is there any other prostate cancer known in your immediate family? Hope it all turns good for you at this point.

David in SC
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 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, 6 month on 5/9

John T
Veteran Member

Date Joined Nov 2008
Total Posts : 4268
   Posted 3/16/2009 12:02 PM (GMT -6)   
Get all the info you can and I highly recommend always getting a 2nd opinion from a prostate oncologist and a radiologist who has no connection to your urologist. Armed with this information you can make an informed decision about your treatment options.

64 years old.

I had an initial PSA test in 1999 of 4.4. PSA increased every 6 months reaching 40 in 5-08. PSA free ranged from 16% to 10%. Over this time period I had a total of 13 biopsies and an endorectal MRIS all negative and have seen doctors at Long Beach, UCLA, UCSF and UCI. DX has always been BPH and continue to get biopsies every year.

In 10-08 I had a 25 core biopsy that showed 2 cores positive, gleason 6 at less than 5%. Surgery was recommended and I was in the process of interviewing surgeons when my wife's oncologist recommended I get a 2nd opinion from a prostate oncologist.

I saw Dr Sholtz, in Marina Del Rey, and he said that the path reports indicated no tumor, but indolant cancer clusters that didn't need any treatment. He was concerned that my PSA history indicated that I had a large amount of PC somewhere that had yet to be uncovered and put me through several more tests.

A color doppler targeted biopsy in 11-08 found a large tumor in the transition zone, gleason 6 and 7. Because of my high PSA Dr. suspected lymph node involvement, 30% chance, and sent me to Holland for a Combidex MRI, even though bone and CT scans were clear.

Combidex MRI showed clear lymph nodes and a 2,5 cm tumor in the anterior. I was his 1st patient to come up clear on the Combidex which has a 96% accuracy,

I've been on a no meat and dairy diet since 12-08 and PSA reduce to 30 while I awaited the Combidex MRI.

The location of the tumor in the anterior apex next to the urethea makes a good surgical margin very unlikely. Currently on Casodex and Proscar for 8 weeks to shrink my 60 mm prostate. Treatment will be seeds followed by 5 weeks of IMRT while continuing on Casodex and Proscar. So far no side affects from the Casodex.


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