This is an example of the value of a 2nd opinion from a prostate oncologist vs a surgeon.
With the surgeon I had three pieces of information, Gleason 6, 5% in two cores of 26, one in right lobe, one in transition zone and PSA of 40.
Prostate Oncologist: No cancer in right lobe, Large transition zone tumor, Gleason 3+4 and 4+3, 18mm by 16mm, tumor
location precisely mapped out and confirmed by T3 MRI. PCA3 of 41, PAP low, indicative of non agressive tumor. Base line color doppler images, and 1525 MRI images of lymphatic system showing clear, and anterior tranzition zone tumor. No indication of capsular penetration.
The 1st DX would indicate watchful waiting or surgery.
The 2nd opinion would indicate radiation, because of the tumor
location and possibly HT in conjunction with radiation.
Which information would you rather have in considering treatment options?
64 years old.
PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DX BPH and continue to get biopsies yearly. Positive Biopsy in 10-08, 2 cores of 25, G6 less than 5%. Scheduled Surgery as recommended.
2nd Opinion from Dr Sholtz, an Oncologist said DX wrong, path shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G 4+3 approx 2.5cm diameter.
Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy.
Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and burining urination. Daily activities resumed day after implants.
Scheduled for 5 weeks IMRT in July