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Regular Member

Date Joined Mar 2010
Total Posts : 31
   Posted 3/30/2010 4:27 AM (GMT -6)   
not sure wat to expext next  46 yrs old  biopsy posit psa 12 and gleason 8 or 4  4  havnt had a scan as yet as theres a waitin period here  forthat think it may be happening early june not sure as to wat road to go down yet  still dont understand al the medical mumbo jumbo just find it confuses me  and gets me quite depressed at times tend to ponder on the worse case outcome i proably dont understand where a lot of u guys are at yet  but r geting there so many options to consider ht rp brac ert itr etc al bit mind numbing  really

Veteran Member

Date Joined Sep 2009
Total Posts : 3172
   Posted 3/30/2010 6:40 AM (GMT -6)   

What's next is a whole lot of education and learning, so that you can better understand what is going on inside of you and what to do about it.

In my view, a $40 investment in two books will be your best next step. Go online and buy Stephen Strum's "A Primer on Prostate Cancer: The Empowered Patient's Guide", and Patrick Walsh's "Guide to Surviving Prostate Cancer."

You can shift the tide which is overwhelming you right now through education and learning. You can gain confidence and understanding by reading and re-reading those books. Then, use this board to supplement your learnings (but don't use this board as your primary source of learning).

best wishes...

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 3/30/2010 9:03 AM (GMT -6)   
Right on Casey, knowledge is your sturdy shelter and foundation to build upon and tell ' FEAR ' a scary four letter word , and a return answer with a scarier four letter word and a noun attached to it: e.g. _ _ _ _ _ _ _ to PCa and to bias doctors or agendas. You can get to know enough to see if things are being done righteous enough or not. Your scans (ct and bone type scans) which most patients end up getting are usually a total waste of money and time (Dr. Strum points out the huge waste in expense, why?) First off the scans are not definitive enough at all, to tell a patient your are 100% clear (it is a blantant lie if any doc says you are totally is unknown because of the inferiority of the machinery). Secondly, ok the scan shows I have extended PCa (mets etc.), yeap then you are under drug therapies for can rule in PCa...but it cannot totally rule out PCa, now unless you have a very high psa level (maybe even well exceeding 40 range and a number of positive cores and maybe high Gleason scores)..then it may show up in these scans!!! My scans were found clear and I noticed my uro-doc had a somber face with no change at all, naturally I was smiling thinking hey clear is contained!!! WRONG doesn't mean that either, means nothing found right now that is large enough to show up.

I had clear scans with some pretty ridiculous stats, so yours will likely be clear, do we have anyone on this forum found with definitive scans with PCa??? (excluding-Andrew/OhioState used color doppler and high risk scenario and John T. because probably most of us will not be able to get the Comidex scan(Holland)...which is proven superior methodology...just for this lesson John,  I was  excluding..also may prove a point on Combidex).
Hey a suggestion on your travels, do not mention you know anything about the scanning(you know zero let's say), and see what the doc says to you, after they are done and if he says all clear, then mention what  Dr. Strum(et al) acknowledge about such things, then see how he answers that??? Consider that clue number straightforth/direct and knowledgable is my doc???? The doc is going to have trouble with this one, especially with a patient found "clear", because we just spent thousands of dollar on this test(guarantees??). Well your insurance company did! If found clear ask him, is this 100% factor?   I prefer hearing the actual truth on anything as opposed to wishful thinking and especially on issues this important, but nobody has to groups there never is 100% agreement on anything. 

Dx-2002  (all bad news-good news still doing well currently  8 yrs. out, my brothers uro-doc said 1-2 yrs. and RIP)

Youth is wasted on the Young-(W.C. Fields)

Post Edited (zufus) : 3/30/2010 8:28:41 AM (GMT-6)

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 3/30/2010 9:43 AM (GMT -6)   

you are still in the "fear" stage. you have a PC dx with a Gleason 8 and a PSA of 12. the other gents are right on target. now, is the time for knowledge. now is the time for second opinions, or even a third opinion. the 2 books mentioned above, are great choices to get your started. as zufus has preached many , many times, knowledge overcomes fear.

we are here to support you, even to guide you, but none of us are doctors or specialists, and we are here if you need to vent, or to ask questions about things that just don't make sense.

even with your numbers, you have time to learn and to make an educated decision about what to do. don't be bullied by any doctor's choice for you, it needs to be your choice when you are ready to make a decision. if a doctor gets too pushy toward you, that's a danger signal.

keep close touch with us here, we can at least help you work through all of this, and you will know there's a bunch of us here, all rooting for you.

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, 3/6 Cath #13 out - 4 days, Cath #14 out - 27 days, Cath #15 - 3/29

Ed C. (Old67)
Veteran Member

Date Joined Jan 2009
Total Posts : 2460
   Posted 3/30/2010 10:31 AM (GMT -6)   
I had the CT scan and MRI and as Zufus mentioned, they both came out negative. It really doesn't mean a hell of a lot. My Gleason score after DX was 8 but my PSA was lower than yours. You can see from my signature how my treatment has gone so far. Educate your self on what treatment path you want and choose the best doctor to treat you.
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

John T
Veteran Member

Date Joined Nov 2008
Total Posts : 4268
   Posted 3/30/2010 11:53 AM (GMT -6)   
A little about scans: A Ct scan can only pick up a lymphnode that has a tumor greater than 10mm. In order for PC to produce a tumor of this size psa would have to be at leat 40 or most likely in the 100's. PC moves from the lymphnodes to the bones; so if the lymphnodes are clear there would rarely be any PC in the bones; again psa would have to be extraordinarily high in order to see anything.
Much better tests for lower levels of psas ar color doppler or MRIS or MRI with a contrast using a 3t MRI. At least in this case it may point out extracapsular extension, location and tumor size that are very useful pieces of information in any treatment recommended. PAP, 2nd opinion on biopsy slides with plodidy, and PCA3 can also provide more informatio than CT and bone scans. All this information together with partin tables and PC tools can give a much better picture of your PC. Once you have put all the pieces together you can then make an informed decision about your treatment and have a much better chance of a favorable outcome. If your doctor is unfamiliar with these or doesn't recommend them, then get a doctor who does. It's your life on the line, not his.

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.


Regular Member

Date Joined Jul 2009
Total Posts : 162
   Posted 3/31/2010 9:51 AM (GMT -6)   
The scans only provide assurance if cancer is found outside the prostate and in that case, it has to be pretty big. Otherwise, they provide no assurance that the cancer hasn't already metasized.
I have to say my uro, at least, doesn't suggest going gung-ho into something that, with a relatively low psa, is a waste of money in getting. 
Zufus...I cannot believe there are doctors that say you have "X" years to live but I have heard so many stories of this that it makes me sick. How does anyone know how one will respond to treatments/ better diet? Better to say "your condition is serious, we will attack it with our best treatments, change treatments, if necessary and keep you alive as long as God is willing. 
Age -57; Diagnosed 10/05 PSA 13.4 GS 7 (4+3) Organ confined (T2B)
Cryoablation 4/06 Allegheny Hosp-Dr Ralph Miller (Cohen/Miller)
Post Cryo Nadir 8/06 0.2
Rising steadily to 0.7 4/09 :-(
Steady at 0.7 (7/09)
Doubled to 1.5 (2/10) YUCH!
Hoping to qualify for salvage cryo or radiation

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