i been to 2 oncologists and both and my uro/surgeon not agreeing with a plan with my prostate cancer
one radiation oncologist wants a ct ,bone scan, and prostascint scan with hormone therapy.the other says prostascient scan not reliable. my uor/surgeon says no to hormone therapy and forget about the prostascient scan, ct and bone scan and get your radiation therapy started.i am stuck in the middle with these guys. so i called the cancer treatment center of america and will go to them and see what options they have. if you ever want to brouse their website go and read . i talked to the lady at the center and hope to talk with the dr's, etc. and get their input all in on sitting. i need answers and fast. so i hope the center will give me ideas and just might go there for treatments.
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
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
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 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