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.