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Veteran Member

Date Joined Nov 2009
Total Posts : 7187
   Posted 11/28/2009 12:49 PM (GMT -6)   
Biopsy Monday.
If the results are positive but surgical, I have plans in place.
If not, any suggestions on who I would consult (in Michigan? Or go elsewhere? Or...??).
I know I should slow down a bit, but I'd like some ideas on this eventuality.
PSA-- 3/08--2.90;  8/09--4.01; 11/09--4.19 (Free PSA 24%), this after 45 days on cipro!
History of BPH/prostatitis.
Awaiting results of my PCA-3 test which will determine whether a biopsy is in my immediate future. Just in: BAD NEWS: PCA-3 = 75.9! Cut-off is 35. Biopsy scheduled for 11/30

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 11/28/2009 1:06 PM (GMT -6)   
Mel see you are knee deep in this jungle and quick sand, consider that 'normal' this jungle has less knowns than known definitives. Can't blame you or anyone for feeling kind of paranoid, the unknown and grey areas especially concerning ones own future or quality (thereafter) can be overwhelming. You are amongest others whom have gone against this before you or myself, much can be learned from that alone.

Tell your uro-doc you want your pathology/biopsy slides sent to one of the few experts, like Bostwick, Epstein, Oppenheimer et al. Then when it comes back see that you have the actual blanking copy in your hands even if you pay for a copy. Then read, analyze and post it herein and elsewhere so as to find out what it means in laymans terms. Do not rush into any treatment within a few days, that would be against your best judgement. This data you are getting is the closest thing to definitive that can be known up front or without further special testings or lymphendectomy= (biopsies-another possibility) and all decisions are based upon this pathology(for the most part) is what it bascially amounts to.

Dx-2002 (unreal beginning-high risk patient)- good news living la vida loca atleast thus far!

Veteran Member

Date Joined Apr 2009
Total Posts : 990
   Posted 11/28/2009 2:00 PM (GMT -6)   
WAIT. Please turn off the "Fast Forward" setting and step away from the machine!

Life is still beautiful even if you now have one more worry. There is football on TV, holiday leftovers in the fridge. If you are out of things to think about, sit down and write some java code to draw pictures of Santa! Do not cross the line between thinking and obsessing.

Ok. biopsy on Monday -- one week to get the results. Maybe you should get the computer to draw reindeer too! IF you really belong here then it is a minimum of six weeks after biopsy before surgery can be done (some docs think 8 is better.) You are going to have 4 choices -- surgery, radiation, seeds, watchful waiting. You have already learned a lot about PC but you cannot go much ahead without data. With data, how much doubt will remain? How much time will the decision really take? Maybe you should draw wreaths as well -- I wonder if you could get neat results using fractals.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan, Bone scan 1/09 both negative.

Robotic surgery 03/03/09 Catheter Out 03/08/09
Pathology: Lymph nodes & Seminal vesicles negative
Margins positive, Capsular penetration extensive Gleason 4+3=7
6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
10 weeks: no pad at night -- slight leakage day/1 pad.
3 mo. PSA 0.0 - now light pads
6 mo. PSA 0.00 -- 1 light pad/day

Veteran Member

Date Joined Jun 2008
Total Posts : 1804
   Posted 11/28/2009 3:31 PM (GMT -6)   
Compiler, you are doing yourself a great disservice right now. I will tell you what a radiation oncologist told me when a spot was noted on my husband's bone scan and I asked the "OK...worst case..." question. The doctor told me to stop it...and said "we can't treat something that isn't there." In your case, we simply don't know what is or isn't there and neither do you or your doctor. Have the biopsy - wait for the results. It will be hard but there's nothing to be done about it. When you have the results - if they are what you fear them to be - then start looking at your treatment options and speaking with doctors. You will have several weeks after the biopsy before you can take any action, so will have plenty of time to decide what will work best for your situation. Until you know whether or not you have PCa, what the Gleason score is, how many cores were taken and how many were positive, the % of cancer in each core, etc. worrying about the "what ifs" useless. Sure, gather information and educate yourself but please slow down. You've received much good information from your questions. Hopefully you won't need to use any of it!

I do hope that you will be able to get through the next week.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (single small EPE in posterior left). Perineural tumor infiltration present. Apex margin, bladder neck and SV negative. Final Gleason 3+4 SA. PSA: 0.0 til July 2009. August 2009 PSA was 0.1, in September it was 0.3 Met with radiation oncologist, CT scan and bone scan clean. Third PSA on October 16 - PSA BACK TO UNDETECTABLE! Next PSA scheduled for early December. No radiation treatment at this time!

Veteran Member

Date Joined Jul 2008
Total Posts : 981
   Posted 11/28/2009 3:52 PM (GMT -6)   
compiler said...
Biopsy Monday.

If the results are positive but surgical, I have plans in place.


Why would you have plans already? Even when you learn the results of your biopsy and IF you do need treatment there likely will be no big rush. Notice I said LIKELY because you don't know your results yet. In most cases you can have months to possibly years before you need to choose a treatment, or just do active surveillance indefinitely. Do take your time choosing there are no do overs and the after effects may be with you the rest of your life. If you choose surgery remember it is major surgery. I've seen guys almost as obsessed as you rush to surgery and expect to go back to work the following weekend like it's no more than a simple biopsy. It doesn't work that way. Usually I end these talks to new people recommending they take their time deciding what to do. I went from ready to opt for surgery, to radiation to joining a clinical trial with a saturation biopsy and targeted focal cryosurgery. But that advice is for more slower paced less panicked people. In your case I can see you rushing to some treatment I just hope for your sake it's one you can live with afterward without regrets. I swear my kids when younger had more patience than you do while on a cross country road trip.
Diagnosed 11/08/07 - Age: 58 - 3 of 12 @5%
Psa: 2.3 - 3+3=6 - Size: 34g -T-2-A
2/22/08 - 3D Mapping Saturation Biopsy - 1 of 45 @2% - Psa:2.1 - 3+3=6 - 28g after taking Avodart - Catheter for 1 day -Good Candidate for TFT(Targeted Focal Therapy) Cryosurgery(Ice Balls) - Clinical Research Study
4/22/08 - TFT performed at University of Colorado Medical Center - Catheter for 4 days - Slight soreness for 2 weeks but afterward life returns as normal
7/30/08 - Psa: .32
11/10/08 - Psa.62 - Not unexpected bounce after the 80% drop the quarter earlier. Along with urine flow readings, an acceptable amount left in bladder measured by sonic. Results warrant skipping third quarter tests, and to return April, 2009 for final biopsy scheduled to
complete clinical research study 
April 2009 12 of 12 Negative biopsy
10/12/09 - Psa .30

Post Edited (realziggy) : 11/28/2009 2:56:43 PM (GMT-7)

Veteran Member

Date Joined Nov 2009
Total Posts : 7187
   Posted 11/28/2009 6:53 PM (GMT -6)   


I think you might have misunderstood my comment regarding having "plans in place."

Yes, I am certainly squirming like a kid on a cross-country trip, I'll grant you that.

Frankly, AS would certainly be my first choice if I had a positive biopsy and AS was deemed advisable. What I meant was that if surgery is the way to go, I have a plan there. That plan is to meet with Dr. Menon, have him give me his recommendation, and go from there. This is predicated on his stellar reputation and willingness to say "NO SURGERY" if he feels it will not be helpful. I have not scheduled an appointment or anything like that. I KNOW I have to wait for the biopsy report. It may turn out to be totally benign. That would be the best result. Actually, that would still be AS, effectively!

We are leaving tomorrow late afternoon. Biopsy Monday. I'll be glad to get it over with...and then the waiting REALLY starts!


PSA-- 3/08--2.90;  8/09--4.01; 11/09--4.19 (Free PSA 24%), this after 45 days on cipro!
History of BPH/prostatitis.
Awaiting results of my PCA-3 test which will determine whether a biopsy is in my immediate future. Just in: BAD NEWS: PCA-3 = 75.9! Cut-off is 35. Biopsy scheduled for 11/30

Regular Member

Date Joined Jul 2008
Total Posts : 123
   Posted 11/28/2009 9:05 PM (GMT -6)   

I may have missed it, but how old are you?
@ 53 yrs PSA 4.8
T1c – Gleason 3 + 3
IMRT 1/07 thru 2/07 (42 treatments)
PSA 6/07 – 0.76
PSA 12/07 – 0.36
PSA 6/08 – 0.72
PSA 12/08 - 1.06
PSA 6/09 - 1.02

Veteran Member

Date Joined Nov 2009
Total Posts : 7187
   Posted 11/28/2009 10:15 PM (GMT -6)   
PSA-- 3/08--2.90;  8/09--4.01; 11/09--4.19 (Free PSA 24%), this after 45 days on cipro!
History of BPH/prostatitis.
Awaiting results of my PCA-3 test which will determine whether a biopsy is in my immediate future. Just in: BAD NEWS: PCA-3 = 75.9! Cut-off is 35. Biopsy scheduled for 11/30

Cajun Jeff
Veteran Member

Date Joined Mar 2009
Total Posts : 4069
   Posted 11/28/2009 10:28 PM (GMT -6)   
Mel, Best of luck with the biopsy. After the results are in then lets toss out ideas. Till then, if you are married. Have yourself a GRAND OLD SEXEY TIME. You will probably want to ware a condome till the ejaculate clears up. It is kind of freeky.

Keep us posted.

Jeff T
Cajun Country
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.

English Alf
Veteran Member

Date Joined Oct 2009
Total Posts : 2209
   Posted 11/29/2009 10:49 AM (GMT -6)   

I definitely agree with the "slow down" suggestion.

Firstly the biopsy itself is not as minor an invasive act as some think. It will take a while to recover from that in itself. And that will mean that no doctor or surgeon will let you have any treatment like surgery for weeks maybe several months. The prostate gets bruised and cut up by the biopsy and needs time to recover otherwise a surgeon could open you up and not be able to tell where all the bloodvessels and nerves and stuff were because everything was be so swollen.

Also on the "get back to work after a week" side opf things that has been mentioned, the problem with a robot operation is that on the outside your body looks only slightly poked about wherease on the inside it has effectively been just as poked about as with open surgery, my surgeon told me it would take my insides about 6 months to recover.

Yes it's fine to be ready for bad news, I took that approach, but don't assume it's bad news. My urologist told me the news and it was bad news, but then after we'd discussed a load of things he told me to go away for a fortnight and investigate things slowly and not make any decisions.

The HW guys will help and support you.


Elite Member

Date Joined Oct 2008
Total Posts : 25355
   Posted 11/29/2009 11:42 AM (GMT -6)   
Alfred, you bring up a good point on the surgical approach to treatment. I am not sure all our new friends here fully understand the seriousness of PC surgery. It is considered one of the most complex surgeries. The robotic approach advantage in recovery is only in the abdominal area. With robotic, you have several smaller in size wounds to heal, as opposed to the open surgery's one large opening. Though in this day and age, the one opening isn't that huge, not like the old days. I have a jagged 8" scar on me from having a gall bladder removed 28 years ago, can you imagine that.

I think, that some men assume that since robotic is less invasis on the outside, that's its the same complex surgery on the inside. Perhaps some doctors and robotic centers over sell the healing fast part with robotic.

Realistically, my own surgeon said that even a guy in good shape, it will take 6 - 12 months to fully heal up from either type of surgery.
I am slightly over a year out, and I would testify that is pretty accurate. Of course, one's general medical health ,age, physical condition, etc are also recovery factors.

I have yet to see hard evidence that robotic surgery lowers ED or incontinence. Also feel that some guys get caught up in the "techo" side of the surgery, just as I was recently amazed at the IMRT radiation machine that was my home for 39 days.

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

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