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Berdoo/Arkansas
Regular Member


Date Joined Feb 2010
Total Posts : 183
   Posted 2/23/2010 8:04 PM (GMT -6)   
I've finally reached a narrowing of the road to a biopsy.
I had that fancy color doppler sonogram done at the hospital $700 whew.
medicare is a little stingy about tests.

So there they were 2 nodules, 1 on the left 1 cm, and another on the right with .78.
prostate 4 x 3 x 5cm vol 35.7cc
several dense echos producing acoustic shadowing suggesting calcification.

impression slight hypertrophy of the prostate.

psa has been a stead 4.0 to 4.5 for the last year.

I PSA and DRE every 3 months. so far in 2 years there has not been a change the doc can feel?
Doc said those 2 little bumps may have been there a long time?

Geezer67
age 67 3/4
DRE firm on right side
periodic sore groin area.

keysailfisher
Regular Member


Date Joined Dec 2009
Total Posts : 346
   Posted 2/23/2010 8:47 PM (GMT -6)   
Sounds like a favorable report, just keep up with your test and you should be good.
 
Best of luck,
Neal
age 45
psa 3.09
Biopsy results 12/9
Left side base 3+3=6 21% 2/2 cores positive
Left side mid  3+3=6 100% 2/2 cores positive
Left side apex 3+4=7 88% 2/2 cores positive
Right side - 0/6
CT & Bone scan negative
Davinci Feb. 5th 2010/ cath removal 2/16
 
Gleason-3+4=7
Extent of tumor-Bilateral
Extraprostatic Extension-Absent
Seminal Vesicles-Negative for tumor
Surgical Margins-Rt apical margin focally positive
lymphovascular invasion-Suspicious in areas of capsular involvement
Regional lymph nodes-One node negative
Stage-T2c NO Mx
Incontinence-yes


James C.
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Date Joined Aug 2007
Total Posts : 4462
   Posted 2/24/2010 10:12 AM (GMT -6)   
So, are you saying you will do the biopsy or that you aren't going to, based on thsi doppler reading?
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
32 mts: PSA's: .04 each test since surgery, ED Continues-Bimix .3ml PRN or Trimix .15ml PRN


Berdoo/Arkansas
Regular Member


Date Joined Feb 2010
Total Posts : 183
   Posted 2/24/2010 11:43 AM (GMT -6)   
I'm still up in the air on this. based on the misery most guys go through for the rest of their lives, It don't seem like it's worth it to me.
Especially since statistically there is no longevity difference between the forms of treatment and life expectancy.
True, If one has an aggressive cancer, It will shorten your life.
With my watchful waiting, since the nodules are not pressing on the uretha and since they are cot buldging out of the capsule I am in a holding pattern.

Key here is it slow growing or fast. If slow, my kidneys, heart will probably go first, as my health is poor.
sugar diab, high BP, high Tryglicerides, painful arthritus.

It seems 10 years after detection there is a 5% death rate, with or without treatment.

But, Like I say, If a change is significant then I'm off to a biopsy.

I still have the open question as to what is a nodule? are all nodules cancer? or benign cysts?
the 25% hit rate for cancer? how accurate is that. How accurate are a urologist stats?

I've had urologist lie to me and say there is NO pain for a biopsy. I have interviewed patients and discovered the
pain was considerable. This is unsettling if even the Urologist is NOT honest.
If it hurts say it hurts, and say on a scale from 1 to 10!!!

geezer67
age 67, psa 4.5, 2 nodules 1.0 cm and .78 cm.
no blood flow to the nodules.
Heavy calcification.

dre firm on the right Not knuckle hard, , but 1 cm nodule is on left.

Berdoo/Arkansas
Regular Member


Date Joined Feb 2010
Total Posts : 183
   Posted 2/24/2010 11:46 AM (GMT -6)   
exactly what are nodules? cysts? if 25% is the hit rate, what exactly are the other 75% masses?
calcium? benign cysts? Can a patholodgy report actually tell if Mets is emminent?
Does the path report indicate your time left on the planet?

geezer67

James C.
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Date Joined Aug 2007
Total Posts : 4462
   Posted 2/24/2010 12:39 PM (GMT -6)   
Sorry to be rude, but if you haven't had the biopsy, you can't really call it watchful waiting, it's called watchful hoping/ignoring, etc. If you don't know what you have, you have no basis to establish what your course of action and treatment will be for the cancer. Personally, I wouldn't risk my future health on some fear of a biopsy, especially one that is so variable among men, and that can be more accurate as to your current condition. As you should know by now, ANY abnormality felt during the DRE, or even with the color doppler visible, will trigger the action of a biopsy in the common standards of treatment. If anything felt is out of the ordinary, them prudent care will be to biopsy. I know it's not my business, but I think you are still minimizing the chances of and the seriousness of the possible PCa and maximizing avoidance by the fear of biopsy and that you may have PCa. Not a safe long term approach to determining your chance of cancer, I think. Just my brotherly concern, if I crossed the line, I apologize.
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
32 mts: PSA's: .04 each test since surgery, ED Continues-Bimix .3ml PRN or Trimix .15ml PRN


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4088
   Posted 2/24/2010 2:13 PM (GMT -6)   

Dear Berdoo:

I was trying to figure out how to phrase my response but then I read what James said.  I agree with him 100%!!!!!!!!!!!!!!!!!!!!!!!

Tucpock


Age 62, Gleason 4 +3 = 7, T1C, PSA 4.2, 2 of 16 cores cancerous, 27cc
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 12/09.  6 month PSA 1.4 and now 1 year PSA at 1.0.  My docs are "delighted"!

Casey59
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Date Joined Sep 2009
Total Posts : 3172
   Posted 2/24/2010 2:23 PM (GMT -6)   

I would urge you...please don't pass on a biopsy because you are concerned it might hurt!! 

Step #1 before deciding a treatment path (which would include Active Surveillence/Watchful Waiting) is to determine agressiveness.  The biopsy result is an essential input to Step #1.

The biopsy results in some "pricks" in an uncomfortable location...but it ain't that bad!!


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 2/24/2010 2:33 PM (GMT -6)   
I agree with James 100% also on this one

I had 3 biopsies spread over 18 months, 2 of them just 6 weeks apart. I have a low tolerance level for pain, and I didnt find any of the biopsies painful. I just didn't like the snappping noise it makes when they take a core, reminded me of a staple gun going off.

Without a biopsy in your plan, you really aren't in a plan, and as the others said, not to be rude, you are only doing WT (Wishful Thinking)

Please consider a biopsy asap. For those that can do Watchful Waiting or AS, more power to them, but it has to be done right.

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


Dutch
Regular Member


Date Joined Feb 2007
Total Posts : 400
   Posted 2/24/2010 4:15 PM (GMT -6)   
Berdoo:
 
Haven't seen it mentioned - have you ever had a "free" PSA with your PSAs??  Also, does Berdoo mean you are from San Bernardino?  If so, read book by Robert Marckini - "You Can Beat Prostate Cancer" available at Amazon.com and go visit Loma Linda's Proton Center in your area.  Best of luck to you.
Dutch
Diagnosed Feb 2001  (Age 65)  Currently 73
PSA 4.8      Gleason 3+3=6      Stage   T2b
Completed Proton Therapy @ Loma Linda - 2001 - No side effects.  My journey is at: http://www.healingwell.com/community/default.aspx?f=35&m=727565
8yr PSA - 0.2
Our responsibility now is to educate men about Pca, PSA and the importance of early detection. 
 
 
 


Franchot
Regular Member


Date Joined Jun 2009
Total Posts : 130
   Posted 2/24/2010 8:05 PM (GMT -6)   
"I just didn't like the snappping noise it makes when they take a core, reminded me of a staple gun going off."

Yeah, that's the thing that bothered me the most also. I didn't experience any pain except in my eardrums from that sound.
Age: 53 6' 0" Weight: 170 Caucasian

Rising PSA over the last six years (from when I started being tested) from 3.9 to 5.2 to 4.6 to 4.5 to 4.9.

DX with PC in January 2009 after biopsy. Bone scan--negative

Consulted Cedars-Sinai Beverly Hills urologist--recommended surgery
Consulted Cedars-Sinai Beverly Hills radiologist--recommended IMRT
Consulted San Diego Cyber-Blade doctor--recommended treatments
Consulted Long Beach radiologist--recommended IGRT
Consulted Loma Linda radiologist--recommended Hypo-fractionated Proton treatments

Insurance approved any treatment I wanted.

Consulted Marnia del Rey urologist Dr. Scholz.
Dr. Scholz referred me to Dr. Bahn for a Color Doppler test.
Scholz and Bahn recommended Active Surveillance, some diet changes, and steady exercise.

I am currently on Active Surveillance.


Berdoo/Arkansas
Regular Member


Date Joined Feb 2010
Total Posts : 183
   Posted 2/25/2010 12:32 PM (GMT -6)   
yes, san bernardino. nice close to the proton gun! I heard about 6 months to get in? anybody here a proton member of the balloon? I have a coffee club friend a proton survivor, he is absoluetly thrilled and a proponent. And I agree all my docs, and most folks agree that the biopsy will let me know what is going on and how aggresive to treat. The IV sedation , although painless, is quite a hastle for a 20 minute. Not many guys here report extreme pain on biopsy, I think 2? and they couldn't say if they had Lidocaine or not.
also nice to drive home and not be nauseas from IV!! Lotta guys are keen on that aspect.
Only problem I see with a biopsy is that if NOT found then another biopsy is scheduled until it is found.
My urologist said just a matter of time most men with nodules and PSA jump will get pc!!?? It is ironic that my dad and dozens of friends, who I grew up with and watch die of various cancers and heart disease and Diabitus, never was there a mention of prostate cancer. But it sure is the latest rage nowadays with some statistics reporting 1 in 6 before 70 and 50/50 after 70. Is this an epadimic?

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 2/25/2010 4:16 PM (GMT -6)   
Prostate cancer is not some kind of "latest rage" disease, that seemed like an odd remark. Since the development of and use of the PSA test, more and more men have become aware of the possibility of prostate cancer. From PSA tests and DRE's, biopsy's are ordered that ultimately detect prostate cancer. The one out of six figure has been around for years. And that is just those men who were detected through testing, it is often thought that many, many more men have prostate cancer, in very low agressive states and indoloent and will never know it in their lifetimes, and unless an autospy picked it up, you would never know. So the real number of men with some form or stage of prostate cancer would be much higher.

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


Berdoo/Arkansas
Regular Member


Date Joined Feb 2010
Total Posts : 183
   Posted 2/26/2010 10:58 PM (GMT -6)   
I should explain latest rage. what I meant is very high in the news media. A huge public awareness, massive increases in treatments and biopsies as the years go by.
Urologist offices around here are jam packed, takes quite a while to book an appointment.
a HUGE number of treatment options, and a huge number of different antibiotics to take,
and some infections are now resistant to cigpro? and some doctors don't require an enema before a biopsy.
There seems to be no guarantee cure, no gold standard treatment? Loma Linda says they are ABOVE the gold standard!!! and No consistant biopsy standard? used to be 6 then 8 then 12, now loma Linda is 15 , Redlands is 20 or 24.
San Bernardino Urology is 12. some guys say no pain at all, piece of cake, others have extreme pain? Like 8 on the 1 to 10 scale.

Berdoo/Arkansas
Regular Member


Date Joined Feb 2010
Total Posts : 183
   Posted 2/26/2010 11:01 PM (GMT -6)   
from an old medical textbook, 1953. I don;t seem to see any evidence that the surgery is no longer Major?

Development: 65% of men over 50 have enlargement of the gland. 20% of these enlargements become malignant. The cancer of the prostate is the least progressive in growth in cancers of any part of the body. A typical case is a man of 50 has minor urinary difficulty and seeks his physician.
He is then consults a specialist who examines and finds NO nodule. He comes back every 3 months and if a nodule is felt via DRE he is watched carefully. Conservative urologists with many years of experience defer operation until they are definitely certain there is some progression.

It must be remembered that this is a very serious operation, the mortality is high, and the possibility of stirring up trouble and sending some of the cancer cells from the prostate to a remote organ is not small. Death then occurs in months.
Since PC is slow growing the patient has a better chance to advance to old age with very little prostatic difficulty.
The fist sign or symptom of the cancer my be blood coming from the urethra. It is most likely that there will be no pain.
Time to seek the urologist, the gland may be perfectly smooth or nodular. If nodular cancer is probably present.
If the case is far advanced and there is discomfort or pain then the admin of female hormones will give relief. Removal of the testicles is a little used
procedure. As a last resort an opening is made in the urethra from above or below to get relief for urination.

Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
   Posted 2/27/2010 5:37 AM (GMT -6)   
Thank GOD for the continuous improvements which have taken place in this medical field leading to sharp declines in prostate cancer mortality and huge increases in quality of life for treated patients!

Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 2/27/2010 6:42 AM (GMT -6)   
I've been following this thread since its beginning, and now feel that I must chime in with my own opinion.

Berdoo, I can't speak as someone with prostate cancer but I can speak as one directly affected by it. While individual situations vary greatly, my husband had 2 biopsies - the first was 8 samples and, 4 years later, a 10 core biopsy was done. He had both done in the urologist's office with lidocaine and a script for some valium-like drug to take the edge off. While not his favorite thing, my husband did not find the biopsy a hard thing to do. Uncomfortable yes; painful no.

I agree 100% with James - without a biopsy to confirm whether or not you actually have prostate cancer, you are in limbo.
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. PSA: 0.0 til July 2009. August 2009- 0.1, September 0.3, October back to 0.0, December 0.0. Thank you God!


JoeFL
Regular Member


Date Joined Oct 2009
Total Posts : 420
   Posted 2/27/2010 8:32 AM (GMT -6)   
berdoo -
 
Here is one more experience with a biopsy to add to your "collection". I took a small pill to "take the edge off" prior to the procedure. My urologist talked me through exactly what he was going to do before he did it so there were no surprises. I found the snips to take the samples to be uncomfortable but not painful. Had some blood in the urine for several days after. (I do realize that every person has a different definition of "pain")
 
I also agree with the point made earlier in the string that until you have a biopsy done you're just guessing about what may be going on in there. And if it comes back positive, you may well have some options for treatment that don't result in "misery for the rest of your life" as you stated in an earlier post. There are a lot of men on this site that have done just fine with their choice of treatment options. In the end, however, it is totally your call.
 
Joe (also 67)  

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. Blood in urine for a week. Side effects as expected -  some burning, frequency, urgency.   Resumed daily  1 ½ mile walk after 3 days. Side effects have subsided some in the last week.

 

BT followed with 25 IGRT treatments beginning Feb 15 (4500 Gy's). 

 


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4188
   Posted 2/27/2010 11:06 AM (GMT -6)   
Berdoo,
It seems you have gotten a lot of information about PC and procedures, but they are snippets of many things and you don't seem to have a plan that makes any sense.
Yes, PC is slow growing, but some PC is relatively fast growing and will kill you within 5 years.
Yes, most doctors don't know a lot about PC and give conflicting information. Some doctors actually know a lot and will steer you in the right direction without a conflict of interest; try Drs Barkin and Scholz in your area or even dr Doug Chin.
You can't make a plan or decision without information. Doing nothing is a decision and you don't have enough information about your situation to know if that decision is best.
PC is confusing, but with the right guidence it does make a lot of sense.
The basic rules are:
Know the biology of your PC
Match the treatment option to the biology
Pick the very best artist to perform the treatment (yes, medicine is an art)
Doing this will result in the most favorable outome. Guessing will result in a less favorable outcome.
JohnT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 2/27/2010 11:39 AM (GMT -6)   
James, John, Casey et al. and those who say Berdoo does not have a plan.

Berdoo does have a plan: "I PSA and DRE every 3 months. so far in 2 years there has not been a change the doc can feel." He is 67 and "my health is poor. sugar diab, high BP, high Tryglicerides, painful arthritus."
He is knows the statistics of various treatments and is aware that unless the PCA is agressive the treatment options have very little effect on mortality.

He is working on the assumption that what he has is slow growing and he will respond quickly if the PSA jumps.

You know me, that is not a choice I would make, I'd go with the biopsy and have it yanked. But then again I am 10 years younger and in otherwise very good health - albeit now with incontinence and ED. Maybe he does not want to add those two items to his already long list of health problems.

Just my two cents.
Jeff
Married 34 years, DX Age 56. First routine PSA test on April 8, 09: 17.8. Start 2 weeks of Cipro to rule out protatitis. May '09 PSA: 22.6, 3 weeks later: PSA: 23.2.
Biopsy 6/10/09: 7/12 scores positive, 20%-70%, Gleason 6=3+3. Bone and C/T scans neg.
RP DaVinci -7/21/2009 @ Univ of Roch Medical Center
Left nerve gone, right partial spared.
Catheter removed - 7/31/2009 Pathology report received:
Gleason 3+4=7, Tumor size: 2.5 x 1.8 cm, location: both lobes and apex.
Extraprostatic extension present; Perineural invasion: present, extensive.
No Malignancy in Seminal Vesicle, vasa deferentia, lymph nodes 0/13
Prostate mass 56 grams. Pathologic Stage: pT3aN0MX
Post Surgery Status:
Potency - 12/11 5 months, Still no activity, zip. Using pump daily since 11/11. No effect with 20 mg of Cialis or 100 mg of Viagra. Shots next See Uro 1/22/10 Trimix #1. Try 0.08- 25%, 0.12-25%, 2/26/10 try 0.16 First Success! 90%.
Incontinence - 8/20 4 full pads per day
.. 9/7 3-4 full pads per day (Try cutting down on fluids. Bad idea. I know.)
12/11 5 months: Still 3 pads per day. 400-450ml/day
2/26/10 7 months: Still 3 pads but leak is now 320 ml (5 day avg.)
Post Surgery PSA - 9/3 6 weeks - 0.05; 10/13 3 months - 0.04, 1/14 6 months - 0.05.


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4188
   Posted 2/27/2010 12:58 PM (GMT -6)   
Jeff,
You have a good point. Berdoo has a nodule which should be confirmed by biopsy. If he didn't have a nodule it would be an entirely different story. The nodule alone puts him into a high risk catagory.
JT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT

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