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Jake T
Regular Member

Date Joined Mar 2009
Total Posts : 44
   Posted 3/24/2009 8:39 PM (GMT -6)   
Age 56   12/22/08 DRE   1/12/2009 PSA 3.4     6 weeks later PSA 3.8  March 9th biopsy.  Monday March 23 received results 3 out of 12 Prostatic Adenocarcinoma one was 80% second 40%  third 2% Gleason 6
   Going for a second opinion 3/30 with Erik Goluboff Director of Urology in Columbia Presbyterian in NY. Looking for a recommendation for a third MD and opinion. To add to my confusion 2 medical studies were published questioning the benefit of being observed vs being treated for patients diagnosed with localized prostate cancer. This includes a statement by the Chief Medical Officer of the American Cancer Society. This report conflicts with what my MD is saying,and is causing much distress and confusion. Thanks for any feedback, Jake

Post Edited (Jake T) : 3/24/2009 8:06:25 PM (GMT-6)

Regular Member

Date Joined Apr 2008
Total Posts : 270
   Posted 3/24/2009 9:35 PM (GMT -6)   
It appears you are catching it early and that is in your favor. On the other hand an 80% and 40% sample would indicate some possible substantial growth. It also appears your rising PSA would indicate growth as well. There are many opinions about all of this, but of course it is your life - as you know.

You are in the right place to do a lot of research and reading. There are many links from this sight as well as experienced and helpful people with a lot of savy about prostate cancer. No one can tell you what to do, but with a Gleason 6 and the biopsy you described you have some time to consider all the alternatives, but I would not wait too long. Admittedly, I don't have a track record for watching and waiting - I did not have that option. I am not sure how viable your option is in that regard. The blessing of catching these things early and treating them early is the best long term hope - I believe. Besides, for me the most difficult time mentally was making my decision. Once that was made things improved. I wish you well.

Age 61 (now 62)
Original data - pre-operation
PSA: 5.1
T1C clinical diagnosis, Needle biopsy - 10 cores, Gleason 7 = 3+4 in 1 core (40%), 7 cores Gleason 6 = 3+3 ranging from 5% to 12%
All scans negative
Lupron administered 4/9/2008 for 4 months (with idea I would undergo external beam radiation followed by seed implants - then I changed my mind).
Robotic DiVinci surgery - Dr. Fagin (Austin) May 19th
Post operative - pathology
pT2c NX MX
Gleason 3+4
Margins - negative
Extraprostatic extension - negative
seminal vesicle invasion - uninvolved
1st Post PSA <.04
2nd Post PSA <.01 10/30/2008

NV RTRD 2007
Regular Member

Date Joined Jan 2009
Total Posts : 75
   Posted 3/24/2009 11:05 PM (GMT -6)   
I was dx ini Feb 2008 but did not have surgery until Dec. Besides my Urologist, I went also the UCSF for their opinion and ultra sound. I talked also to the VA urologist before I made up my mind to go for surgery. There are lots of option, so weigh them carfeully to your benefit. One says the other is better, but it's only could make the right decision for your self. Also, as you read through the posts here, it's different case for every individual. Good luck and always stop by to check this forum. There's a lot information here. I wish I found this sooner before I had my surgery.
Age 54; Age DX 53
PSA: May 07- 2.9; Dec 07-4.3; Jan 2008- 6.1; May 2008- 6.4; Sep 2008- 7.3 ; Sep 2008- 9.6
Bone Scan: Mar 2007- Normal without evidence of metastatic disease.
Biopsy Mar 2008: 6/6 core right gland- No evidence of malignancy; 5/6 core left gland- positive Gleason score 3+3=6 average tumor volume 5 mm.Clinical Stage II.
Transrectal ultrasound at UCSF Jun 2008: 7x14x10 mm hypoechoic lesion in left gland. DRE positive, PSA Density- 0.23 and Prostate volume - 27 CC.
RRP: 4 Dec 2008; Discharged - 8 Dec 2008; Cath removed- 18 Dec 08.
Pathology Report: Prostate- 33 grams; L/R pelvic lymph node -No evidence of malignancy; Right Lobe- No definite tumor; Adenocarcinoma, Gleason 3+4.
Post PSA: 7 Jan 2009 - <.05.

Regular Member

Date Joined Jan 2009
Total Posts : 27
   Posted 3/25/2009 5:48 AM (GMT -6)   
Ask yourself, maybe look at yourself in the mirror, if you will be able to DEAL (live peacefully) with the fact going forward that the cancer is there, will probably expand, might be close to capsular penetration if near the wall of the prostate, and probably won't decrease in size. Basically ask yourself IF watchful waiting is best for you! In my case in 1995 even with a Gleason 2+1=3 I could not handle watchful waiting. I had a RP. I have been able to watch and wait with recurrent PC. My psa rose to recurrent 2 years after my RP (0.2) and it it now (0.6) 11 years later. I have been able to keep the recurrent rise in psa in the backround and not let it bother my peacefull life.  It is really up to You! Sincere best wishes to you as you decide what to do. Do not rush your decision. Al 

Veteran Member

Date Joined Feb 2008
Total Posts : 655
   Posted 3/25/2009 8:39 AM (GMT -6)   

Greetings, Jake.  You have to do what is right for you - do the research - make a decision and go with it.  You will find that there is probably somewhat of a bias towards surgery on this site.  I will be the first to admit that my bias is toward that option and here is why.  My stats are very similar to yours right down to age.  I was 55 at diagnosis and now am 56.  If you look back a few threads you will see a tool to use to find your real age and your life expectancy.  My real age is something like 47 and life expectancy 88.  While I don't put a lot of stock in those numbers, I do think I should have 30 good years left.  My decision was to get the cancer out of my body and get on with my life.  Yes, there are issues to deal with but there are issues with every treatment option.  I would have been a basket case with watchful waiting.  Some guys can probably do that and be fine - I couldn't. 

We trust that you will get good information and make the good decisions you need to make - whatever is right for you.  David

Age 55
Diagnosed Dec 2007 during annual routine physical
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 positive with 2 marginal
Gleason 3 + 3 = 6
RRP 4 Feb 08
Both nerves spared
Good pathology - no margins - all encapsulated - Gleason 4 + 3 = 7
Catheter out Feb 13 - wore pad for couple of days - pad free Feb 16
Great wife and family who take very good care of me

Jake T
Regular Member

Date Joined Mar 2009
Total Posts : 44
   Posted 3/25/2009 10:17 AM (GMT -6)   
Hi, i just want to thank everyone for their time in trying to help me make a decision, I am really glad i found this web site, and David you are right i have been a  basket case since Monday, I wish everyone well. 
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