i will see second oncologist

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gregory m helman
New Member

Date Joined Oct 2009
Total Posts : 16
   Posted 11/13/2009 7:09 PM (GMT -6)   
i will see second radiation oncologist on thursday and hear what he has to say.
my first oncologist called today and wants me to call him on monday and he knows my psa is climbing .
i know the radiation treatments  are coming but just don't when until i talk to this oncologist.
it is making me upset because its during the holiday season, but i need to get this over with.
i am wondering how i will feel when i get these treatments during  the weeks ahead.
  age 52
had rectal exam and found prostrate nodule detected.
psa was .097 before exam.
referred to urologist and also rectal exam , but couldn't feel anything.
we discussed about biopsy to be on safe side.
Final   Diagnosis of biopsy
specimen  is received in formalin in 8 parts labeled A-H.
A-G ------ no atypia or malignancy found.
H---- prostrate needle biopsy, left anterior horn:   Adenocarcarcinoma,
gleason score 3 + 4= 7,    4 mm in greatest linear dimension, involving approximately 20% of tissue from this site. less than 1ml cancer and less 1% of gland involved.
prostrate surgery done 7/29/2009 -- radical perineal surgery.
robotic was out of the question due to previous surgeries, hernia repair,gall bladder,had mesh put in.
 before surgery , psa was at 0.97.
09/2009 psa ---- 0.55
10/2009 ----- 0.39
11/2009 ------- 0.45
10 days with foley  cathereter
drain tube for 2  days
hospital stay--- 2 1/2 days
 had trouble with bowl movements constipated due to pain meds .
on stool softners
 after cath was out 2 pads a day
6 weeks later just 1 pad a day.
slight leakage , when lifting, sneeziing
post op pathology report
specimen type - radical perineal prostatectomy
specimen is intact
pre op psa level 0.97/ng/ml
other organs-seminal vesicle(s)
microscopic --tumor site-1 nodule
nodule#1- involves left lateral mid and left lateral
dimensions--0.6 x 0.2 x 0.6 cm
Histologic type------ Adenocarinoma
histologic grade---gleason
primary pattern is-grade 3 : single acini of variable size and seperation , cribriform and papillary patterns
Secondary pattern is: grade 4 : irregular masses of acini and fused epithelium , can show clear cells
gleason score (primary + secondary)  = 7 : Moderately poorly differentiated
Tumor Quantitation:
preportion of prostrate involved by tumor =<1 %
estimated tumor volume(% involved by tumor x prifixation vol) =< 1 ml
extraprostaic extention - absent
seminal vesicle invasion- absent
perineural invasion - absent
blood /lymphatic vessel invasion --absent
extent of invasion : pT2a: tumor involves < one half of one lobe
regional lyph nodes: NX; cannot be assessed
margins :
margins involved by tumor : anterior left lateral mid
margin involvement is extensive (> 1 HPF)
beingn prostatc acini are present at margins , not in area of tumor

Regular Member

Date Joined Jul 2006
Total Posts : 202
   Posted 11/13/2009 9:46 PM (GMT -6)   
Sorry to hear you'll be going through the radiation treatments over the holidays.
Sometimes the slow moving aspect of PCa gives us a bit of a window to take our time.
I agree that in your current situation, you don't have the luxury of that window of time.
With your PSA, I don't think waiting until after the holidays is an option.
Hopefully your second radiologist will concur with your first and you'll have a solid plan in place.
Good luck!

PSA 5/22/06: 5.6
DaVinci surgery: 9/14/06
Gleason: 3+3
Organ confined, clean margins.
Both nerve bundles spared.

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 11/13/2009 9:50 PM (GMT -6)   
I am glad that you are getting a second opinion on your current situation.
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sess/72 gys cath #8 33 days, 11/2- SP Cath #9 in place

Regular Member

Date Joined Jun 2008
Total Posts : 407
   Posted 11/13/2009 9:53 PM (GMT -6)   
Each of us makes the decision we think is in our best interest.  If this were me I'd wait until I received the report from my Oncologist before shopping for a second.  If I had so little faith in the first then I'd find one I felt better about, but I wouldn't shop around looking for the answer I wanted to hear - I'd want a report and recommendation based on my medical history and the analysis of the professionals.  Taking care of my cancer came first, before other things including holidays - because I wanted to live a better, healther and longer life.  Best wishes for a successful course of treatment.

Age:  60 (58 at diagnosis - June, 2008)

April '08 PSA 4.8 ("free PSA" 7.9), up from 3.5 year prior

June '08 had biopsy, 2 days later told results positive but in less than 1% of sample

Gleason's 3+3=6

Developed sepsis 2 days post-biopsy, seriously ill in hospital for 3 days

Dr. recommended robotic removal using da Vinci

Surgery 9/10/08

Northwestern Memorial Hospital, Chicago, IL

Dr. Robert Nadler, Urologist/Surgeon

Post-op Gleason's:  3+3, Tertiary 4

Margins:  Free

Bladder & Urethral:  Free

Seminal vesicles:  Not involved

Lymphatic/Vascular Invasion:  Not involved

Tumor:  T2c; Location:  Bilateral; Volume:  20%

Catheter:  Removed 12-days after surgery

Incontinent:  Yes (1/2 light pads per day)

Combination of Cialis and MUSE (alprostadil) three times weekly started 9-27-08

Returned to work 9-29-08 (18-19 days post-op)

PSA test result, post-op, 10/08: 0.0; 12/08: 0.0; 4/09: 0.0; 9/09: 0.0


Veteran Member

Date Joined Jul 2009
Total Posts : 1267
   Posted 11/13/2009 10:48 PM (GMT -6)   
Gregory, I wish you the best ....

The cancer is down, now go for the knock out blow.

Sheldon AKA Sleepless
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9, so far, so good
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"
First post op PSA Sept 09  less than 0.02
PSA on Oct 23 test again less than 0.02
Oct 1st 09 -- dry at night, during day some stress issues, but better every week. 
Feel free to email me at:  sheldonprostate@yahoo.com    

Cajun Jeff
Veteran Member

Date Joined Mar 2009
Total Posts : 4119
   Posted 11/13/2009 10:57 PM (GMT -6)   
Gregory, I to wish you the best. Lets kick some PC ASS.
Jeff T Age 57

9/08 PSA 5.4, referred to Urologist
9/08 Biopsy: GS 3/4=7
10/08 Nerve sparing open RRP- Path Report: GS 3+3=7 Stg. pT2c, margins clear
3 mts: PSA .05 undetectable

10th month PSA <0.01
1year psa <0.01
ED- 5 mg Cialis daily, pump daily, going to try MUSE next. Next step injections.

Regular Member

Date Joined Sep 2006
Total Posts : 187
   Posted 11/14/2009 1:14 AM (GMT -6)   
Always sorry to hear these things, but don't worry. I had radiation over the holidays three years ago and didn't skip a beat. Worked every day, even played some gigs (former rocker on the side). At your age, radiation shouldn't slow you down too mcuh. Drink lots of water, and walk a lot if you can (got a tread mill?) I got a little tired half way thru treatment, a little butt irritation, and minor urinary issues....nothing that kept me down. I travel a lot in my job, so the worst part was having to be at the same place every day!

Look at it this way, your diaognosis was "Pearl Habor" - a sneak attack. Your surgery was the Battle of Midway - the turning point of your war. And radiation is Hiroshima --- you're going to nuke this problem once and for all. For a life time of peace after that! Good luck!
Age 49 - pre-surgery PSA 39 (at age 45)
Open Radical Prostatectomy 6/9/2006
Pathological Stage T3a, Positive Surgical Margin
Gleason 3+4
PSA rose to .24 in November of 2006
6 month hormone therapy initiated December 1. 2006
36 sessions of IMRT Ended Feb 1, 2007
PSA as of May 25, 2007 undetectable
PSA as of November 29, 2007 undetectable
PSA as of May 14, 2008 undetectable
PSA as of November 25, 2008 undetectable
PSA as of May 22, 2009 undetectable

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