Origially posted on the New Prostate Cancer Info link.
The number was 20% not 22%
Onik et al. have now published data comparing the results of 3D-PMB with those from traditional TRUS-based biopsy data in 180 patients who had initially been diagnosed with unilateral cancer on TRUS biopsy. These patients were all considering some form of conservative management, and were restaged with 3D-PMB prior to making final treatment decisions. The 3D-PMB was carried out transperineally using a brachytherapy grid under TRUS guidance. Biopsies were taken every 5 mm throughout the volume of the prostate, and labeling of the specimen coordinates allowed accurate reconstruction of the
location and extent of each patient’s cancer.
The results of this analysis were as follows:
3D-PMB was used to obtain a median of 50 cores (with a standard deviation of ± 20.61).
110/180 patients (61.1 percent) were shown to be positive bilaterally by 3D-PMB.
41/180 patients (22.7 patients) had their Gleason scores increased to ≥ 7.
36/180 patients (20 percent) had negative results on 3D-PMB.
Complications of 3D-PMB were self-limited (in other words, they resolved over time without specific intervention).
14/180 patients (7.7 percent) required short-term urinary drainage using an indwelling catheter.
2/180 patients (1.1 percent) had blood in his urine (hematuria), and one of them required overnight bladder irrigation.
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.