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weesa
New Member


Date Joined Mar 2010
Total Posts : 8
   Posted 3/13/2010 11:47 AM (GMT -6)   
Hi! I'm a new member, and a loving, concerned girlfriend.

Sadly, my boyfriend has had some prostate issues lately, which brings me to this forum.

We're at a place where we're starting to research potential next steps online, and it's pretty scary. There's so much conflicting information out there, and it makes it hard to decide what the right course of action is. I guess I'm hoping someone can either point us in the direction of where we might find some answers, or offer their thoughts on our situation.

My boyfriend is 42, and in good health. While he has no family history of prostate cancer, and has no symptoms, there is a strong family history of colon and pancreatic cancer, and so he decided to err on the side of caution, and do yearly PSA screening (PSA & DRE).

He had a baseline PSA at age 40, which was 2.8, and the DRE was normal.

At age 41, the PSA remained at 2.8, and the DRE was normal.

This past January, the PSA increased to 3.2, and his PCP recommended being over-cautious and going to the urologist for the DRE and follow-up, despite the fact that he said he honestly believed the jump to be a fluke. (Not knowing it could affect his test results, we had sex 12 hours prior to the PSA blood draw.)

The urologist did the DRE, collected prostate fluid samples, urine, and drew blood for total and free PSA.

He just got a letter from the urologist with his test results, and a recommendation for biopsy: DRE, prostate fluid, and urine were all normal. The total PSA dropped back down to where it had been all along - 2.8, but the free PSA was low at 11%.


My boyfriend has concerns about biopsy - and is debating what to do about it. He's worried about the possibility of having cancer, but also is very concerned about the complications of over-treatment, given his age, and everything we've been reading about the majority of prostate cancers being insignificant, slow-growing, and non-life threatening. As well, he doesn't like the potential risks and complication associated with biopsy.

He'll be following up with the urologist this week, and will be asking about the pca3 test, and whether the results of it might be helpful in determining whether a biopsy is really necessary at this point.

Given the free PSA is low, but slightly above the 10% cutoff point, and the total PSA seems to not be increasing and is only slightly higher than the 2.5 typical for his age, he's wondering if the urologist is being a little jumpy or maybe over-cautious in suggesting a biopsy.

Any thoughts or comments on this would be most appreciated. This is our first experience with PC, we don't know anyone who's had it, and so we're quite frightened and alarmed.

Thank you for reading, and considering to comment.

kuls
Regular Member


Date Joined Mar 2010
Total Posts : 57
   Posted 3/13/2010 12:07 PM (GMT -6)   
Hi Weesa!

My husband (45) was just diagnosed, and we're considering all the treatment options at present. You can read our story on the board if you wish to.

As far as the biopsy, I would DEFINITELY recommend doing it! It may turn out to be negative (which would be great), it may turn out to be very low risk (which would then give him the option of Active Surveillance vs. immediate treatment), and finally, it will (hopefully) rule out aggressive disease!! If it IS a slightly more aggressive form, it will likely have been detected early enough for a successful treatment outcome!!

Good for you for being such a loving and supportive girlfriend!! Thoughts to you both, and keep us posted!!

Karen

weesa
New Member


Date Joined Mar 2010
Total Posts : 8
   Posted 3/13/2010 12:20 PM (GMT -6)   
Hi Karen,

Thank you so much for your reply!

I just read your story, and it's helpful to understand that we should take time for consideration and not quickly jump to conclusions and decisions. We're freaking out right now, to be honest. ;-)

We've been reading about biopsies being "like finding a needle in a haystack" - a biopsy might not find anything, given its 10-12 samples that may or may not be taken from a cancerous area. I guess one fear is that a negative biopsy will lead to a continual cycle of repeat biopsies - the numbers indicating that cancer is likely there, but based on the numbers, hasn't been found yet. Hence the thought of the pca3 test.

I will definitely post more, when I have more news.

And I'll certainly be watching for your news, and thinking of you both.

Thanks so much for the info, and your reply!
Lisa

kuls
Regular Member


Date Joined Mar 2010
Total Posts : 57
   Posted 3/13/2010 12:35 PM (GMT -6)   
If the biopsy were to come back negative, you wouldn't necessarily have to do a bunch of repeat biopsies.....you could always just monitor the PSA and free PSA levels at more regular intervals.

I can really understand where your boyfriend is coming from with his concerns about having the biopsy. Knowing my husband's situation RIGHT NOW (low-risk) I'm really thankful that he didn't have a screening PSA at age 40 (even though I'm an advocate of doing it), which may have prompted a biopsy, and us having to deal with a diagnosis back then! If he hadn't have had his PSA/biopsy at age 45 and had waited until age 50 to get it done, would things be any different?? Who's to say.........

All I know is that while going through this is hellish, We're both very grateful he caught things in the early stages!! Now that we know about it, we have to deal with it in one way or another.....there's no going back! NO regrets, and NO looking back!!

I am asking ALL my friends and family members to get a baseline PSA at 40......at least if we had had one at 40 it would have given us the valuable information as to how quickly it had climbed. I'm sure though, that others here will give you their valuable, more experienced opinions!!

Good luck with whatever you decide to do!!
1st PSA done (age 45) at routine physical  PSA 3.8
DRE at physical indicated no abnormality other than slightly enlarged
Consult with urologist Jan. 2010---DRE negative, PSA 3.89
Biopsy Feb. 10, 2010:  Gleason 3 + 3, 2/10 cores pos. (5% in one core, <5% on other core) 1% of core volume positive


weesa
New Member


Date Joined Mar 2010
Total Posts : 8
   Posted 3/13/2010 12:56 PM (GMT -6)   
When this first started - when the PSA jumped up, we were both so annoyed at the PCP. I kept saying, "If it's a fluke high number because we had sex a few hours before the blood draw, why go to a urologist?? Why not ask the PCP to repeat the PSA to confirm it's not really elevated, FIRST, to see if you even need a urologist."

It's funny, but we were expecting the repeat PSA to be normal, and then he was going to not screen again until he was 50. Of course the repeat PSA IS normal, as is the DRE. The only suspicious thing is the free PSA of 11%. If he'd first repeated the PSA with the PCP, then he wouldn't have even gone to the uro, and we wouldn't have this odd, free PSA number to worry about.

Without a rising PSA, and no symptoms, we wouldn't be dealing with this at all, and at this early age. So I guess while I wish my BF hadn't gone the urologist, now that we're here there's nothing to be done but worry and investigate.

Thanks so much for sharing your feelings. It's very helpful....

60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2215
   Posted 3/13/2010 12:58 PM (GMT -6)   
Karen and Lisa,
Glad you found each other and also in the process got, and gave good advice.
Michael
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
Michael


kuls
Regular Member


Date Joined Mar 2010
Total Posts : 57
   Posted 3/13/2010 1:02 PM (GMT -6)   
It's all pretty crazy-making, isn't it??? I don't know much about free PSA, but maybe you guys could wait and just test it again before proceeding with a biopsy??? I'd be tempted to talk to the urologist about doing that instead.....

Again, I'm new to all this, so hopefully some of the "experts" can give you some good advice!

Chin up!
Karen
Husband's 1st PSA done (age 45) at routine physical  PSA 3.8
DRE at physical indicated no abnormality other than slightly enlarged
Consult with urologist Jan. 2010---DRE negative, PSA 3.89
Biopsy Feb. 10, 2010:  T1c, Gleason 3 + 3, 2/10 cores pos. (5% in one core, <5% on other core) 1% of core volume positive


weesa
New Member


Date Joined Mar 2010
Total Posts : 8
   Posted 3/13/2010 1:19 PM (GMT -6)   
It is making me crazy!!

I did some research on free PSA - I don't know exactly how they calculate it, but it's used to differentiate between harmless, benign prostate enlargement (BPH) and prostate cancer. When prostates are enlarged without cancer, the free PSA is higher than in a prostate with cancer.

From what I've read, they like to see free PSA at 25% or higher. Under 25% and they're concerned. Under 10% means cancer is suspected and likely.

I hope the experts will chime in as well! I'm curious how much weight this free PSA score carries... especially as there is no enlargement in this case.

I think we should all go out to a movie, forget about this for a bit, and enjoy the day. ;-)

And thank you, Michael, I AM glad to have connected! And nice to meet you, as well.

Lisa

Uncle Harley
Regular Member


Date Joined Feb 2009
Total Posts : 79
   Posted 3/13/2010 1:31 PM (GMT -6)   
Weesa, Welcome to our little club here. You'll find quite a few opinions here on what you should do. The first thing to remember is PC is slow to cause major problems. With your BF's low PSA, you don't have to decide on treatment any time soon. Take your time making decisions, read all you can, & continue to visit us here. There's several great books posted in the top of the forum, many available at a public library. My 2 cents says the urologist wants to do a biopsy to cover his/her ***. I would definately retest PSA with no sex prior as you stated. I wish that's what I would have done. My PSA is lower now than when I went to the uro with a high velocity reading. Nearly steady for over a year now. My biopsy showed a low grade cancer that many men over 50 have. So now I'm in Active Surveilence, monitoring PSA every 6 mo. If you have any ?'s just ask away.
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 61


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 3/13/2010 2:50 PM (GMT -6)   
Welcome to HW, to be completely on the safest side, I would go for the biopsy, as a general rule, they are unpleasant but not a major pain event (I had 3). At this point, only a prostate biopsy is going to detect PC. We have men here with full blown PC with PSA scores no higher than you mentioned. If there is cancer now, hopefully it would be small, minimal, and contained at this point, and he might be best served by AS as mentioned above. If there's not, then you did all the right thing, and have more than a good baseline if things start to change in the future. You can have a raging case going on, and never have a positive DRE or high PSA, and without the biopsy, there is really no way of knowing for sure. Tough call either way, so you two will have to do you homework as you are doing, and make your own choice.
The free PSA % # is low enough to be suspicios at this point.

Also depends how much of a gambler one is. Best time to catch PC is when it is tiny and contained and can be controled.

Please keep us posted.

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


tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2840
   Posted 3/13/2010 3:09 PM (GMT -6)   
Lisa and boyfriend -
Sorry you are in such a panic , but as the other postings have stated, you are not in a rush and have time to examine what is going on in your boyfriend's body and prostate. And to learn what treatments are out there.

One way to help take pressure off you two is to think of it as your boyfriend has prostate problems and you need to know more about it - it may be cancer in its very early stages - it may not be - the tests will help with more information on that.

One thing to consider regarding family history of colon and pancreatic cancers - that is a completely different type of cancer and does not make the boyfriend more subject to PCa ( prostate cancer) - if there are a family history of breast cancer, then early detection would be benefit to him for PCa ( they are similar types of cancer). My urologist/surgeon dismissed my family history of colon / bladder / sarcoma cancers .

Wishing you and your boyfriend all the best - and no sex for 3-4 days before PSA ( I could be cruel and say a week - others here will have their own timelines )
hugs
BRONSON
.................
Age: 54 - gay - with spouse, Steve - 59
PSA: 04/2007- 1.68 - 08/2009 - 3.46 - 10/2009 - 3.86
Confirmation of Prostate Cancer: October 16, 2009 - 6 of 12 cancerous samples , Gleason 7 (4+3)
Doctor: Dr. Mohamed Elharram -Urologist / Surgeon - Peterborough Regional Health Centre
Radical Prostatectomy Operation: November 18, 2009 , home - November 21, 2009
Post Surgery Biopsy: pT3a- gleason 7 - extraprostatic extension - perineural invasion - prostate weight - 34.1gm -
ED Prescription: Jan 8/2010 - started daily 5mg cialis - girth back to normal -but not much length - will go for trimix in April when I see doc
Incontinence: 3-5 pads/1-2 clothes changes/day- finally seeing improvement - March 3, 2010 - week 14 after surgery -
location: Peteborough, Ontario, Canada
Post Surgery-PSA: to be announced - April 8, 2010
............


medved
Veteran Member


Date Joined Nov 2009
Total Posts : 1096
   Posted 3/13/2010 3:49 PM (GMT -6)   
I would re-test the psa, making sure to use the same lab and the same assay as the prior tests, but abstaning from sex for at least 48 hours before the blood draw.   I would have them re-test free psa at the same time.   I would not take much comfort in 11% free psa, though there is some debtate about the utility of percent free psa where total psa is <4.   I would also ask the urologist to estimate the prostate volume, since a larger prostate will, ordinarily, generate more benign psa.  (In other words, 2.8 psa is more concern in an average sized prostate than in a significantly enlarged prostate).
 
It might make sense to do a PCA3 too, as you suggest.  However, there are some issues regarding PCA3, including determining the appropriate cutoff to use.  (The higher the cutoff, the greater the specificity of the test, but the lower the sensitivity).  If this does not make sense to you, let me know and I will explain.
 
In your BF's situation, I would personally do the PCA3.  However, if the bpsa has increased over 2.8 upon re-test, then I would do the biopsy unless both the percent free psa and the PCA3 indicated low risk.   Of course, that is just my judgment, and others could reach a different conclusion.   But my own thought would be that, for a young guy in good health, there is significant value to diagnosing p ca, if it is there, within the "window of curability."
 
One final comment:   You say your BF's total psa is only slightly higher than  the 2.5 psa that is typical for his age.  It is not true that a psa of 2.5 is typical for a man in his early 40s.  It is very high for a man of that age -- certainly in the highest 5%.  A typical psa for a man in his early 40s would be around .6.    That does not mean your BF has pca, but it is certainly high enough to  pay attention to.
 
Best wishes,
  
 
 
 
Age 45.  Father died of p ca. 
My psa starting age 40: 1.4, 1.3, 1.43, 1.74, 1.7, 1.5
 

Post Edited (medved) : 3/13/2010 2:54:31 PM (GMT-7)


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4080
   Posted 3/13/2010 3:54 PM (GMT -6)   

Hi Lisa:

First of all remember that none of us here are urologists, we just play them on the internet!  Secondly, while your friend's % free PSA score is in the low end of intermediate it does not necessarily indicate cancer.  I also suspect your urologist is practicing defensive medicine which is not an illogical approach.  As David said, if you want to be safe and conservative, progressing to biopsy is a resonable step (a 16 core sample is state of the art...not 10 or 12).

However, if it was me with those stats, my next step would be a PCA3 test.  See the link:

Welcome — PCA3

If that indicated a high chance of cancer, I would proceed to biopsy.  If not I would re-take PSA, free PSA and PCA3 tests every 6 months to check on changes.
 
But...I'm not a doc, am not in your firend's shoes and don't know his tolerance for risk.  So...I provide the info with those disclaimers and wish you the best.  Please stick around and let us know how things progress.
 
Tudpock
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"!

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 3/13/2010 4:26 PM (GMT -6)   
Welcome to the forum. A question, I may have missed the answer. In what order did the urologist do the testing dre then blood draw or reverse? If the first, then a psa retest is indicated. In any case, another test is easier than a biopsy, so I'd have another, without sex, dre, biking or any other very strenous activity involving the abdomen and pelvic area. That's what I'd do, if it were me.
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


weesa
New Member


Date Joined Mar 2010
Total Posts : 8
   Posted 3/13/2010 4:29 PM (GMT -6)   
Thanks to everyone for all the helpful answers and info thus far. You've given us things to consider and think about.


As far as the repeat PSA without sex - we actually already did that, and the total psa was back down to its usual 2.8.

I say 'usual' because it's been 2.8 since his baseline at age 40.

I will definitely stick around! I want to share this forum post responses with him, and see what he thinks. I think he's leaning toward pca3, which seems like it might help clarify whether a biopsy would be a good idea.

Thanks so much!! Will write me as I have time...

Lisa

weesa
New Member


Date Joined Mar 2010
Total Posts : 8
   Posted 3/13/2010 6:34 PM (GMT -6)   
The repeat PSA was done with abstinence and about 2 weeks after DRE. Not sure if it was the same lab that processed. I think not, actually.

Gordy
Veteran Member


Date Joined Jun 2005
Total Posts : 528
   Posted 3/13/2010 7:16 PM (GMT -6)   
Weesa- I post here very rarely these days - only stop in on occasion to see if there is anything which pertains to my particular (unusual) situation, and that is almost never.

My advice: pay attention to what Tudpock18 says and, as far as the others go, note their "Date Joined" and Signature and follow their advice accordingly. The Signature gives an insight as to whether the poster's condition has any relevance to your boyfriend's and also gives insight into the poster's current condition, in part, based on his choice of therapy and choice of practitioners.

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7197
   Posted 3/13/2010 7:35 PM (GMT -6)   

I was in a similar position and I did go the PCA-3 route, hoping to avoid a biopsy. That test is very specific for cancer. Unfortunately, for me it did lead to a biopsy (see my signature). But that is the next step I would think!

 

Mel


63 years old . PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (Free PSA 24%),  after 45 days on cipro! DREs have always been normal. PCA-3

Biopsy on 11/30/09. 5 out of 12 cores positive. Gleason 4+3. 2 cores were 3+3 (one 5% and the other 30%) on one side. On  other side:2 cores are 4+3 (5%)--1 core 3+4 (30%) no peri-neural invasion. prostate is 45 grams. Stage: T1C.  

Surgery with Dr. Menon at Ford Hospital, 1/26/10. He says all looked good. Spared nerves. Unfortunately: Pathology Report: G 4+3 (65%-35%). Cancer in 15% of gland. Lymph Nodes: Clear.  Perineural Invasion: yes. Seminal Vessical Involvement: No.  Extraprostatic Extension: yes.  Positive Margin: Yes-- focal-- 1 spot .5mm. Final Weight is 52.7 gms. 

 Incontinence: joined that club-- definite leaks—1 pad/day. Night is dry, was  using 1 pad at night for security, but pretty much dispensed with that most nights. Update: no pads at night. No pads while at home, but still very uncomfortable. Use 1 pad for out-of-house activities. Suddenly got MUCH better on 3/10/10, almost overnight. Still some urgency but no pads about 90% of the time.

Next Event: First post-op PSA on 3/10/10--DRUM ROLL: 0.01


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7197
   Posted 3/13/2010 7:39 PM (GMT -6)   

Corrected signature to include PCA-3 results.

 

Mel


63 years old . PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (Free PSA 24%),  after 45 days on cipro! DREs have always been normal. PCA-3 was about 75 (way above the 35 threshold). That led to:

Biopsy on 11/30/09. 5 out of 12 cores positive. Gleason 4+3. 2 cores were 3+3 (one 5% and the other 30%) on one side. On  other side:2 cores are 4+3 (5%)--1 core 3+4 (30%) no peri-neural invasion. prostate is 45 grams. Stage: T1C.  

Surgery with Dr. Menon at Ford Hospital, 1/26/10. He says all looked good. Spared nerves. Unfortunately: Pathology Report: G 4+3 (65%-35%). Cancer in 15% of gland. Lymph Nodes: Clear.  Perineural Invasion: yes. Seminal Vessical Involvement: No.  Extraprostatic Extension: yes.  Positive Margin: Yes-- focal-- 1 spot .5mm. Final Weight is 52.7 gms. 

 Incontinence: joined that club-- definite leaks—1 pad/day. Night is dry, was  using 1 pad at night for security, but pretty much dispensed with that most nights. Update: no pads at night. No pads while at home, but still very uncomfortable. Use 1 pad for out-of-house activities. Suddenly got MUCH better on 3/10/10, almost overnight. Still some urgency but no pads about 90% of the time.

Next Event: First post-op PSA on 3/10/10--DRUM ROLL: 0.01


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2457
   Posted 3/13/2010 8:16 PM (GMT -6)   
Weesa,
The 11% free PSA is a worry. Before I had my biopsy, I had a PSA of 3.8 and a free PSA of 11%. My Urologist suggested that I should have a biopsy. He felt that with such low free PSA I had a 30% chance of having PC. I did have a 12 core biopsy and the rest is history. The biopsy was not painful at all for me but, there are some on this board who felt differently. Take your time and remember he still has a 70% of not having PC. I wish you and him the best.
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09 Dr Fagin, Austin TX
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm in circumference.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 4 months
8 weeks PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1
8 months PSA test 10/9/09 result <0.1
11.5 months test 1/21/10 result 0.004


defender3
Regular Member


Date Joined Nov 2009
Total Posts : 98
   Posted 3/13/2010 9:37 PM (GMT -6)   
+1 to being a loving girlfriend and taking steps so you can be your own best advocate. I'd also recommend the biopsy. It's an office procedure that while uncomfortable (and psychologically stressful for your man), can really aid your peace of mind and actually help decide direction whether the biopsy is good news or not so good news. In addition, the biopsy, if negative, will also provide a pathological test result for PIN (Prostatic Intraepithelial Neoplasia), which can be valuable information. For example (and simplistically), a low grade PIN alerts you to the potential for cancer and lets you take actions well before a cancer develops (which could be 10 years). If a high grade PIN is detected, it's basically a pre-cancer warning. You’ll have time to make reasoned decisions before the cancer erupts (which it will as a high grade PIN), but again, maybe not for some years. I don't want to sound patronizing, but you’ve taken some excellent steps so far, I’d suggest one more, the biopsy. My best to you both!

Gleason7
Regular Member


Date Joined Feb 2010
Total Posts : 111
   Posted 3/14/2010 10:03 AM (GMT -6)   
Fact his PSA went back down (as I recall to 2.8) I would continue on with three or six month PSA's. If you decide to proceed with a needle biopsy make sure his urologist incorporates a "numbing" medication!!! Personally, beginning when my prostste became enlarged and my PSA began elevating the needle biopsy's began. After two nine sample biopsy's over a four year period both negative, I decided to change urologists (didn't offer NUMBING)! Finally a twelve sample biopsy 12/23/09 found two cores with the big "C" and PSA had leveled of at 6.8. After being informed a large prostate complicates some forms of treatments I decided to go the Henry Ford Vattikuti robotic prostatectomy route. (procedure offered lots of places these days). Had mine 2/10/2010 and feeling fine. BOTTOM line for me would be to do a few more PSA's before going for the biopsy's

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7197
   Posted 3/14/2010 10:47 AM (GMT -6)   

Hey Gleason 7:

I had mine done at the same place on 1/26. Just curious-- did Dr. Menon do yours? Are you from Michigan?

Mel


63 years old . PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (Free PSA 24%),  after 45 days on cipro! DREs have always been normal. PCA-3 was about 75 (way above the 35 threshold). That led to:

Biopsy on 11/30/09. 5 out of 12 cores positive. Gleason 4+3. 2 cores were 3+3 (one 5% and the other 30%) on one side. On  other side:2 cores are 4+3 (5%)--1 core 3+4 (30%) no peri-neural invasion. prostate is 45 grams. Stage: T1C.  

Surgery with Dr. Menon at Ford Hospital, 1/26/10. He says all looked good. Spared nerves. Unfortunately: Pathology Report: G 4+3 (65%-35%). Cancer in 15% of gland. Lymph Nodes: Clear.  Perineural Invasion: yes. Seminal Vessical Involvement: No.  Extraprostatic Extension: yes.  Positive Margin: Yes-- focal-- 1 spot .5mm. Final Weight is 52.7 gms. 

 Incontinence: joined that club-- definite leaks—1 pad/day. Night is dry, was  using 1 pad at night for security, but pretty much dispensed with that most nights. Update: no pads at night. No pads while at home, but still very uncomfortable. Use 1 pad for out-of-house activities. Suddenly got MUCH better on 3/10/10, almost overnight. Still some urgency but no pads about 90% of the time.

Next Event: First post-op PSA on 3/10/10--DRUM ROLL: 0.01


dogyluver
Regular Member


Date Joined Sep 2009
Total Posts : 35
   Posted 3/15/2010 6:31 PM (GMT -6)   
Ejaculation can effect psa results as can excersizing, and bike riding. The good thing is your boyfriends psa is going down. As far as your research goes stick to major hospitals, Mayo Clinic, Cleveland Clinic and keep in mind that no matter where you do your research the stats can and usually are false. The only patients that they accept for their programs are of the very best physical health other than prostate cancer usually non-smoker, non-drinker, physically active, and under the age of 50. Get more than 1 opinion and keep in mind that whatever their speciality is that is what they recommend. So stick with the doctor that you feel comfortable with.
April 09 PSA 3.2
May 09 DRE enlarged prostate
July 09 PSA 5.2
July 09 Biopsy 5 out of 12 malignant
Gleason score: Primary 3, Seconary 4 Total 7
August 24, 2009
Radical Open Prostatectomy Andocarcinoma of the prostate
% of 4 and/or 5: 1-25%
% of 3    76-90%
Androgen deprivation effect: Negative
Apical involvement: Positive
Apical marginal involvement: Negative
Extraprostatic extension (EPE): Negative
Margin: Negative
Bladder Neck Shave: Negative
 
Areas of involvement: Right and Left lateral, posterolateral and posterior and left anterior apex and mid prostate
Principle area of involvement: Right and left lateral, posterolateral and posterior apex and mid prostate
Focality: Multifocal
Volume: Medium(100 Sq mm)
Ejaculatory Duct: Negative
Seminal vesicles involvment (SVI): Negative
Vas deferens N/A
High Grade PIN: Positive
Neuroendocrine differentiation: Negative
 
Pathologic Stage: pT2c NO MX

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