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compiler
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Date Joined Nov 2009
Total Posts : 7269
   Posted 12/9/2009 9:18 PM (GMT -6)   
OK, my signature is below. I'm VERY curious. What treatment do you think UMICH will recommend?
 
Will the surgeon say surgery and the radiation guy say radiation?
 
I wonder if they will recommend surgery immediately followed by radiation?
 
What is  YOUR GUESS? You make the call!!!
 
(Don't worry -- I'll make the decision and it will not be based on your vote!)
 
Mel
63 years old
PSA-- 3/08--2.90;  8/09--4.01; 11/09--4.19 (Free PSA 24%), this after 45 days on cipro! DREs have always been normal.
 
History of BPH/prostatitis.
 
PCA-3 test: 75.9 (bad news, guaranteeing I have to do....):
 
Biopsy on 11/30/09
 
Biopsy Report—Prostate Cancer

5 out of 12 positive

Gleason 4+3. More specifically:

2 cores were 3+3 (one 5% and the other 30%) on one side. On the other side:

2 cores are 4+3 (5%)--

1 core 3+4 (30%)

no peri-neural invasion

prostate is 45 grams

Stage: T1C

 Latest: Have set up an appointment at Umich with surgeon, radiation guy, general medical oncologist on Monday, 12/14. Trying to also set up appointment with Dr. Menon at Ford Hospital. Looking at another reading of the slides.


Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 12/9/2009 9:55 PM (GMT -6)   
Ok, my guess is surgery and no radiation. Bonus: no more BPH/prostatitis :-)
Pre-op:
Age 63 at diagnosis, now 64.
No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4 of 12 cores.
Operation:
Non-nerve sparing RRP on 7 March 2008.
Two nights in hospital; catheter out after 7 days.
Post-op:
Continent; no pads needed from the get-go.
Pathology showed organ confined and negative margins. Gleason downgraded to 4+4=8.
PSAs:
6-week : <0.05
7-month: <0.05
13-month: 0.07 (start of a trend?)
19-month: 0.09 (maybe)
ED:
After a learning curve, Bimix injections (0.2ml) worked well. From 14 months, occasional nocturnal erections. Have "graduated" to just the pump.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 12/9/2009 9:56 PM (GMT -6)   
I say they will say robotic surgery on the first pass, SRT only if proven needed later down the line
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, Cath #9 in 35 days, 12/7/9 - Cath #10 in place


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2692
   Posted 12/9/2009 10:13 PM (GMT -6)   
I guess surgery. They would not recommend surgery unless you have a positive margin, or EPE, or lymph node involvement.

I would say the radiologist will say you have an option of both, but will most likely point out the advantages of radiation.
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


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7269
   Posted 12/10/2009 12:53 AM (GMT -6)   

Ohio:

I guess maybe it's a silly question, but maybe not. It helps me get a read on how I am doing digesting all the information. My guess is pretty much what was mentioned (surgery then SRT if necessary).

I know YOU FEEL more tests are needed, and I will certainly ask about that. But do you think they will SUGGEST more tests? I think not, but it's a close call.

BTW, are we allowed to ask silly questions?

 

Mel


63 years old
PSA-- 3/08--2.90;  8/09--4.01; 11/09--4.19 (Free PSA 24%), this after 45 days on cipro! DREs have always been normal.
 
History of BPH/prostatitis.
 
PCA-3 test: 75.9 (bad news, guaranteeing I have to do....):
 
Biopsy on 11/30/09
 
Biopsy Report—Prostate Cancer

5 out of 12 positive

Gleason 4+3. More specifically:

2 cores were 3+3 (one 5% and the other 30%) on one side. On the other side:

2 cores are 4+3 (5%)--

1 core 3+4 (30%)

no peri-neural invasion

prostate is 45 grams

Stage: T1C

 Latest: Have set up an appointment at Umich with surgeon, radiation guy, general medical oncologist on Monday, 12/14. Trying to also set up appointment with Dr. Menon at Ford Hospital. Looking at another reading of the slides.


Tony Crispino
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Date Joined Dec 2006
Total Posts : 8128
   Posted 12/10/2009 2:34 AM (GMT -6)   
Mel,
You have gathered enough information only to know that you should take action with your disease.

The brachytherapy with external beam radiation (IMRT) option would be likely what a good radiologist would offer. And given your age and numbers, it could do very well for you. Dr. Menon will recommend radical prostatectomy, and he is very skilled in robotic surgery. And he will remind you that the best way to get definitive information about the prostate will be with surgical removal. You are a borderline high risk patient, and both methods could fail on the front line but the 2nd and third options change. With any form of failed radiation, you would likely need hormone therapy to control PSA. With surgery and a definitive pathology, you could immediately add radiation if the results confirm high risk, or you could watch and wait if your post surgery PSA cooperates.

Any further imaging could produce usable information, and it may not. If it does tell you the cancer is likely out of the prostate locally, then you are predestined for hormone therapy, but that does not preclude a local intervention. If there are metastasis that are too small to be seen then no imaging will help you. You PSA is very low still and that usually indicates you are still contained in the prostate. You can use the Partin Tables to see what your probabilities are and that may help you with your decisions.

My cores were very close to yours in grade of cancer but mine were up to 80% cancerous. I still chose surgery because I wanted that definitive pathology report. With a good surgeon (like Menon) I have had decent luck with the plumbing. Even with the cancer out of the prostate my radiologist knew where to concentrate my adjuvant radiation therapy. We added adjuvant hormone therapy, much like the radiation protocol I discussed above I have had a flatline of zeros since 4 weeks after surgery. I'll take it since my PSA was 19.8 when we started out.

I am also very glad I have that final pathology sample of the entire prostate.

Good luck to you in your decisions. May peace be with you...

Tony
Prostate Cancer Forum Co-Moderator


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 12/10/2009 2:43 AM (GMT -6)   
Mel,
Also look at this website. Choose the Pre-Treatment Nomogram and enter your data. This table will give even better calculation than the Partin Tables.

www.mskcc.org/applications/nomograms/prostate/

This Nomogram is from Memorial Sloan Kettering. They are a multi-faceted cancer center. These probability percentages are taken from actual research cases by MSK and published in PubMed at the National Institute of Health.

Tony
Prostate Cancer Forum Co-Moderator


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4848
   Posted 12/10/2009 6:42 AM (GMT -6)   
My guess is that we shouldn't waste time playing guessing games on such a serious site....
 
Could do it with a Happy Hour crowd maybe.

LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 12/10/2009 8:58 AM (GMT -6)   
I'm with you there Steve....bottoms up
You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral w/PNI - Gleason (3+3)6 Stage T1C
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (3+4) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
PSA 5 week Oct 2008 <.05
                   3 month Jan 2009 .06
                   6 month Apr 2009 .06
                   9 month Jul  2009 .08
                 12 month Oct 2009 .09 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 12/10/2009 10:03 AM (GMT -6)   
Mel,

You can ask any question(s) you wish here, that is the spirit of HW. If someone thinks its silly and/or a waste of time, they will be quick to tell you as a couple of posters already have.


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, Cath #9 in 35 days, 12/7/9 - Cath #10 in place


medved
Veteran Member


Date Joined Nov 2009
Total Posts : 1100
   Posted 12/10/2009 10:18 AM (GMT -6)   
I obviously don't know what any particular doctor will tell you, but my guess is you will leave the day with this bottom line conclusion: You have the option of surgery or radiation, and the likelihood of being free of biochemical recurrence 10 years from now is very close between the two options. But you will learn more about the each of the options.

In terms of radiation after surgery, I don't think they will tell you whether they recommend that or not, but instead would want to see the post-surgery pathology report before deciding (and some docs would say they want to see some subsequent psa results before moving to post-surgery radiation).

Oh, and don't be put off by the "that's a silly question" comments. People who don't like your question could just as easily ignore it. In my mind, if the answers give you information that you find helpful (even if someone else would not find it helpful), then it is not a silly question. But I am new around here, so...
Age 45.  Father died of p ca. 
My psa starting age 40: 1.4, 1.3, 1.43, 1.74, 1.7, 1.5
 


Zen9
Regular Member


Date Joined Oct 2009
Total Posts : 314
   Posted 12/10/2009 1:31 PM (GMT -6)   

I'll throw this out just for the heck of it.

When I went to a university cancer center, I first met with a radiologist.  He pushed proton beam therapy (got to pay for that expensive machine).  While he was talking, the urologist-surgeon came in; the radiologist stopped talking immediately; the urologist-surgeon started pushing da Vinci surgery (got to pay for that expensive machine).  

When the consultation was over, I was gathering up my stuff thinking that either way could work for me.  On the way out a nurse handed me a packet of information and a one-page "Summary of Recommendations."  That said that their joint recommendation was da Vinci surgery.  The next day I called the radiologist to discuss this "joint" recommendation.  He was obviously uncomfortable and his answers seemed very evasive.
 
I later learned that the urologist-surgeon was a full professor and the radiologist was an associate professor.  For what it's worth.
 
Zen9
 
 
No family history of PC.  PSA reading in 2000 was around 3.0 .  Annual PSA readings gradually rose; no one said anything to me until my PSA reached 4.0 in September 2007, at which point my internist advised me to see a urologist.   
Urologist advised a repeat PSA reading in six months = 4.0 .  Diagnosed May 2008 at age 56 as a result of 12 core biopsy.  Biopsy report by Bostwick Laboratories = Gleason 3 + 3. 
Interviewed two urologists - the one who did the biopsy and another - the latter had the biopsy slides re-examined = Gleason 3 + 3. 
Then went to M. D. Anderson Cancer Center in Houston in July 2008 and met with a urologist and a radiologist.  Biopsy slides re-examined yet again, this time by MDA's internal pathology department = Gleason 3 + 4.   
Chose da Vinci surgery over proton beam therapy; surgery performed at M. D. Anderson Cancer Center on August 15, 2008.  Post-operative pathology report = four tumors, carcinoma contained in prostate, clean (negative) margins, lymph nodes clear, seminal vesicles clear.  Gleason = 4 + 3. 
Minor temporary incontinence; current extent of ED uncertain due to lack of sexual partner; refused treatments for ED as being pointless under the circumstances. 
PSA readings: 
November 2008 = <0.1 ["undetectable"]
June 2009 = <0.1   
December 2009 = <0.1
 


zachattack
Regular Member


Date Joined Dec 2009
Total Posts : 97
   Posted 12/10/2009 1:58 PM (GMT -6)   
When I found out I had pc I just wanted it out of me.Now I will take radiation, any thing to get back to 0.0

Zach
age 55dx 12-2008,psa at biopsy 8.6
biopsy 12/12 gleason 3+4=7
da vinci surgery 6-09 by DR. John W. Scott (my hero)
Hospital 3 days cath 7days still leaking from cough(bad lungs)
still have ed may be the hormones.
9-09 psa 2.2 hormone inj
10-09 nuclear bone scan no results yet I will have gold markers placed 12-29-09
start rad 1-10-09
organ confined
extracapsular seminal vesicle involvement
lymph node involvement


Sephie
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Date Joined Jun 2008
Total Posts : 1804
   Posted 12/11/2009 7:09 AM (GMT -6)   
Just a thought about why some doctors push their particular area of expertise (e.g., surgery vs. radiation). Bear with me on this one, please.

A friend of mine had recurrent breast cancer that had spread to her bones. She met with many oncologists, and tried every type of chemo available. Her last chance was a bone marrow transplant. She went to a major cancer center in New York City and met the head of the program there. Money was not an issue for her. She wanted into the program because this was the only thing that could save her life. After reviewing her history and stats, the doctor declined to treat her. Why? Because the bone marrow transplant would likely not be successful and this would lower their success rates which would affect their research grants. So, in this particular case, the decision was based on money. Sadly, this dear woman lost her battle with breast cancer.

I had a similar experience with the same hospital but a different doctor. When we thought that John was headed for SRT, I contacted a leader in prostate cancer at the hospital. I spoke with his secretary who explained how it worked: we would send the slides to the doctor and he would review them (for a fee). After reviewing the slides, the doctor would decide whether or not he would treat my husband - was told that the doctor would decide if my husband's case was "interesting enough". I was left feeling angry and rather disillusioned that this hospital, which is one of the most famous in the world, would treat any patient this way.

My point is that perhaps when a doctor "pushes" his or her particular treatment, they might do so because they believe the treatment will be successful and will boost their success rates. I'm not saying this is so for all doctors or even for most of them but obviously it was true in these particular situations.
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!


Modelshipwright
Regular Member


Date Joined May 2009
Total Posts : 215
   Posted 12/11/2009 7:44 AM (GMT -6)   
There are no silly questions in my opinion when you are dealing with a serious health issue. I see room for advice, encouragement and humour on this forum as most of us do.

Regards,
Bill

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 12/11/2009 10:03 AM (GMT -6)   
Good luck Mel you probably have plenty of things to weigh on this. I am not endorsing this for you but you might want to atleast hear of another twilight zone approach that is possible and not often chosen, but the results don't look ridiculous.

I have mentioned this before herein it is way different: Rick K. (Michigan guy, too) back in 1995 diagnosed with psa around 11.0 area, had two positive cores found and graded low at (2+3) Gleasons, but was not reviewed by experts. Rick said no to major treatments, decided on the then almost new concept of drug therapy as major treatment. Did ADT3 (lupron+casodex+proscar) for 13 months, then quit and took only proscar for maintenance purposes. Manhood and all normal within months (he says) and got rebiopsied two times in different years, later....nothing was found in those. Went about 12 Yrs. after ADT3 and finally psa moved up to where he decided recently to go back into round #2 of 13 months of ADT3 and quit. Yes, he still could do surgery, radiations and basically all treatments and surgery is more difficult with shrunken gland...but he has those options still.

So is this option totally beyond belief (lol) or is in insane? I have talked to Rick a little while back and he is a happy camper so far in his journey. This is how wild PCa can be, may ways to either try to fight it and none come with a guarantee. The plus on Ricks side for a newbie is that research is headed more into gene therapies, dendretic cell manipulations and that kind of stuff that will likely produce results for better control or cures. Leukine therapy is being used right now by Dr. Sholtz (Calif.) (some other onco-docs too) and is not a hormone therapy but on the cellular level this works, maybe not perfectly yet...but has like no side effects (per se). So if someone choses such a thing, you can also buy time.

Again not endorsing it and only mentioning it so you get an idea of, yes there are other protocols too. I know of a guy whom did chemo(1st)+brachy+IMRT rad and his results from 2002-3 are excellent, in the zero club and his stats were not low end. Unique protocol? Yeah especially in 2002-3 era. Alot of ways to fight PCa at any stage, alot of them render results....so when a patient is told you have 2-3 choices....question everyting. Maybe the standard issue protocols are all sane...but question it anyway.
 
Good luck to you Mel, both places you are going are well regarded and I was pleased with both of them compared to someother places checked out.  Dr. Menon told me I will not do surgery on you. (I appreciated an honest reply like that, didn't like the message of course, an honest messenger is a righteous one) so that is my bias on him. smile

Post Edited (zufus) : 12/11/2009 8:15:50 AM (GMT-7)


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7269
   Posted 12/11/2009 2:12 PM (GMT -6)   

I have to admit that the more I read/learn the more questions come up (but the questions become more focused and detailed). Also, the more vague things become too.

 

I also have come to the conclusion that PC has a mind of its own. The reports/results give you probabilities, but there are enough exceptions so that it is VERY difficult to be confident in the future. You just have to somehow come to an acceptance that your new life will be one of terrible uncertainties. I will eventually have to learn to deal with it.

 

I am trying to come up with answers which are not forthcoming. Is my cancer aggressive? Well, the PCA-3 result sure points that way. The G 4+3 also points a bit that way. But  the two PSA tests and the PSA-3 tests and the core volume might indicate otherwise. Eventually, if I do surgery, that pathology will point somewhere.. But it will not give me a huge degree of certainty either way; I'll have to adjust. The first step, I guess, is to recognize that I need to adjust.

 

I deal in mathematical certainties all the time and I also deal in probabilities (I also am a serious tournament poker player). It is much more fun dealing in "abstract/academic" probabilities than this high personal stakes stuff!!

 

Mel


63 years old
PSA-- 3/08--2.90;  8/09--4.01; 11/09--4.19 (Free PSA 24%), this after 45 days on cipro! DREs have always been normal.
 
History of BPH/prostatitis.
 
PCA-3 test: 75.9 (bad news, guaranteeing I have to do....):
 
Biopsy on 11/30/09
 
Biopsy Report—Prostate Cancer

5 out of 12 positive

Gleason 4+3. More specifically:

2 cores were 3+3 (one 5% and the other 30%) on one side. On the other side:

2 cores are 4+3 (5%)--

1 core 3+4 (30%)

no peri-neural invasion

prostate is 45 grams

Stage: T1C

 Latest: Have set up an appointment at Umich with surgeon, radiation guy, general medical oncologist on Monday, 12/14. Trying to also set up appointment with Dr. Menon at Ford Hospital. Looking at another reading of the slides.


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7269
   Posted 12/11/2009 2:14 PM (GMT -6)   

Oopsss... in the post I just made I said PSA-3 but I meant PSA-free

 

Mel


63 years old
PSA-- 3/08--2.90;  8/09--4.01; 11/09--4.19 (Free PSA 24%), this after 45 days on cipro! DREs have always been normal.
 
History of BPH/prostatitis.
 
PCA-3 test: 75.9 (bad news, guaranteeing I have to do....):
 
Biopsy on 11/30/09
 
Biopsy Report—Prostate Cancer

5 out of 12 positive

Gleason 4+3. More specifically:

2 cores were 3+3 (one 5% and the other 30%) on one side. On the other side:

2 cores are 4+3 (5%)--

1 core 3+4 (30%)

no peri-neural invasion

prostate is 45 grams

Stage: T1C

 Latest: Have set up an appointment at Umich with surgeon, radiation guy, general medical oncologist on Monday, 12/14. Trying to also set up appointment with Dr. Menon at Ford Hospital. Looking at another reading of the slides.


Ziggy9
Veteran Member


Date Joined Jul 2008
Total Posts : 981
   Posted 12/11/2009 2:41 PM (GMT -6)   
I deal in mathematical certainties all the time and I also deal in probabilities (I also am a serious tournament poker player). It is much more fun dealing in "abstract/academic" probabilities than this high personal stakes stuff!!



Mel


Upon dx many like yourself and I did too try to deal with this logically. But you can't, you soon learn. Mel you'll soon need to factor in quality of life issues along with possible longevity into it next. Like many say, take your time there isn't any obvious answers. The more you learn the more you empower yourself. You may see this differently every few days, it's an emotional roller coaster. I went from leaning towards surgery, to seeded radiation, to finally a clinical study with focused cryosurgery. There aren't any wrongs answers. Just hope afterward there aren't any major regrets for you have to live with them from then on.
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
 
 
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 12/11/2009 2:45 PM (GMT -6)   
Mel, despite your occupation with math, you will have to accept what we all have to come to terms with, PC is very unpredictable, all the studying and formulas and what if's will never give you a complete piece of mind. Easy cases sometimes turn agressive quickly and some cases that start out agressive never materialize along the way. Good pathology reports have lead to reaccurances, and Bad ones just stay the say, and then in some cases, good is good, and bad is bad.

You will drive yourself crazy if you try to fit your PC into some precise box or set of logic or rules. Your journey and outcome will be unique to you, Mel. You will have to make your own decisions, and let it play out beyond that. And be prepared for anything or everything the best you can. Not wanting that to sound cold, but I have been a professional accountant/finance guy most of my life, and I can't make my own PC fit into any standard format, just not going to happen.

You probably be better off to have your arranged meetings, and start coming to terms with how Mel wants to treat it. Then get into your primary treatment, then into your recovery, then into whatever side effects do or don't happen. Instead of seeing PC as this overwhelming monster that makes no sense. Work on on piece of the puzzle at a time. There be plenty of time to worry and think about the next step along the way.

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, Cath #9 in 35 days, 12/7/9 - Cath #10 in place


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7269
   Posted 12/11/2009 4:07 PM (GMT -6)   

David

Reread my last post. I think that is exactly whAT I am saying!

 

I agree with you. There are obviously probabilities involved. But when the probability says 65% Y will happen, we see many cases where Y doesn't happen.

 

Mel


63 years old
PSA-- 3/08--2.90;  8/09--4.01; 11/09--4.19 (Free PSA 24%), this after 45 days on cipro! DREs have always been normal.
 
History of BPH/prostatitis.
 
PCA-3 test: 75.9 (bad news, guaranteeing I have to do....):
 
Biopsy on 11/30/09
 
Biopsy Report—Prostate Cancer

5 out of 12 positive

Gleason 4+3. More specifically:

2 cores were 3+3 (one 5% and the other 30%) on one side. On the other side:

2 cores are 4+3 (5%)--

1 core 3+4 (30%)

no peri-neural invasion

prostate is 45 grams

Stage: T1C

 Latest: Have set up an appointment at Umich with surgeon, radiation guy, general medical oncologist on Monday, 12/14. Trying to also set up appointment with Dr. Menon at Ford Hospital. Looking at another reading of the slides.

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