Active surveillance - biopsy results

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*Optimist*
Regular Member


Date Joined Jun 2009
Total Posts : 35
   Posted 2/8/2010 10:22 AM (GMT -6)   
Here are the results of my biopsy for those that were interested:

PSA at time of Biopsy - 3.48
DRE: Nornal
Trus volume: 34cc

3 out of 10 cores positive
one core @ 15%
One core @3%
one core @ 5%
Overall percentage of tissue involved - 2%
Gleeson 3+3
Oct/07: PSA 2.63
Jan/08: PSA 2.32
July/08: PSA 4.30
Jan/09: PSA 3.48 / Free PSA 10%
Feb/09 - Biopsy - cancer diagnosed
Now on Active Surveillance
July/09: PSA 3.16
Jan/10: PSA 2.77
 
Current Age 56
 


Reinardo
Regular Member


Date Joined Jan 2010
Total Posts : 23
   Posted 2/8/2010 12:09 PM (GMT -6)   
Nice to meet you here. On diagnosis you kept your cool and didn't jump at hard core treatment, didn't over-react. Nor did I. Do you do anything supplementary like changing diet, food additives or so? Please report.
Best wishes to you.
Reinardo
Current age 78
Diagnosed  in 2001, PSA = 8.9  Gleason 2+3 = 5
In 2001/2002 triple hormone therapy  protocol Leibowitz.
Watchful waiting thereafter.
Actual PSA = 10.6
Change of lifestyle and diet, food additives,  homoeopathy
In 2009 palliative TUR


MrGimpy
Veteran Member


Date Joined Jul 2009
Total Posts : 504
   Posted 2/8/2010 12:27 PM (GMT -6)   
Hi,

Wondered what the 2/09 Biopsy found

Also what does "Overall percentage of tissue involved - 2%" mean ? is that the percentage of sampled tissues or all tissues in the prostate ?
Stats:
Age: 52, PSA (2008)=1.9
Biopsy on 01/09/09, Gleason Score = 3+3
One (1) out of twelve (12) cores was positive, plus external nodule found
Surgery (Da Vinci, robotic prostatectomy): 4/7/09
Post Op Path 3+3
Removed Catheter: 04/19/09
100% bladder control - Pad free 7/09
PSA 7/09 undetectable, under .0
Trimix provides 100% erectile function


profman
Regular Member


Date Joined Jan 2010
Total Posts : 55
   Posted 2/8/2010 12:44 PM (GMT -6)   
Hi all - I also considered active surveillance after my first biopsy results (3 of 10 cores positive, Gleason 3+3, PSA 3.5, 10% involvement in one core, and less than 5% involvement in the other two cores). My uro/surgeon referred me to the following article , by Klotz, which listed "criteria" to be placed under active surveillance. After seeing the results of the first biopsy, the doctor thought it prudent to do a second biopsy just to be sure the cancer was not more wide spread (afterall, they are shooting in the dark). The second biopsy came up with 5/10 positive cores, with some with as much as 40% involvement. This put me out of the criteria that Klotz defined for success with active surveillance.

Best of luck to you, and may those PSAs stay static for many years to come.[url]
Diagnosed 9/4/09
PSA 3.5, up from 1.8 year before
First biopsy showed 3/10 positive cores, Gleason 3+3, less than 10% involvement in all three cores, diagnosed as T2a
Doc and I decided on Active Surveillance, pending a confirmatory biopsy
Second biopsy showed 5/10 positive cores, Gleason 3+3, left side (4 postitive cores) had 40% involvement
RRP on 12/15/09
Home on 12/16/09
Failed cystogram on 12/23/09, catheter out on 12/29/09
Path report was all good news, Gleason 3+3, no margin involvement, no perineural involvement, everything clean other than core of prostate, tumor on both sides, but more prevalent on left side, 5% involvement, 42 gram organ
Within two days down to one pad a day, now continent except if I sleep more than four hours
Back to work 1/4/10
First PSA 1/28/10 - nondetectable, next scheduled June 2, 2010
ED present, although blood does flow after Viagra. Will try pump in a week


profman
Regular Member


Date Joined Jan 2010
Total Posts : 55
   Posted 2/8/2010 12:44 PM (GMT -6)   
The url did not come through - http://jco.ascopubs.org/cgi/content/abstract/23/32/8165
Diagnosed 9/4/09
PSA 3.5, up from 1.8 year before
First biopsy showed 3/10 positive cores, Gleason 3+3, less than 10% involvement in all three cores, diagnosed as T2a
Doc and I decided on Active Surveillance, pending a confirmatory biopsy
Second biopsy showed 5/10 positive cores, Gleason 3+3, left side (4 postitive cores) had 40% involvement
RRP on 12/15/09
Home on 12/16/09
Failed cystogram on 12/23/09, catheter out on 12/29/09
Path report was all good news, Gleason 3+3, no margin involvement, no perineural involvement, everything clean other than core of prostate, tumor on both sides, but more prevalent on left side, 5% involvement, 42 gram organ
Within two days down to one pad a day, now continent except if I sleep more than four hours
Back to work 1/4/10
First PSA 1/28/10 - nondetectable, next scheduled June 2, 2010
ED present, although blood does flow after Viagra. Will try pump in a week


*Optimist*
Regular Member


Date Joined Jun 2009
Total Posts : 35
   Posted 2/8/2010 2:26 PM (GMT -6)   
Reinardo:
 
I did not change any of my habits - I was already execising daily and eating a low fat diet. My only vice is red wine and I am not willing to give that up.
 
Mr Gimpy:
 
I am not certain what the 2% figure is referring to - I assumed it was the amount of cancer seen as a percentage of the tissue in the 10 cores taken.
 
Profman:
 
Thanks for your comments. Being under diagnosed is a risk all take with AS. The odds are in one's favor with the right profile but there are no guarantees. I am glad you caught your more serious situation. I am hopefull to be in the majority with indolent cancer.
 
Regards
Oct/07: PSA 2.63, Jan/08: PSA 2.32, July/08: PSA 4.30,
Jan/09: PSA 3.48 / Free PSA 10%
Feb/09 - Biopsy - cancer diagnosed - age 55
PSA at time of Biopsy - 3.48
DRE: Nornal
Trus volume: 34cc
3 out of 10 cores positive
one core @ 15%
One core @3%
one core @ 5%
Overall percentage of tissue involved - 2%
Gleeson 3+3
Now on Active Surveillance
July/09: PSA 3.16
Jan/10: PSA 2.77
 
Current Age 56
 


zampilot
Regular Member


Date Joined Aug 2009
Total Posts : 152
   Posted 2/8/2010 2:54 PM (GMT -6)   
Congrats on your PSA's, but..you have prostate cancer and it won't go away on it's own. Does your Doc simply think it won't get worse?

*Optimist*
Regular Member


Date Joined Jun 2009
Total Posts : 35
   Posted 2/8/2010 3:02 PM (GMT -6)   
I know the cancer will not go away on it's owm and is ever present in my body. The thinking is that with indolent cancer it may never progress to threaten one's life. Until something chages either with PSA results or changed diagnoses on repeat biopsy we will continue to monitor..
Oct/07: PSA 2.63, Jan/08: PSA 2.32, July/08: PSA 4.30,
Jan/09: PSA 3.48 / Free PSA 10%
Feb/09 - Biopsy - cancer diagnosed - age 55
PSA at time of Biopsy - 3.48
DRE: Nornal
Trus volume: 34cc
3 out of 10 cores positive
one core @ 15%
One core @3%
one core @ 5%
Overall percentage of tissue involved - 2%
Gleeson 3+3
Now on Active Surveillance
July/09: PSA 3.16
Jan/10: PSA 2.77
 
Current Age 56
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 2/8/2010 3:24 PM (GMT -6)   
Optimist:

I think from following your numbers and story, you are still a good candidate for AS like you are doing. I hope it continues to do well for you in the months and years ahead.

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
Post SRT PSA: 1/10 .12
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 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12 in at the same time, 2/8-Cath #11 out - 21 days


In This Together Wife
Regular Member


Date Joined Dec 2009
Total Posts : 135
   Posted 2/8/2010 3:37 PM (GMT -6)   
Hello and "welcome" we are interested, please keep us posted.
CareBear
(Bear's stats)
Age 49
 healthy-had bronchitis once :)
 8-4-09    Family Practioner for back pain  PSA 4.9
8-20-09  Consult with urologist                PSA 4.89
9-2-09    Biopsy          3 cores positive 7% 3+3 (6) gleason
9-22-09  Birthday turned 49
10-12-09 2nd opinion
11-13-09 DaVinci
11-23-09 Cath removed  Path report cancer contained neg. margins
Feb 2010 wil be followup PSA


JoeFL
Regular Member


Date Joined Oct 2009
Total Posts : 420
   Posted 2/8/2010 3:40 PM (GMT -6)   
Optimist and Mr. Gimpy -
 
According to my biopsy report and map from Bostwick Labs - "The percentage shown in each area illustrates the amount of the biopsy core where cancer cells were found". I take that to mean sampled tissues, not all tissues on the prostate.
 
Joe

Age -67 PSA - 4.5

Biopsy  (9/4/09) - Positive in 5 of 8 cores. In those 5 cores, 5 of 11 samples were positive. Gleason 3+3=6. Stage – T1C  Ct and Bone scans negative

 

BT performed on 12/11/09. 84 seeds of Palladium 103. Surgery at 7:30 - Home at 12:30 same day with no catheter. Side effects as expected -  some burning, frequency, urgency. (Blood in urine stopped after 1 week).  Resumed daily  1 ½ mile walk after 3 days.

 

BT will be followed with 25 IGRT treatments beginning Feb 8. 

 


Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
   Posted 2/8/2010 4:44 PM (GMT -6)   
*Optimist* said...
I did not change any of my habits - I was already execising daily and eating a low fat diet. My only vice is red wine and I am not willing to give that up.
 
Optimist,
 
Thanks for your posting, and congratulations to you.  I am thrilled to hear of more AS success!  I'm sure that we will continue to hear of more and more over time as indolant and aggressive PC characteristics become more widely known, understood and accepted.  While not everyone is diagnosed while in the very early stages appropriate for AS, there is a very large number who are...and with more success stories out there, more will  likely turn with increasing confidence to AS as a "treatment deferal strategy."  I just wanted to comment and to wish you the very best!
 
Regarding your red wine "vice"...there, again, keep up the good cancer-fighting work!  Studies (still in their early stages) are showing that the red wine antioxidant properties lessen the progression of PC once it occurs...pomegranate juice also being shown to do the same. 
 
[By the way, to proactively head-off any possible nay-sayers on the wine studies, it should be noted that other less prominant studies have shown no correlation; but, NONE have shown increased risk of cancer progression.  So, you are putting the odds in your favor by continuing to enjoy a glass or two per day.]
 
best regards...
 
 
edited wording for added clarity

Post Edited (Casey59) : 2/8/2010 4:29:58 PM (GMT-7)


Uncle Harley
Regular Member


Date Joined Feb 2009
Total Posts : 85
   Posted 2/8/2010 5:24 PM (GMT -6)   
*Optimist* said...
I know the cancer will not go away on it's owm and is ever present in my body. The thinking is that with indolent cancer it may never progress to threaten one's life. Until something chages either with PSA results or changed diagnoses on repeat biopsy we will continue to monitor..

My thoughts exactly. AS is a very individual choice that many of us have difficulty making. I hope others will be understanding that it comes after many hours or days of considering all the options. I was fortunate in finding HW before I made my decision. In my own case, looking back, I've felt the 2.54 PSA reading was a fluke. It put me just over the velocity limit & my FP recommended a trip to the uro. I wish he would have said retest but with no sex for 3 days prior. But, here I am, not fat dumb & happy, just fat & content with my decision!


PSA History
3/99 1.2
3/00 1.04
3/01 1.16
7/02 1.24
2/06 1.59
3/07 1.79
3/08 2.54
8/08 2.3
4/09 2.3
7/09 2.6
12/09 2.3
12 needle prostate biopsy Jan 09
Dx of (1) core adenocarcinoma 20%
Negative DRE
All other cores benign
Gleason 3+3 T1C
12 needle prostate biopsy Dec 09
Dx of (2) core adenocarcinoma 10% each
All others benign
Gleason 3+3 T1C on each
Currently in Active Surveillence W/ Dr Approval
Age 60

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