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gregory m helman
New Member

Date Joined Oct 2009
Total Posts : 16
   Posted 11/25/2009 8:06 PM (GMT -6)   
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.
  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

Veteran Member

Date Joined May 2009
Total Posts : 2691
   Posted 11/25/2009 8:44 PM (GMT -6)   
Many doctors combine HT and radiation, so a combo plan is not out of the question. The HT cuts off the food supply while the radiation takes effect.

The prostacint hopefully would help locate where else the cancer may be. The post on the MRI in Holland is also appropriate. I think that is the big question, has it spread anywhere else ?

I do agree that sooner instead of later is appropriate. You are the boss here. You need to decide what plan you want to take , and then go for it. You have the most skin in this game. Don't let the doctors make all the decisions for you.

Good luck my friend.
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injections

Elite Member

Date Joined Oct 2008
Total Posts : 25355
   Posted 11/25/2009 9:57 PM (GMT -6)   
My radiation clinic is part of Cancer Center of America, and I have been well treated in every way. Used them 10 years ago too with other cancer treatments. They know all about great patient care and compassion.

David in SC
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
Incontinence:  1 Month     ED:  Non issue at any point post surgery
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

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 11/26/2009 5:58 AM (GMT -6)   
Try researching the internet for the "Bolla study" this abstract data does help show that patients whom did hormone therapy prior to radiations, had longer survival times than those whom did not. As a patient you get to decide if you wish to follow this protocol as it does show some results that could be in our best interests.
This data is not brand new, but patients have been using this for years. Although, may not be widely known by patients and even some docs.
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