Got Biopsied Today- was (No Subject)

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crewa2
Regular Member


Date Joined Jun 2009
Total Posts : 43
   Posted 6/7/2009 8:51 AM (GMT -6)   
Hi everyone,
I'm 43 and found my psa at 4.3 on a routine blood test. My Dr. referred me to a Urologist who felt abnormalities on the left and right side of my prostate during a DRE.
I have a biopsy scheduled for later this month. I;m really stressed out. After a lot of reading, I've convinced myself that cancer is the probable cause. The docter said about 50/50 but I think he was taking it easy on me.
Thanks for listening.
 
Subject added by James C.

Post Edited By Moderator (James C.) : 6/27/2009 1:52:20 PM (GMT-6)


coxjajb
Regular Member


Date Joined Nov 2008
Total Posts : 184
   Posted 6/7/2009 9:02 AM (GMT -6)   
Crewa2, this is a great site for information and support. Glad you found us, but hope you don't need us. The biopsy can confirm or rule out cancer. Until then, try not to stress out. I know that's easier said than done. You'll find that the biopsy prep is worse than the actual procedure. Try not to worry about that either. Good luck. I hope the biopsy comes back clean. Hang in there.
Age 51, (50 at DX)
Pre - Op PSA, 4.3
Gleason 3+4=7
Stage T1C
da Vinci Prostatectomy 8/1/08
No issues with incontinence since day 1 after catheter removal
ED, need a little help from Levitra
First post op PSA 11/11/08, 0.00
Second post op PSA 2/10/09, 0.00


crewa2
Regular Member


Date Joined Jun 2009
Total Posts : 43
   Posted 6/7/2009 11:08 AM (GMT -6)   
Thanks for the replys
Do you think I should go for a color doppler ultrasound for the first biopsy or have the TRUS first?

crewa2
Regular Member


Date Joined Jun 2009
Total Posts : 43
   Posted 6/7/2009 2:15 PM (GMT -6)   
I'm in central Florida, anybody have recommendations for doctors.

RonE
New Member


Date Joined May 2009
Total Posts : 12
   Posted 6/7/2009 4:09 PM (GMT -6)   
crewa2:

In the Orlando area, my surgeon was Stephen Baker at Orlando Urologists (orlandourologyassociates.com). Another doctor in the area is Rakesh Patel at Winter Park Urology (wpurology.com). A radiation oncologist that specializes in prostate cancer is Patrick Kupelian at MD Anderson (orlandohealth.com/MDAnderson).

There are lots of good people and a wealth of information and experience online here, so keep in contact.
_______________________________________________________________
Oct 2007 - Family doctor checkup at age 53
PSA 2.4, ~10% increase from 6 months previous
Nov 2007 - Consult with urologist
Biopsy 1/12 cores positive 1% Gleason 6=3+3
Jan 2008 - DaVinci radical prostatectomy
Hospital stay of 3 days, JP drain in 1 week and catheter 10 days
Gleason 7=3+4 with early foci extracapular extension
Surgical margins clear, prostate 5x4x4cm & 43g, involvement 3%
Apr 2008 - Feb 2009 PSAs undetectable
Mar 2009 - Consult with radiation oncologist about adjuvant radiation therapy


crewa2
Regular Member


Date Joined Jun 2009
Total Posts : 43
   Posted 6/8/2009 6:23 AM (GMT -6)   
I'm glad I found this site, thanks for the help and I will post my results.

Father3
New Member


Date Joined May 2009
Total Posts : 6
   Posted 6/8/2009 1:31 PM (GMT -6)   
Crewa2,
It is very normal to be worried; we were all worried when we first found out but this is a great site to get advice and just get a sense of what's going on in the world of PC, whether or not you have it.  Clearly, you need to get a lot more information and you need to make sure that the doctors do the biopsies in places that are the most logical.  My doctor recommended a rectal MRI, which also helped with the operation when I needed it.  Hopefully, everything will be non-cancerous, but having just had the operation in April, I found that having caught it early - even the worst case wasn't so bad.  Good luck.

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 6/8/2009 3:17 PM (GMT -6)   

Highly recommend to anybody either wanting to know about or maybe diagnosed with PCa , read DR. Strums book: A Primer on Prostate Cancer..The Empowered Patients Guide (2nd edition-search the net).  You will find plenty of excellent information as to what this 'jungle' of PCa is. He is an oncologist of world class proportion and even helps on the internet with his free advice /opinions on PCa patients digests submitted on the net. Anyway the book is amongest the best for patients to read and he is not selling you a treatment proposal, just information.

 

 

 

 



 

Post Edited (zufus) : 6/8/2009 3:20:02 PM (GMT-6)


DS Can
Regular Member


Date Joined May 2009
Total Posts : 195
   Posted 6/9/2009 8:08 PM (GMT -6)   
welcome crewa2,
Educating yourself is very important at this stage.  If you have a companion that can help you through this, that's great, get them educated too.  My wife was actually more prepared than I was.    
It is difficult not to worry, but continue to maintain a healthy diet and get some exercise.  It should help you sleep better.
I wish you the best,
DS     
PSA 01/07 was 1.2, PSA 01/08 was 1.9, PSA 01/09 was 2.5.
BIOPSY 02/24/09, adenocarcinoma DX at age 52
 Right:GS 3+3=6, tumor 3/6 cores, 10% involvement,PNI-Yes
 Left: GS 3+3=6, tumor 1/7 cores, <5% involvement,PNI-No
LARP 04/09/09,nerve sparing. Final pathology:
 GS 3+4=7, Margins uninvolved, 2 lymph nodes negative.
Catheter removed on 04/17. First no-pad day was 05/03.
ED treatment is 25 mg Viagra nightly.
First followup PSA results on 05/28/09: <0.1,undetectable!
 
 


crewa2
Regular Member


Date Joined Jun 2009
Total Posts : 43
   Posted 6/19/2009 1:05 PM (GMT -6)   
Had the biopsy today, glad that part is over. Should have some results in about a week. It went pretty much as other posts I have read online. I did take a pain killer and a valium which helped. Doc still felt the nodules during the DRE. They took 10 samples (too few?), not much pain from the needle but I did have a strange pain in the tip of my penis with each jab. The tech told me my prostate was about 19 grams. Hoping for good results.

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 6/19/2009 3:13 PM (GMT -6)   
crewa2, Since it appears you may be starting a little Journey with us, I changed your title subject for easier archiving and searching

Hoping for a big negative on your results, by the way smilewinkgrin
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
21 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix .35ml 2X week continues
PSA's: .04 each 3 months


bates
New Member


Date Joined Jun 2009
Total Posts : 8
   Posted 6/19/2009 5:14 PM (GMT -6)   
Glad to hear your biopsy went okay.  I just had mine on Tuesday.  I had a little blood in my urine and had a lot in my only ejaculate since Tuesday.  I'm told all that is normal.  I had no pain all week.  Get my results on Tuesday.  I am 45 so we're in the same boat.  Hope your's are all clear

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 6/19/2009 5:25 PM (GMT -6)   
to crew and bates, good luck as you wait for your biopsy results, may they both come back with nothing!

and the pain to the tip of the penis from the biopsy snips, i still remember that well from the 3 biopsies i took in the past
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, 5/9 .10 doubled in 3 months, new test in six weeks, then possibly off for salvage radiation
 
 


mikey1955
Veteran Member


Date Joined Dec 2008
Total Posts : 673
   Posted 6/19/2009 6:11 PM (GMT -6)   

Hi crewa2,

I hope your biopsy results are completely negative. I'm not trying to add to your stress, but biopsies can sometimes result in false negatives. The pain or feeling at the tip of the penis is normal during biopsy and DRE. I had it with biopsy and all DREs.

Good luck. This is a good site and lots of knowledgable people here.

 

Mike 


Lower left groin hernia: mesh and large scar: surgery early 2006
Nov/Dec 07 and March 08 and now Dec 08: Severe perineal pain (between scrotum and rectum). Septra/Bactrim for 8 months (Nov 07-Jun 08) for diagnosed prostatitis.
PSA start of 2008: 5.3..... PSA June of 2008: 7.3
14 DRE all benign or nothing felt
TRUS Biopsy Nov 08: Got copy of pathology (see below). Prostate about 40 cm sq.
General Health: pretty good, 5' 10", 180 lbs, slim.
Bone scan Dec 08: Negative
Barium enema X-ray (March 09 due to several days of blood in stool)
MRI with endorectal coil (April 09 as part of a study)
3D advanced TRUS (April 09 as part of a study)
CT (April 09 as part of a study)
Biopsy Pathology: 5 of 8 cores positive, adenocarinoma in both lobes. 30%-65%. One core perineural invasion. 2 cores "foamy" and suspicious. All +ve cores, 3+3 GS 6.
Open RP surgery: May 5/09 Surgeon spoke to my wife and was very positive. Said both nerve bundles spared and not damaged. Bilateral lymph node dissection performed. Discharged 48 hours after surgery. Staples out, catheter out and pathology sheduled for May 21.
Post Surgery Pathology: pT3a N0 MX, extraprostatic extension (EPE), stage III prostate cancer, lymph nodes clear, seminal vesicles clear, Gleason upraded to 3+4 GS 7. EPE within surgical margins. Other than prostate and EPE, all tissue removed negative for cancer involvement.
Physical State: Getting back to working out slowly. Urinary control pretty much from the time of catheter removal. Rectal pain, sometimes bad but, told is normal. Erectile function at best 25-30% of presurgery. Trying Levitra...first 10 mG dose gave me nasal congestion, 50% chubby and a 24 hour headache...may go away with more use or change of meds. Considering pump. Recovery from surgery going very well.
Mental State: Pre-surgery anxiety gone. Positive attitude. Some anxiety about seeing radiation oncologist and upcoming 3 month PSA. 


crewa2
Regular Member


Date Joined Jun 2009
Total Posts : 43
   Posted 6/25/2009 10:14 AM (GMT -6)   
Well I got the bad news today. 5 samples from the left side positive 3+3, the 5 from the right side were negative. I'm not really sure where to go from here. My doctor does HIFU in the Bahamas and is suggesting that.

Should I have the slides reviewed by another lab?

geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 6/25/2009 11:04 AM (GMT -6)   
Oooh! That HIFU in the Bahamas raised red flags for me.
It may be that you have the right doctor and that HIFU is the right treatment for you but it also may be that your doctor has a significant financial interest in directing you to a particular treatment and place.

This is not to say anything against your doctor, but these facts would lead me to get an independent second opinion.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3 + 4 = 7
CAT scan 1/09 negative, Bone scan 1/09 negative

Robotic surgery 03/03/09 Catheter Removed 03/08/09
Post surgical pathology report. Lymph nodes negative, Seminal vesicles negative
Surgical margins positive, Capsular penetration extensive Gleason 4 + 3 = 7
At 6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
At 10 weeks: no pad at night -- slight unpredictable leakage day/1 pad.


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4157
   Posted 6/25/2009 11:19 AM (GMT -6)   

Dear Crew:

Sorry for the bad news...it's unfortunate that you have to join our club, but I know you will get plenty of advice and support from the folks on this site.

First of all, with your Gleason, PSA score and prostate size you probably have most all treatment options open to you.  So, don't panic or jump at the first possibility.  HIFU is certainly an option but, as you probably know, it is not FDA approved in the USA.  And, despite the hype from the HIFU docs and sites, my understanding when I researched this as a possibility for my treatment was that there were indeed side effects...particularly in the ED area.  I guess my point here is not to dump on HIFU, but to make sure you keep your eyes open and recognize that ALL treatment have some side effects.  You need to research the options and make an informed decision.

Now that you have the diagnosis, you should set off to learn as much about the disease and options as possible.  Walsh's book is a good start and a good primer.  My advice is that you also make sure to get some other opinions/perspective re treatment.  Your guy is HIFU-man...great, now you have that perspective.  You should consult with a prostate oncologist (who has no dog in the hunt re bias for treatment), an experienced surgeon and an experienced radiation oncologist.  Yes, it's literally a PIA to go thru that but this is a HUGE decision and you want complete info before making it.

And, experience counts...big time.  If your provider has not done 250+ procedures do not choose them to do one on you.  Let them learn on someone else.

Finally, re your pathology, you have to do what you feel on this one.  Perhaps one or more of the other docs with whom you consult will help you re verifying the expertise of the lab you used.  There are some well known experts, e.g. Epstein at Hopkins and Bostwick in Richmond that you could use.

Hope this helps a bit.  I sure many others will weigh in.  And, if brachytherapy gets on your short list, there are a few of us here who have some experience with that...you can read my journey by clicking the link in my signature.

Good luck.

Tudpock

 

 


Age 62
Gleason 4 +3 = 7
T1C
PSA 4.2
2 of 16 cores cancerous
27cc
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 6/1/09.  6 month PSA now at 1.4 and my docs are "delighted"!

LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 6/25/2009 11:35 AM (GMT -6)   
crewa2....What Tudpock stated is the best advice you could ever receive. Take your time and follow his advice and you will be very glad that you did.

Best of luck to you in this next phase...it's a long one and difficult one. You will be on information overload for awhile, so once you have taken it all in...take a few days off and the right treatment plan will come to you. One that you feel will be the best for you.

Sorry you became a member of this club...but now that you are here...welcome aboard.
You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral w/PNI - Gleason (3+3)6 Stage T1C
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (3+4) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
PSA 5 week Oct 2008 <.05
                   3 month Jan 2009 .06
                   6 month April 2009 .06


Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 6/25/2009 6:44 PM (GMT -6)   
While this is not a good news to get, the alternative would be far worst. If you have cancer, but biopsy does not find it. I had 5 of them over the course of five years - all negative. When it was detected, it was high grade and a lot of it. Sorry you have to go through this, but it is far better to do while cancer is in the early stage. Best of luck on your decision making. I can only re-iterate the earlier advise - you have some time and a lot of options, so take your time making the decision - it is an important one.

Father died from poorly differentiated PCa @ 78 - normal PSA and DRE

5 biopsies over 4 years negative while PSA going from 3.8 to 28

Dx Nov 2007, age 46, PSA 29, Gleason 4+4=8

Decided to participate in clinical trial at Duke - 6 rounds of chemo (Taxotere+Avastin)

PSA results:            1/8/2008-33.90, 1/11/2008-29.50, 1/31/2008-38.20,

2/21/2008-32.00, 3/13/2008-26.20, 4/3/2008-26.60, 4/24/2008-20.60

RRP at Duke (Dr. Moul) on 6/16/2008

Pathology:              Gleason downgraded 4+3=7,   Duke: T2c N0MX, one positive margin,

2nd opinion at Sloan Kettering: T3a N0MX, extraprostatic extension, two positive margins

PSA undetectable for 8 months, then 2/6/2009-0.10, 4/26/2009-0.17, 5/22/2009-0.20, 6/11/2009-0.27

6 Months ADT: Casodex started 6/12/2009, Lupron 6/22/2009

IMRT to start mid-Aug


IdahoSurvivor
Veteran Member


Date Joined Aug 2007
Total Posts : 1015
   Posted 6/25/2009 7:34 PM (GMT -6)   

Hi Crew,

So sorry for the news.  It is good news, however, that you seem to have caught this thing early.

You may wist to carry or send you slides to another facility for a second opinion.

With a low PSA and good Gleason score you do have many options.

At your young age, you want to do your homework and get the treatment most effective to give you the best chance for a cure.

As was mentioned here, HIFU is a very interesting option.  I just wonder if there is enough practice and follow-up studies to give you the confidence you need.

The links in one of the frozen forum topics above provide information on various treatments and success stories and statistics.

You do have some time to make an informed decision.  Likely several months.  I did make a treatment decision for my doctor rather quickly, but I did visit with several other health care professionals to discuss whether or not my treatment decision was appropriate for my situation.

Our thoughts and prayers go out to you as you make an informed decision.

Remember, there are no "dumb" questions here.

Best regards,


Barry ~ (a.k.a. "Idaho")

 

Da Vinci Surgery July 31, 2007… 54 on surgery day
PSA 4.3  Gleason 3+3=6  T2a  Confined to Prostate

Post-PSAs  09/07  <0.04; 12/07  <0.04; 03/08  <0.04;

06/08  <0.04; 12/08  <0.04;

06/09  =0.062 (doc says don't worry yet)

My web site: http://pca-info.blogspot.com


crewa2
Regular Member


Date Joined Jun 2009
Total Posts : 43
   Posted 6/26/2009 5:25 AM (GMT -6)   
This is a hard decision, so much information to take in. I have ordered an information kit from the proton center. Right now I'm considering proton and robotic surgery. My urologist kind of put me off with the HIFU when he told me he needed a decision in the next two weeks.

From what I've read so far, if I'm a viable candidate for proton beam therapy, it sounds promising.

Anyway, I'm just starting out on this journey and have a lot of research ahead of me.

Thanks for listening

geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 6/26/2009 7:41 AM (GMT -6)   
Run Away Screaming!!!!

OK, you have got a urologist who knows that you need HIFU -- not as part of a legitimate clinical trial (and thus subject to medical oversight) but at a special offshore clinic which he just happens to run.

Then he tells you that this "special offer" is good for only two weeks!

Does anyone on this forum see any legitimate reason that crewa2 needs to be treated with such haste?

Oh, sometimes if the two weeks only doesn't pull the marks in they will offer you a "free" one week beachfront vacation to go along with your operation -- if you haven't got that pitch yet, hold out for another week and he'll probably throw in a set of super kung fu slicing and dicing knives if you order in the next twelve minutes.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3 + 4 = 7
CAT scan 1/09 negative, Bone scan 1/09 negative

Robotic surgery 03/03/09 Catheter Removed 03/08/09
Post surgical pathology report. Lymph nodes negative, Seminal vesicles negative
Surgical margins positive, Capsular penetration extensive Gleason 4 + 3 = 7
At 6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
At 10 weeks: no pad at night -- slight unpredictable leakage day/1 pad.


Colin45
Regular Member


Date Joined Feb 2009
Total Posts : 216
   Posted 6/26/2009 8:30 AM (GMT -6)   
I would have thought that the prostate could do with a bit of rest after a biopsy I was told at least 4 to 6 weeks for an operation would this not apply to HIFU
 
 
Age 64 From UK now in Thailand 
Baby boy born 2/14/2009
 
First PSA was showing 9.73 on 1/21/09.   on 5/7/09 PSA 9.78  Free PSA 0.83   Free:Total  PSA 0.08 
1/28/09 Biopsy carried out 12 core results were
findings
Both specimens show no adenocarcinoma
 
MRSI done on 5/8/09 No signs of any cancer
5/15/0924 Core biopsy results
Gleason'S Grade 3+2=5
Involving approx 30% of one out of 12 cores on each side
no perineural or angiolymphatic invation identified
One side PIN High Grade
Bone scan clear 
 


IdahoSurvivor
Veteran Member


Date Joined Aug 2007
Total Posts : 1015
   Posted 6/26/2009 2:00 PM (GMT -6)   
Hi Crew,

This sounds fishy to me. The 5-6 health care professionals I talked to said that I had several months to make a decision and get treatment. I believe my condition was like yours or even less urgent in terms of pathology.

From what you've told us, I would take my medical reports with me and go get a second opinion from an experienced oncologist or surgeon or both. You should be able to get a few recommendations. It's your future.

Kind regards,

Barry ~ (a.k.a. "Idaho")

 

Da Vinci Surgery July 31, 2007… 54 on surgery day
PSA 4.3  Gleason 3+3=6  T2a  Confined to Prostate

Post-PSAs  09/07  <0.04; 12/07  <0.04; 03/08  <0.04;

06/08  <0.04; 12/08  <0.04;

06/09  =0.062 (doc says don't worry yet)

My web site: http://pca-info.blogspot.com


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 6/26/2009 2:06 PM (GMT -6)   
I had to wait 8 weeks after my last biopsy before my operation
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, 5/9 .10, 6/9 .11, July 13 - meet with radiation oncologist
 
 

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