What should I expect

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Woodworker
Regular Member


Date Joined Apr 2010
Total Posts : 90
   Posted 4/2/2010 8:11 AM (GMT -6)   
Age : 56
2 cores of 12 positive
PSA 2.7; Gleasen (3+4) 7
 
I just received my diagnosis about 5 days ago. The decision has been made to do robotic assisted surgery. I expect the surgery to take place in about
6 to 8 weeks from now. My question is, what can I expect after surgery. I am talking about post-operative treatment, problems, etc.  Any inputs would be greatly appreciated.
 
 

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 4/2/2010 8:28 AM (GMT -6)   
Woodworker,

First, welcome to HW Prostate Cancer. This was a great place to come to, now that you have a PCa diagnosis.

My first thought, is that you were only diagnosed 5 days ago. And you have already made up your mind about your primary treatment? That sure isn't give you much time to think about options and choices. With a Gleason 7, I agree that it needs to be treated, but have you thought through all of your choices? Not questioning your decision, as much as the shortness of time. Robotic Surgery is a common and well used treatment here, but like any surgery, it can come with a big price as far as side effects and quality of life issues.

Some here would reccomend getting a second opinion on your diagnosis.

I had open surgery with an agressive and fast acting Gleason 7 myself. If you go for surgery, we can help you with any phase of your surgery, pre-surgery and post surgery, dealing with incontinence issues, and ED issues.

My "specialty" from experience only is in the areas of catheter use and care, and a good understanding of pain managament. Be happy to help answer any questions you have.

We will support any decision a man makes here for treatment, but just wanted to make sure that your weren't rushing into surgery before you had a chance to slow down and think about what that really means. Whether it be robotic or open, PC surgery is a very complex and invasive, life changing surgery. So its important that one newly diagnosed knows what he is getting into, and what the risks and rewards can be.

No such thing as a dumb question here. The brothers and our dear sisters here, will more than eager to help you and support you along the way.

Please keep us well 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, 3/6 Cath #13 out - 4 days, Cath #14 out - 27 days, Cath #15 - 3/29


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 4/2/2010 10:01 AM (GMT -6)   
Woodworker, I don't have any advice about surgery except to tell you that it is invasive and major...

I am curious - and hope you don't mind my asking - but with a PSA of 2.7 at age 56, what led you to do the biopsy? Was there a sharp increase over time? A nodule felt on exam?
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (solitary focus of extraprostatic extension). Perineural tumor infiltration present. Apex margin, bladder neck and SVs negative. Final Gleason 3+4. PSA: 0.0 til July 2009. August 2009 - 0.1, September 0.3, October back to 0.0, December 0.0, March 2010 0.0. Next PSA in 6 months. Thank you God!


Woodworker
Regular Member


Date Joined Apr 2010
Total Posts : 90
   Posted 4/2/2010 10:14 AM (GMT -6)   

David

I appreciate your response. When I spoke to the surgeon he did point out to me that a surgeon would have a tendency to push surgery and an oncologist would lean towards radiation. The surgeon did offer to make me an appointment with an oncologist for a second opinion. I passed on the offer.

Instead I made an appointment with my Primary Care Physician. It is his attention to detail that got me in for the biopsy. My wife (a retired nurse) and I went through a lot of doctors  before we found one that we felt was competent and actually talked to you.  As a result we trust his judgment. 

When I asked his opinion he immediately told me surgery and why.  When he found out who my surgeon was he was not happy with that and immediately made arrangements for somebody that he thought was better qualified. After reading the background of both surgeons I agree. 

I left that appointment with the feeling that my PCP was making a deliberate effort to make sure my best interests were served.

Before making my decision, I did look at radiation as well.

I considered the side affects of both radiation and surgery. I also read the stories of quite a few prostate cancer survivors as well.  I was leaning towards surgery before I met with my Primary Care Physician. He was the straw that finalized the decision.

It is my understanding that with surgery the prostate is sent to the lab and tested to see how bad the cancer was (level) how wide spread it was and if it made it to the outer part of the prostate( which would lead one to believe that cancer may have spread beyond the prostate).  I did not see anything that indicated to me that this information would be available by any method other than surgery.

It is because of this information collection  and my PCPs input that I chose surgery.  I realize there are not any absolutes. But I felt like this was the closest thing to it.

Kevin

 


Woodworker
Regular Member


Date Joined Apr 2010
Total Posts : 90
   Posted 4/2/2010 10:16 AM (GMT -6)   
Sephie

My PCP seems to be a very intuitive and alert person. It wasn't the level that conerened him, It was how much it had increased from 2 years before.

Kevin

Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
   Posted 4/2/2010 10:17 AM (GMT -6)   
You've been busy in the last 5 days.

best wishes...

Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
   Posted 4/2/2010 10:21 AM (GMT -6)   
There is a "sticky", which appears as the very first item in the list of posts.

It is called "Prostate Cancer: The Really Useful List made by HW people for HW people", but 90% of it is focused on pre- and post-surgery. It's kinda random thoughts captured & somewhat organized. Not everyone would agree with all the points, but most are good.

Take a look...

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 4/2/2010 10:22 AM (GMT -6)   
Woodworker,
Welcome. I would echo David's question, although I had done a lot of the research before I got the full biopsy report (the DRE was basically bad enough that they shuffled schedules to get the biopsy in as soon as possible), so I had a short (several week) decision path. I had several full professional additional opinions, and because I have some family connections to the medical world, I had a lot of short conversations with some leading professionals, and patients (through local contacts).
My pathology was fairly brutal (age 56 myself at first diagnosis, 12 core biopsy, 9 positive, Gleason 4+3 in 2, Gleason 4+4 in 7).
I did not want Radiation combined with the expected long-term HT, due to the lifestyle changes, and the relatively low success rate the doctors quoted.
I was very excited about seeds, since that was a technology I followed closely many years ago, thinking it would be one of the most exciting uses of radiation (I once did programming for radiology labs, and felt like it was some of the most valuable work from the point of impact on others I ever did). Pity that every doctor to the last one interviewed said I was too far along for seeds.
HIFU is not considered by my insurance.
Proton theraphy would have been a viable option, but a combination of medical and job considerations ruled me out of the nearest program.
I finally did DaVinci, more because I trust the surgeon, and he doesn't do open anymore. I don't regret or question my decision, but I do wish I had found it earlier.

So we all look at time to decision thinking about our own paths, and compare our numbers to yours.

I have posted a lot both here and over on CSN's prostate page (same id) about preparation, and some things about "afterwards" - I am not the poster child for painless and dry recovery, so don't be too discouraged by my stories - 98% do better if you accept the publicity. On this site, we have a member who has consolidated a lot of our thoughts in a post that shows up at the top of the forum - start with that.

Again, welcome.

(added)
Tells you everyone is active here - I started my post after David's, and 5 more were added before I hit "submit".

Post Edited (142) : 4/2/2010 10:25:52 AM (GMT-6)


RCS
Veteran Member


Date Joined Dec 2009
Total Posts : 1247
   Posted 4/2/2010 10:34 AM (GMT -6)   
Woodworker,
 
If you haven't done so, you might want to consider getting copies of two books:
"Guide to Surviving Prosate Cancer", by PAtric Walsh, and
"Saving Your Sex Life, A guide for Men with Prostate Cancer.
 
I found the books addressed many of my questions.
 
Good Luck!
PSA 2007 - 2.8
PSA 11/24/2008 - 7.6
Pc Dx 2/11/09; age at Dx 62
RLP 4/20/09
Biopsy - Invasive moderately differentiated prostativ andenocarconoma; G 3+3=6; PT2C; No evidence of Seminal Vesicle or Extraprostatic Involvement; Margins clear; Tumor identified in sections from prostatic apex.
Immediately continent after removal of cath.
ED - Trimix works well; viagra @ 60%
PSA - 7/31/09 <0.06
PSA - 12/1/09 <0.06
PSA - 3/29/10 <0.06
 
 
 


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 4/2/2010 10:41 AM (GMT -6)   
Adding to the books - Michael Korda, "Man to Man"
Written in 1996, but if I'd written one last week, wouldn't be much different. It is a quick read. I read it after the fact, and was amazed how close the stories could be - but I didn't have the ER run afterwards, luckily.

Tamu
Veteran Member


Date Joined Oct 2006
Total Posts : 626
   Posted 4/2/2010 11:17 AM (GMT -6)   
Woodworker,

The first person you should ask about what to expect after surgery is your surgeon. The good ones can quote you their statistics relative to incontinance and ED. You should also ask your surgeon about penile rehab and what is his protocol for it. You should have already received from the surgeon a printed brochure that tells you such things as prep needed, days with the catheter and restrictions post op and how long for them. I believe it is difficult to get an idea of complications rate from this forum as those men who do not have any incontinence or ED issues have no motivation to be posting on this site or any others. If you have not found it yet there is a a web site, www.yananow.net, which has a lot of men's experiences with different types of treatments.

I am impressed with you PCP. I would say he is above the average.

Tamu
Diagnosed 7/6/06, 1 of 10 core samples, 40%,Stage T1c, Gleason 3+3
Da Vinci on 11/01/06, Catheter out on 11/13/06
56 Years Old
Post Op Path, Gleason 3+3, Approx. 5% of prostate involved
Prostate Confined, margins clear
Undetectable PSA on 12/18/06, 6/25/07, 1/8/08
No more pads as of 1/13/07
Began injections in April '07
 


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4157
   Posted 4/2/2010 11:42 AM (GMT -6)   

Kevin, I will not try to change your mind about surgery and if that is your choice, good luck.  However, I must say that I really agree with David's (Purgatory) advice.  Making a decision within 5 days after talking with only a PCP and a surgeon is not good due diligence.  If you don't take the time to talk with a radiation oncologist and a prostate oncologist you are not doing your homework, IMHO.  This is a potential LIFE CHANGING decision that you are making.  Do yourself a favor and do your research before you leap...

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"!

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 4/2/2010 12:29 PM (GMT -6)   
In Tamu's comment, the operative word was "should", and I agree whole-heartedly that you should be given a mass of information. I found that all of the doctors I worked with would answer any question I asked, even being tape recorded, but other than some really simple, boilerplate sheets, I got virtually nothing in un-provoked guidance from the medical community. My hospital is part of one of the largest university / research complexes in the States, but they did not provide the booklets or CDs that some people talk about getting.

If I had not had the lists from sites like this, and a local Prostate Cancer Foundation branch, I would have been brutally surprised by a lot more than I was. Even then, no one warned me that my testicles would swell up to the size of grapefruit about 4-5 days out. I was ready to call an ambulance until I found it on a site as a frequent side effect. (I didn't know about HW until after my surgery).

I've brought the subject up, and am told that because the advice and suggestions in mass printed material are not custom to my case, there are legal issues based on who gives it to me and in what context. I talked to the post-op folks at a couple of other big local hospitals, and got the same reaction. That is also why we all tend to remind each other that we tell our experiences, and always send you back to your physician for advice.

But search and read so that you can ask the right questions. As English Alf has in the list - forget about all the daily, trival things that people think you should care about, and focus on understanding what you need for the next few weeks.

gold horse
Regular Member


Date Joined Nov 2009
Total Posts : 360
   Posted 4/2/2010 1:47 PM (GMT -6)   
Hi woodworker,I hope you know there is a difference between(4+3)and (3+4)the later is worse than the first.yes it is soon to make that choise,but for me the sooner I get pc out of my system the beter it will be. the surgery is a life changing but I guess any other procedure is.In my humble opinion you made the right move.good luck and we are here to stay with you every step of the way.God bless you.tongue

DIAGN=46 YEARS
GLEASON=3+3
FATHER HAD PC,THEN I THEN MY BROTHER STILL HAS TWO BROTHER PC FREE.
MARRIED,TWO CHILDREN.AGE 13 AND 8.
LAPROSCOPY SURGERY 6/2005
PATOLOGY REPORT.
GLEASON=3+3
TUMOR VOLUME=5%
LYMPHOVASCULAR INVASION=NEG
PERINEURAL INVASION=POSI
TUMOR MULTICENTRICITY=NEG
EXTRAPROSTATIC INVASION=NEG
SEMINAL VESICLES BOTH=CLEAN
MARGIN ALL=NEG
PT2ANXMX
DEVELOP SCART TISSUE AND NEEDED A SECOND SURGERY BECAUSE COULD NOT URINATE,
PSA 6/05=0.04,0.04,0.04,6/06,0.04,0.04,0.04,6/07,0.04,0.04,0.04,6/08,0.04,0.04,1/09
0.04,10/09,0.04
 


Woodworker
Regular Member


Date Joined Apr 2010
Total Posts : 90
   Posted 4/2/2010 1:51 PM (GMT -6)   

I guess I should have elaborated a bit more. When I received my initial diagnosis, the doctor’s office handed me a CD, a bunch of pamphlets, and a list of web sites to visit.  I have gone through that material and a lot more.

I have also spoken to somebody at our church that has had the radiation seeds. I am the type of person that wants huge amounts of information. If that information starts showing a pattern I am comfortable with it. If it doesn't I keep digging till I find the pattern.

There are several of you that think I have made this decision too rapidly and I appreciate the concern. Before I made my decision I looked at long term affects, success rates and what to expect immediately after the procedure (both radiation and surgery).  I do feel very comfortable with my decision.

However, experience has taught me that nothing can compare with first hand accounts like the ones I am reading about here.  They are going to prove invaluable as I get ready for this and after I have had the surgery. 

For what its worth, I know life will never be the same and I am scared to death about this whole process and its aftermath.  I just know that it has to be taken care of.

 


Woodworker
Regular Member


Date Joined Apr 2010
Total Posts : 90
   Posted 4/2/2010 1:58 PM (GMT -6)   
Gold Horse

I appreciate you cluing me in about the Gleason score. I just looked at the pathology report and it says:

LEFT APEX PROSTATE: ADENOCARCINOMA GLEASON SCORE 7 (3+4)
-CARCINOMA INOLVES 25% OF THE SPECIMEN
-2 OF 2 CORES POSITIVE

All other portions of the prostate indicated benign

Kevin

Ziggy9
Veteran Member


Date Joined Jul 2008
Total Posts : 981
   Posted 4/2/2010 2:41 PM (GMT -6)   
I have to agree with Tud you should take more time educating yourself. The Pca has been growing for years a few more weeks/months aren't going to make a difference. I always shake my head at those who rush to major surgery and possible life altering side effects only a few weeks after dx. Many here take more time in buying a car than in choosing radical cancer treatments. You may well go with radical surgery but be confident by the time you do you really understand what you are signing possibly up for. There are no do overs afterward.

AS an example when I first arrived here a few weeks after dx I was leaning towards radical surgery, then I was going to go the seeded option and through luck and geography I found a less invasive therapy with hardly any side effects instead. If I had rushed to treatment as fast as you are I'd have major regrets now. I'm just saying educate yourself, reflect on all the issues pro and con take a week off the best you can to rid yourself worrying about PCa. Then after reflection choose an option, then don't look back.
Diagnosed 11/08/07 - Age: 58 - 3 of 12 @5%
Psa: 2.3 - 3+3=6 - Size: 34g -T-2-A
 
2/22/08 - 3D Mapping Saturation Biopsy - 1 of 45 @2% - Psa:2.1 - 3+3=6 - 28g after taking Avodart - Catheter for 1 day -Good Candidate for TFT(Targeted Focal Therapy) Cryosurgery(Ice Balls) - Clinical Research Study
 
4/22/08 - TFT performed at University of Colorado Medical Center - Catheter for 4 days - Slight soreness for 2 weeks but afterward life returns as normal
 
7/30/08 - Psa: .32
11/10/08 - Psa.62 -
April 2009 12 of 12 Negative Biopsy
 
2/16/10 12 of 12 Negative Biopsy 
 
 
 


skeener
Regular Member


Date Joined Dec 2009
Total Posts : 214
   Posted 4/2/2010 3:33 PM (GMT -6)   
Woodworker
 
Sounds to me like you have done enough due dilligence and are comfortable with your decision.
 
You are lucky to have such a good PCP.
 
Best wishes as your PCa journey progresses.
 
Skeener
Age:  63 
Biopsy: May 09 showed 2 of 12 cores positive for prostate cancer -- 1 at 5% and 1 at 25%.  Cancer indicated as non aggressive.  Gleason Score: 3+3.
RRP on Oct 23/09 in London, Ontario.  Excellent surgeon. 
7 Weeks Post Op -  The fears I had about bad things about the operation and recovery did not materialise except of course ED!!.  Otherwise, everything went very smoothly.  Incontinence not a problem.  Wear a pad when out just in case. Pain was never a problem.
Pathology:  Unremarkable 
First followup PSA and Visit: Feb 11/10 - 0.0.
 
Next PSA May
Next doctor's visit in 6 months      


Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4106
   Posted 4/2/2010 4:13 PM (GMT -6)   
Kevin: i must say you did make a decision quickly however it looks like you did a lot of homework. Do continue getting info about what to expect. some are leakers and many have problems with ED.

Some of us are very lucky and have an easy ride through the surgery. Little or no pain. I had no pain. Some tend to leak. I have been lucky there as well. Dry!!! Some have ED.... That one hit me...very frustrating. Do ask you Dr about rehab for ED.. My Uro was not very helpful. Healing Well was much more help to me.

Best of luck. Do keep us posted.

Oh by the way, My G was 3+4 7 after surgery downgraded to 3+3 6.

Cajun Jeff
9/08 PSA 5.4 referred to Urologist
9/08 Biopsy: GS 3+4=7 1 positive core in 12 1 pre cancer core
10/08 Nerve-Sparing open radical
Surgery Path Report Downgrade 3+3=6 GS Stage pT2c margins clear

3 month: PSA <0.1
6 month: PSA <0.1
10 month:PSA <0.1
1 year: PSA <0.1
16 month:PSA <0.1

ED - Started Cialis at 3 months, tried all 3, 6 months added pump, 9 months Tried MUSE (YUCK) Bad experience.
1 year mark Found new Urologist visit was at 14th month post surgery
Started Injections, Caverject! (Success)
17 month: ED making improvements : Oral Meds gets me 85%


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 4/2/2010 4:15 PM (GMT -6)   
Goldhorse
you might want to revise what you said. 4+3=7 is a worse diagnosis than a 3+4=7 as it quantitifies what grade cells are predomoninate.
 
Woodworker,
Like the others I would not make a treatment decision without first speaking to a rafiation oncologist. You cannot have to much first hand information.
 
Bill
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07
4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August 08 <0.001 undetectable (disregarded due to lab "misreporting")
Post-op pathology rechecked by new lab:
Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September 08 <0.01 (new lab)
PSA February 09 <0.01
PSA August 09 (2 year mark), <0.01
PSA December 09 <0.01
        My Journey: http://www.yananow.net/Mentors/BillM2.htm
Never underestimate old people ............ you don't get to be old by being stupid.


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 4/2/2010 6:00 PM (GMT -6)   
Kevin,
Once my biopsy showed that my PC was Gleason 8, I spent 2 weeks looking at options and decided to have the robotic surgery. I'm lucky that one of the best robotic surgeons lives in Austin Texas where I live and happens to be my son's neighbor. I didn't want to spend too much time researching further while my aggressive cancer keeps growing. So far, I don't regret my decision.
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


gold horse
Regular Member


Date Joined Nov 2009
Total Posts : 360
   Posted 4/2/2010 7:08 PM (GMT -6)   
Billy Mac it is my understading that (3+4) is worse than (4+3),but I may be wrong let some of the brothers provide more info.yeah
DIAGN=46 YEARS
GLEASON=3+3
FATHER HAD PC,THEN I THEN MY BROTHER STILL HAS TWO BROTHER PC FREE.
MARRIED,TWO CHILDREN.AGE 13 AND 8.
LAPROSCOPY SURGERY 6/2005
PATOLOGY REPORT.
GLEASON=3+3
TUMOR VOLUME=5%
LYMPHOVASCULAR INVASION=NEG
PERINEURAL INVASION=POSI
TUMOR MULTICENTRICITY=NEG
EXTRAPROSTATIC INVASION=NEG
SEMINAL VESICLES BOTH=CLEAN
MARGIN ALL=NEG
PT2ANXMX
DEVELOP SCART TISSUE AND NEEDED A SECOND SURGERY BECAUSE COULD NOT URINATE,
PSA 6/05=0.04,0.04,0.04,6/06,0.04,0.04,0.04,6/07,0.04,0.04,0.04,6/08,0.04,0.04,1/09
0.04,10/09,0.04
 


Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4106
   Posted 4/2/2010 7:15 PM (GMT -6)   
The first number indicated the most dominent found. IE 4+3=7 is more agressive then 3+4=7.

Cajun Jeff
9/08 PSA 5.4 referred to Urologist
9/08 Biopsy: GS 3+4=7 1 positive core in 12 1 pre cancer core
10/08 Nerve-Sparing open radical
Surgery Path Report Downgrade 3+3=6 GS Stage pT2c margins clear

3 month: PSA <0.1
6 month: PSA <0.1
10 month:PSA <0.1
1 year: PSA <0.1
16 month:PSA <0.1

ED - Started Cialis at 3 months, tried all 3, 6 months added pump, 9 months Tried MUSE (YUCK) Bad experience.
1 year mark Found new Urologist visit was at 14th month post surgery
Started Injections, Caverject! (Success)
17 month: ED making improvements : Oral Meds gets me 85%


gold horse
Regular Member


Date Joined Nov 2009
Total Posts : 360
   Posted 4/2/2010 7:19 PM (GMT -6)   
thanks I look the gleason againg (4+3) is worse.yeah

DIAGN=46 YEARS
GLEASON=3+3
FATHER HAD PC,THEN I THEN MY BROTHER STILL HAS TWO BROTHER PC FREE.
MARRIED,TWO CHILDREN.AGE 13 AND 8.
LAPROSCOPY SURGERY 6/2005
PATOLOGY REPORT.
GLEASON=3+3
TUMOR VOLUME=5%
LYMPHOVASCULAR INVASION=NEG
PERINEURAL INVASION=POSI
TUMOR MULTICENTRICITY=NEG
EXTRAPROSTATIC INVASION=NEG
SEMINAL VESICLES BOTH=CLEAN
MARGIN ALL=NEG
PT2ANXMX
DEVELOP SCART TISSUE AND NEEDED A SECOND SURGERY BECAUSE COULD NOT URINATE,
PSA 6/05=0.04,0.04,0.04,6/06,0.04,0.04,0.04,6/07,0.04,0.04,0.04,6/08,0.04,0.04,1/09
0.04,10/09,0.04
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 4/2/2010 7:21 PM (GMT -6)   
gold horse, you do have the combo's in reverse. most would consider a 4+3 Gleason 7 potentially more serious and a 3+4 Gleason 7, because the 4+3 is made up of more "4" cancer cells than "3". The "4" cells generally are more agressive and unpredictible in nature. There was a time when it was thought that the combo didn't make much difference, but even in the past year, more emphasis is being placed on the 4+3 Gleason 7. There are even some experts, that feel like any Gleason 7 should be treated as if it were a Gleason 8, because in either combo, there is a danger of any amount of "4" cancer cells.
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

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