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Regular Member

Date Joined Mar 2010
Total Posts : 37
   Posted 3/10/2010 11:29 AM (GMT -6)   
Hello everyone.  After watching my PSA go up steadily from 2.35 in October of 2005 to 7.68 in January 2010, an "all clear" biopsy in February 2009, I got the not-so-good biopsy on February 16, 2010.   With a 12 needle sampling, one showed cancer and two indicated Prostatic Intraepithelial Neoplasia, High Grade.  My Gleason Score is 7 (3+4).  I am leaning toward the diVinci surgery and am going to a surgeon in Atlanta, Ga (about a 2 1/2 hour drive) next Tuesday to discuss.  Needless to say I'm apprehensive (a good word for scared/nervous/worried!) going to an unknown doctor except what I have found out on the internet.  His name is Dr Scott Miller and according to the info I have does approximately 300 diVinci procedures a year at St Josephs Hospital in Atlanta.

Veteran Member

Date Joined Jul 2008
Total Posts : 966
   Posted 3/10/2010 12:09 PM (GMT -6)   
Welcome Chatuge. Sorry that you had to join us. Don't know the doctor you are going to see, but make sure that you review all the options before making a final decision. One thing I would advise and that is get a second opinion on your biopsy. A Gleason 7 removes you from doing nothing at this time, where as a Gleason 6 may allow you to defer any treatment for the near term. All this of course depends on other stats, such as age and the percentage of cancer found in the one core. The other two cores with HGPIN could tip the tables either way depending on what your doctors protocol is.

Regardless, welcome and keep us posted on your journey. If you have any questions, there are many knowledgable folks here that will respond.
You are beating back cancer, so hold your head up with dignity
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 

Veteran Member

Date Joined Oct 2008
Total Posts : 3257
   Posted 3/10/2010 12:12 PM (GMT -6)   
Hey Man No worries. Seems you have cought it early and your longterm prognosis for a cure is real good. Surgery doesnt sound like fun but what the heck else you gonna do. Well actually there are many options. I know when the cancer word comes into play the first thing you think is get it out of me. Relax and make a good well informed decision. Todd
Age at dx: 42 age now 45
Treated for sciatic nerve pain 6 months prior to dx.
Heavy amount of blood in urine Unable to urinate 
Lung x-ray for pnumonia revealed multiple lesions in each lung
P.S.A. at time of dx. 3216.14
Began lupron and casodex
Cat scan showed large mass in the pelvic area affecting the bladder multiple nodules in both lungs and lymph node envolvement.
Bone scan revealed possible bone involvment in the pelvic area
Biopsy 12 of 12 cores positive gleason 3+4=7
P.S.A.s since lupron 2946, 1274, 532, 5.01 1.23, .09
Begining jan 08 psa .o9, .25, .44, .86, .73, 1.34, 1.49. Doubling time is a little over 3 months
Cat Scan 12/12/08 Prostate normal size and shape. No tumors detected. Left lung clear of all nodules right lung showing only benign scar tissue. Lymph nodes normal
Bone Scan 12/24/08. Clean!!! went off casodex January 4 2009
Current psa 2/13/09 .16
Latest P.S.A. 0.05 newest P.S.A. undetectable

Veteran Member

Date Joined Jan 2009
Total Posts : 2243
   Posted 3/10/2010 1:39 PM (GMT -6)   
Dr. Miller is the best in the State and maybe beyond. Have had a few friends use him and also my urologist. He is well known and likely does at least 300 a year.Wish I had gone to him, but he was not in my insurance network. I thought he used Northside Hospital but could be wrong, but they are in the same area of town. You will be in great hands my friend. Not sure if you live up in Towns County, just guessing by Chatuge, as it is on beautiful lake. Your about 45 minutes north of me if so. Keep us posted as you can.
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
Margin slightly involved
2 pads per day, 1 depends but getting better,
8/5 1 depend at night only, now none
 started ED tx 7/17, slow go
Post op dx of neuropathy
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5
Starting IMRT on 1/18/10
Great family and friends

Regular Member

Date Joined Mar 2010
Total Posts : 37
   Posted 3/10/2010 2:52 PM (GMT -6)   
Thanks guys.  I am also new to this forum stuff so please bear with me.  I'm 67 and consider myself in overall good health otherwise--so, am anxious to talk to the doctor Tuesday.  For Michael, I live on the North Carolina side of the lake and I sure like hearing what you said about Dr Miller.  I have been folowing this forum for several days but just registered.  The amount of information and support here is-to use the over-used teenage word-awsome!

Veteran Member

Date Joined Mar 2009
Total Posts : 739
   Posted 3/10/2010 3:16 PM (GMT -6)   
Go to the link below and hit the panic button, it helped me when I was first diagnosed.
Age 51yrs
6 out of 8 cores positive 3 X 60% / 3 X 10%
PSA 4 Gleason Score 3+4=7 Stage T1c
Robotic Surgery 24/12/08
Upgrade Gleason Score 4+3=7 Gleason Differential 60%/40%
Stage T2c Three small foci total volume <10%
Neg Margins and Nodes
Nil - Extraprostatic Extentions
Dry less than 1 week. ED- okay with Meds.
PSA at 12mths no change remains 0.03
"Everyday in Everyway I get better"

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 3/10/2010 3:24 PM (GMT -6)   

Welcome here, definitely sounds like you are one of us now. I am in SC, not from Greenville, so not too far from you.

Please stick with us and keep your reports coming of your journey.

And ask as many questions as you need, anytime you want.

Great bunch of guys and girls here.

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, no problem post SRT
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  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, Caths #13 & #14 same time, 3/6 Cath #13 out - 4 days

Cajun Jeff
Veteran Member

Date Joined Mar 2009
Total Posts : 4119
   Posted 3/10/2010 4:56 PM (GMT -6)   
Welcome guy...As David said. Fire away with the questions. The more you know before you go in the better. You also get to make an educated decision. Best of luck. Do keep us posted.

Cajun Jeff
AGE:58, 57dx. PSA 5.4
Biopsy: 9/08 Gleason 3+4=7
open RP: 10?08 Nerve sparing. Path Report : GS 3+3=6 Stg pt2c margins clear
Cath for 10 day. Dry day after removal of Cath
PSA @ 3 months <0.1
6 months <0.1
9 months <0.1
12 months <0.1
16 months <0.1

ED Started VED at 3 months, pills followed VCL none did much, tried MUSE at 9 months (YUCK) Hated it. 15 months out injections Caveject (succecc)

James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4463
   Posted 3/10/2010 5:14 PM (GMT -6)   
Welcome to the club....Keep us updated on your journey smilewinkgrin
James C. Age 62
Co-Moderator- Prostate Cancer Forum
Gonna Make Myself A Better Man: www.youtube.com/watch?v=a6cX61oNsRQ&feature=channel
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

Veteran Member

Date Joined Apr 2009
Total Posts : 990
   Posted 3/10/2010 5:32 PM (GMT -6)   
Welcome, we are glad you found us but sorry you are here. If you are not having that "hit upside the head" feeling that comes with the word cancer, then you are not paying attention. BUT know that PC has a high cure rate and lots of time for decision making.

You will probably want to organize your history (PSA tests , biopsy's etc.) into a sig. Look for Control Panel in the blue bar on the upper left. There are a lot of surgery guys here, but don't let that deter you from considering all options.
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
9 mo. PSA 0.00 -- 1 light pad/day ED remains

Veteran Member

Date Joined Apr 2007
Total Posts : 823
   Posted 3/10/2010 8:33 PM (GMT -6)   

Hi Chatuge


Sorry you have to be my NC brother, but glad you found us.  I have a friend and former co-worker who lives on that beautiful lake.  If I had a view on my deck like he has on his I would never leave.  Atlanta is a lot closer from where you live but if you want to travel  to Durham like I did, let me know and I'll give you contact info for my Dr. at Duke.


Take care



age at dx 54 now 57
psa at dx 4.3
got the bad news 1/29/07
open surgery Duke Medical Center 5-29-07
never more than 2 pads
ED is getting better
the shots work great, still can't give them to myself
two years of zero's
Retired again after 36 years February 1, 2010

Regular Member

Date Joined Mar 2010
Total Posts : 37
   Posted 3/10/2010 8:37 PM (GMT -6)   
I so "shook up" I may have spoken too soon about going to a Dr Scott Miller in Atlanta.  As Michael stated he was not in his insurance group-he may not be in mine either!  Hope to find out in the AM when their office opens.  I also have an appointment with a Dr Nikhil Shah in Atlanta on the 22nd of March.  It was to be for another opinion but if Miller doesn't accept my insurance, it may be a first opinion!  Dr Shah does operate in St Josephs Hospital--anyone here have any experience with Dr Shah or St Josephs?

Regular Member

Date Joined Dec 2009
Total Posts : 347
   Posted 3/10/2010 8:53 PM (GMT -6)   
Welcome to the club that no one wants to join. Glad your here great place and great people. Make yourself at home we did. Keep us posted and ask all you want. Seems like your in western NC I'm in Raleigh.
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
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

Veteran Member

Date Joined Jan 2009
Total Posts : 2243
   Posted 3/10/2010 9:43 PM (GMT -6)   
Dr. Shah did mine and was trained at Henry Ford Hospital in Michican. He has done thousands of these operations. If you do see Dr. Miller Tuesday ask about his insurance policy. He does feel that insurance does not pay him what he is worth, and they might not. But if he bills then you would pay the difference between what he charges and what your insurance pays him. I also think the Hospital was out of network so I just felt like I didnt want to out of pocket all of those expenses. If it was a few thousand I might have gone that route.
Dr. Shah operates out of St. Joseph Hospital which was named one of the five best Hospitals in the state of Georgia by Fortune magazine. First rate place. I do not think you could go wrong with either one, but if I had the extra money I would have likely taken Dr. Miller. Your in a good situation so take your time, speak to both men if possible and then make your choice.
Take a walk around that beautiful lake in the morning or just do something you enjoy doing to help ease the anxiety. I almost drove up to Hiawassee this last week to see Jeff Bridges in Crazy Heart which is playing at Fieldstone Cinema. Keep us posted and just take one step at a time and it will work out.
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
Margin slightly involved
2 pads per day, 1 depends but getting better,
8/5 1 depend at night only, now none
 started ED tx 7/17, slow go
Post op dx of neuropathy
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5
Starting IMRT on 1/18/10
Great family and friends

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