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vam4710
Regular Member


Date Joined May 2010
Total Posts : 89
   Posted 5/18/2010 7:55 PM (GMT -6)   
 

Hopefully I’m posting this in the right area...I'm new to the whole forum thing. I don’t know where to start. I am 50 years old with a history of Pca in my family.   Grand dad past away from it, dad was diagnosed 17 years ago, had an RRP and was cancer free until about 7 months ago… strangely enough, he has a tumor growing where the prostate used to be and currently undergoing hormone therapy.  I’ve been monitoring my PSA since I was 40… always been around 1.2 – 1.5 ranges.  In Sept of 2009 it was 1.7, approx. 1 year later it went to 2.14 and about 2 weeks ago a 2.75… so in short it’s about a 1.05 jump in less than 2 years.  My primary doc told me it’s nothing to worry about, I don’t have any other symptoms, but given my family history, I wasn’t going to take any chances.  I was scheduled with a Urologist last Tuesday who performed a DRE and did a PCA3 test. Although he said the prostate felt ok…. My mind has been running amuck for the last week. I’ve been reading everything I can get my hands on for the last week… which is probably good and bad.  The Uro said that if the test comes back positive that he would then schedule me for a biopsy which in itself has me worried since I’ve been reading that there are risks in that also, like possibly spreading the cancer or even sepsis.

 

Well to make a long story longer.. I received my PCA3 results today along with getting an ultrasound procedure. The ultrasound looked good but the PCA3 came back positive as I suspected. Total score was 39.0...   My doctor says this doesn’t mean I have cancer, but rather I definitely have the GENE that would predispose me to it at some point.  He suggested that I definitely get a biopsy done and he has me scheduled for one next Tuesday. It goes without saying that I’m not particularly thrilled with this decision, so there are a million questions going through my mind….

 

1.     Do I get the biopsy done?

2.    If I do that doesn’t mean he’ll find anything….

3.    Do I run and get a second opinion

4.    Do I just wait 3 months and get another PSA, and if that is elevated then do I get one?

 

He did say if the biopsy comes back negative, then he would just monitor me every 6 months….. and of course, if it does come back positive, there is the talk about procedures.  I did find out that he in fact has performed over 500 Robotic procedures and over 1500 RRP’s.

At this point my head is spinning and I am double thinking everything wondering if I should just wait another 3 months, repeat the PSA then have the biopsy if that comes back elevated, or, will I be screwing myself by waiting.  I’m just really confused at this point and after all the reading I’ve done, I thought I would be more lucid about my situation

 

Any thoughts or similar experiences and suggestions would be greatly appreciated

 

Post Edited (vam4710) : 5/18/2010 8:31:05 PM (GMT-6)


Burlcodad
Regular Member


Date Joined Nov 2009
Total Posts : 254
   Posted 5/18/2010 8:23 PM (GMT -6)   

HI V

 

You've come to the right place.  I'm sure you will get many helpful answers here.

 

Ray

 

 

 

 


Diagnosed 9/09 at age 54  
PSA 6/09 1.3 
Stage 2b (biopsy done because of firmness felt on right side) 3 positive cores out of 12 (all less than 25%) Gleason 6
 
Surgery  1/13/10 at UP- Penn Presbyterian - Dr David Lee. Home 1/14/10 Nerves spared on both sides -Catheter removed 1/19/10  Path report scheduled for 2/11/10
 
Post OP Pathology Report Gleason score was upgraded to 7 (3+4)
no capsular involvement, seminal vesicles clear, lymph nodes clear, negative margins, gland involvement 2-10%
 
Since report was good and recovery going well next appt is now  the first psa test appt scheduled for 4/22
 
POST OP PSA   4/10 <0.1,
 
Incontinence - Initial 6 pads a day, 3 Weeks - 3 pads a day relatively dry at night , 3 Months mostly dry 0-1 pad per day
 
ED - yes but seeing some improvements - levitra 10 mg 2x week 3 months  100 mg almost daily
 
 
 


logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 6085
   Posted 5/18/2010 8:25 PM (GMT -6)   
Vam4710, Just get the biopsy done and if its positive, then You can worry about the treatment. In this early stage of this road, I feel its best to stay focused on the immediate situation. As you get " use " to the situation and more " comfortable with it, expand out. By expanding yourself out to all the different end points, this early, especially with a lack of knowledge of the intricacys of this disease, you will be a nervous wreck. Just know that if it is Pca, its early and probably curable. You are in the boat, wish you wer'nt, wish I hadn't been, but then again..... If it is, the chances of it killing you is about 3% statistically. Stay here, you should get some helpful advice on the journey.
age 66 First psa 4/17/09 psa 8.3, 7/27/09 psa 8.1
8/12/09 biopsy 6 out of 12 pos 2-70%, rest <5% 3+3
10/19/09 open rrp U of W Medical Center, left bundle spared
10/30/09 catheter out. continent from the jump.
pathology- prostate confined, only thing positive was the report.everything else negative
9% of prostate affected. gleason 3+4, I suppose thats a negative
After reading pathology myself, gleason was 3+4 with tertiary 5, 2-3 foci That is a negative, but I am a positive !!
Ed an issue but keeping the blood flowing with the osbon pump
Dec 14,2009 psa 0.0 May 10 2010, psa 0.0

" Hypocrisy is vice's homage to Virtue " read it in Bartlet's book of quotation years ago stuck with me, can't remember who said it.


Herophilus
Veteran Member


Date Joined Sep 2009
Total Posts : 664
   Posted 5/18/2010 8:32 PM (GMT -6)   

Get the Biopsy!!!

My Father died from Prostate Cancer at age 74

I was diagnosed at age 51, 10 of 12 cores positive, Brother diagnosed age 46. One other brother had negative biopsy.

Get the Biopsy...                   Hero


Age 51, PSA 08/31/2009= 6.8, DRE Neg.
Biopsy 9/24/09 =10 of 12 positive. Gleason 6. involving up to 75%
da Vinci at Wash U, Barnes on 11/02/09 Non-Nerve Sparing on Rt.
Modified Pathology, Gleason 4 + 3 = 7. Gleason 7 present throughout Prostate involving 20% of the Gland. Surgical Margins Free of Tumor,
4 of 4 periprostatic Lymph Nodes Negative, 10 of 10 pelvic Lymph Nodes Negative. Seminal Vesicles tumor free. Extracapsular extension is absent Perineural Invasion is Identified, Vascular Invasion is not identified.
Post-op PSA 12/10/2009, Undetectable  <0.01
Post-op PSA 05/03/2010, Undetectable  <0.01
I hate this crap
Moved by individuals like Living1963

 


vam4710
Regular Member


Date Joined May 2010
Total Posts : 89
   Posted 5/18/2010 8:33 PM (GMT -6)   
Burlcodad said...

HI V

 

You've come to the right place.  I'm sure you will get many helpful answers here.

 

Ray

 

 

 

 

Thanks Ray.... sent you an email also... didn't realize this was you until I read your last email


Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4119
   Posted 5/18/2010 9:03 PM (GMT -6)   
V, Like you long family history. When I had a PSA jump went to see the URO. He recomended a biopsy and I agreed. Was not real surprised with the positive results.

I made the decision at that point to get it out. The rest is history.

Do the biopsy. Hope it comes back negative if not we will be here to help you through the dance.

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%


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2461
   Posted 5/18/2010 9:13 PM (GMT -6)   
First, I hope that you don't have PCa, however, in order to verify that you must get the biopsy done. You will get different opinions on the procedure itself. Personally, my biopsy was uneventful.
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 5 months
2 months 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 months PSA test 1/21/10 result 0.004
14 months PSA test 4/19/10 result 0.005


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2692
   Posted 5/18/2010 9:16 PM (GMT -6)   
Welcome to the forum.

Take a deep breath and realx a little. If you aren't ready for the biopsy, delay it for a month or two. Take that time to read and understand all the implications.

Obviously with your family history, keeping a close watch on this will be important, but you do have time here to make some well informed decsions.
Goodlife
 
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01


tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2845
   Posted 5/18/2010 9:21 PM (GMT -6)   
Vam-
For your peace of mind, get the biopsy done
- and please don't worry about spread of any cancer from the biopsy - a very low risk if at all.. and for the sepsis - you clean out down there before the biopsy, one or two day routine - so very little risk .
.. I found some articles to be frightening at first, but then discovered they were using fear to direct people to their choice of treatment - not what was best for me (in this case, you !)

all the best
hugs
BRONSON
.................
Age: 54 - gay - with common-law spouse of 13 years, Steve - 60
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: Feb 2010- 3-5 pads/1-2 clothes changes/day- March 3, 2010 - week 14 after surgery -finally seeing improvement - March 29- incontinence better - 1-2 pads a day - one pad at night
location: Peteborough, Ontario, Canada
Post Surgery-PSA: - April 8, 2010 - 0.05 - I am in the ZERO CLUB - hooorah!
Next PSA - October 8, 2010 - TBA -
............


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4269
   Posted 5/18/2010 10:22 PM (GMT -6)   
V,
You have a family history of PC, both your psa and PCA3 are high, but just borderline high. These are three red flags that should not be ignored. Get a biopsy and if it comes out negative keep monitoring closely. It is way too early to think about treatments, if and when the time comes you can make a more rational decision about them once you have the facts.
We have all gone through this period and it is far more trying than the treatment itself because you are dealing with the unknown.
JT

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.

JohnT


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 5/18/2010 10:25 PM (GMT -6)   
Vam,

First, welcome here.

Second, get the biopsy. With your family history, I feel strongly that you need to have it.

The chance of the sepsis is possible, but very, very rare. There is no documented evidence that PC has spready by having a prostate biopsy performed.

And yes, if the biopsy comes back negative, it will give you some breathing room. It took 3 of them over 18 month period to finally find the PC in me, but I was dealing with a much higher and faster accelerating PSA then you have.

It's hard right now for your mind not to be overwhelmed with fear, worries, concerns along with all the facts and figures you are learning along the way. I think all of us here can relate to that one.

We are here for you. No dumb questions here, and we have folks experienced in probably almost every stage and aspect of PC and PC treatments.

Please post often, and if you just need to vent, then you are welcomed to do that too. This is a good place to be, but I am hoping that you won't have a need to be here, the membership dues are too high in my opinion, you actually need that PC dx.

Good luck, and take a moment to breathe.

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, 4/8 .04, next one:  July
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- 27 days, Cath #15 - 26 days, Cath #16 - 4/23 put in


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7270
   Posted 5/18/2010 10:54 PM (GMT -6)   
ABSOLUTELY GET THE BIOPSY DONE.

I was in your shoes about 8 months ago (read my signature).

The whole purpose of the PCA-3 is to decide whether or not to do the biopsy. I was hoping to avoid a biopsy in the face of an increasing PSA. My PCA-3 test results were worse than yours, but regardless if you do the PCA-3 you should abide by the 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.  (Second opinion from Jon Epstein at Hopkins confirmed these results)

 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.  As of 3/12/10--completely continent! Uh...OH. As of about 3/16/10 problems with constant urgency although no pads needed--feels like an infection but none showing in urine.

Update: since late March all is well in that area. I would say 99.9% continent (a spurt here and there, maybe 5 spurts per week).

First post-op PSA on 3/10/10--DRUM ROLL: 0.01 Next PSA in mid-June.


English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2218
   Posted 5/19/2010 1:10 AM (GMT -6)   
Welcome V

Yes I think the combination of all your stats means it's time for a biopsy.

It's important re a biopsy and any infection risk that the doc puts you on antibiotics and that he does so BEFORE the biopsy, probably 24 hours before hand.

When I went for my biopsy that was the first time I saw my uro and he said he couldnt do the buiospsy as I wasn't on the antibiotics. However my Primary doc had anticipated this when referring me to the uro and given me the meds so I had started taking them the day before so the biopsy went ahead.

What ever news/results you get, experience says it's easier to deal with than wondering about what might be going on. So good luck.

Alfred
Age at Dx 48 No Family history of Prostate Cancer
Married 25 years, and I cannot thank my wife enough for her support.
April 2009: PSA 8.6 DRE: negative. Tumour in 2 out of 12 cores. Gleason 3+3.
RALP (nerve-sparing) at AVL-NKI Hospital Amsterdam on 29th July 2009. Stay 1 night.
Partial erections on while catheter still in. Catheter out on 6th Aug 2009.
Dry at night after catheter came out
Post-op Gleason 3+4. Tumour mainly in left near neck of bladder.
Left Seminal Vesicle invaded, (=T3b!)
no perineraul invasion, no vascular invasion. clear margins,
Erection 100% on 15th Aug 2009, but lots of leaking
Stopped wearing pads on 21st Sept 2009
Pre-op style intercourse on 24th Oct 2009 !! No use of tablets, jabs, VED etc.
Nov 17th 2009 PSA = 0.1
Mar 17th 2010 PSA = 0.4!!! referred to radiation therapist
April 13th 2010 CT scan.
April 28th 2010 Started Radiation Therapy (66Gy - 33 sessions)


Paella
Regular Member


Date Joined May 2010
Total Posts : 52
   Posted 5/19/2010 3:49 AM (GMT -6)   
Hello to Vam

It’s funny – I also just joined today; well, yesterday and like you, have never participated in any forum before. My husband and I were diagnosed 2 weeks ago and I must admit I'm getting dizzy from the research and decision-making.

The unknown is scary and the only antidote is knowledge. Then again, a little knowledge can be a dangerous thing.

You don’t have to “run” to do anything. Your stats mean that you have time to make an informed decision.

My guess is that most Urologists would NOT recommend a Biopsy based solely on your PSA rise, especially because you’re only 50. But adding in your heredity and PCA3 changes things. Any peeing symptoms? It’s all about statistics. (I wish we had seen a Urologist when the PSA was at 3.0 four years ago at 61 years old but wonder if a biopsy would even have been recommended at that point with virtually no other symptoms?)

That said, here’re some thoughts / suggestions:

1. Keep reading everything – but remember that the internet is both a blessing and curse because there is soooo much there. Keep notes and an organized filing system of some sort.

2. Get 2 more opinions from recommended Urologists within the next 6 – 8 weeks. To get a recommendation call everyone you know who might have some insider knowledge about great docs, good institutions, etc. Call them. They will see you. Take everything your Urologist has in his file on you plus your PSA history plus PCA3 info. Ask for his assistant and he/she will either give you a copy or fax/mail to your consulting docs. He's required by law to do this and you won't be hurting his feelings...you'll never even talk to him to get this stuff.

3. Ask each Urologist (and your 1st Urologist, too) if there is any way to estimate tumor stage* based on your history and your symptoms without doing a biopsy. IE: is there a “nomogram” for pre-biopsy statistics to help determine if you need a biopsy? Read about nomograms and then check out Memorial Sloan Kettering Cancer Center’s site. They have a prostate nomogram-for-dummies you can play with, but only if you’ve had a biopsy and know gleasons, tumor stage probability*, and number of positive and negative nodes. Don't know how well respected it is, to be honest
*tumor stage via the 1997 UICC Ranking of Cancer. UICC = “Int’l Union
Against Cancer”.

4. Ask each doc if there’s any other way than a biopsy to determine if you have cancer and to what degree. Maybe there’re new procedures, etc. Ask that on this site, too

5. Some people might also recommend that you talk to a radiation/chemotherapist doc or 2 and see if THEY think you need a biopsy.

6. If the Urologists’ consensus is that you should have a biopsy, then get one!

7. Relax about the biopsy. They have a scary reputation but have apparently come a long way in the recent past. My Mac thought biopsy-horribleness would be an 8 on a 10 scale and it was only about a 2.5…valium helped.

Good luck. Stay positive and logical. There is nothing I have found that makes me think my guy is going to die from this. Nothing. And all the negatives associated with treatment tend to be better over time with the vast majority of men. Hang out with friends and family. Prostate cancer survival is excellent and getting better all the time.

Best - Paella

Mac’s statistics:
Age 65 - 5'11" Weight 210 BMI 29.1
Overall Heath Condition: Good
No family history
PSA: November 2001 = 1.0 slowly rising to 4.4 in Feb 2010
Biopsy: 04/19/10: Gleason 3 + 4 with 5 of 12 positive (2 at 15%, 1 at 5%,
1 at 25 and 1 at 35). Both lobes involved (right lobe with 1 positive at 5%).
Left Lateral and Left Apex involved with 15% and 35%.
No base involvement

60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2243
   Posted 5/19/2010 8:34 AM (GMT -6)   
Vam
It sounds like your mind was already racing prior to the latest test results, so having the biopsy done will let you know more about the situation at hand. It might or might not be the results that you want, but at least you will know and then can move on to the next step in the process. Kepp us posted and welcome to HW.
Michael
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed, 61 yo 2010
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
2 pads per day, 1 depends but getting better,
 started ED tx 7/17, slow go
Post op dx of neuropathy
T2C left lateral and left posterior margins involved
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5 on 11/28/10
Starting IMRT on 1/18/10, Completed 39 tx at 70 gys on 3/12/10
6 week Post IMRT PSA .44 a drop from .5 but maybe more
Great family and friends
Michael


medved
Veteran Member


Date Joined Nov 2009
Total Posts : 1100
   Posted 5/19/2010 10:35 AM (GMT -6)   

Did the docs do a free psa?  If so, what was the percent free psa?   (Lower percent free psa is more likely to mean prostate cancer, and higher percentages less likely -- as with PCA3, it is another indicator).

 

Regarding PCA3, there is some debate about what the best cut-point is for that test.  (The usual tension between sensitivity of the test and specificity).  I suspect it is better to look at this test not as generating "positive" or "negative" results, but instead as a  continuum.  Your score is pretty close to the typical cut point.  In other words, it is a little high but not very high.  That is good news because there is evidence that a higher PCA3 test result may correlate with a more aggressive cancer.  And your score is more likely to correlate with a less aggressive cancer - if it is cancer at all.

 

As others have said here, I would get the biopsy.  It is a low risk procedure and if you don't get the biopsy, the wondering will probably drive you nuts.  IF you do have prostate cancer, you want to find it while it is curable.  The good news is that, given your psa score and your PCA3 results, if you do have prostate cancer, there is a very high likelihood that you have a low grade and readily curable cancer.

 

Best wishes,

Medved
 
Age 46.  Father died of p ca. 
My psa starting age 40: 1.4, 1.3, 1.43, 1.74, 1.7, 1.5, 1.5
 


vam4710
Regular Member


Date Joined May 2010
Total Posts : 89
   Posted 5/19/2010 2:40 PM (GMT -6)   

THANK YOU ALL!!!   I didn’t expect such a huge response this soon after posting.

The out pouring of support and advice is greatly appreciated beyond words. I’m glad to be here and to see all the support one can receive during this mind bending time.  I want to thank each and everyone of you who responded.

It makes things a little easier knowing there are people out there that truly care.  I will keep posting and try and stay up to date.

 

Best regards and wishes to ALL my new found friends !


vam4710
Regular Member


Date Joined May 2010
Total Posts : 89
   Posted 5/19/2010 2:46 PM (GMT -6)   
 
medved said...

Did the docs do a free psa?  If so, what was the percent free psa?   (Lower percent free psa is more likely to mean prostate cancer, and higher percentages less likely -- as with PCA3, it is another indicator).

 

Regarding PCA3, there is some debate about what the best cut-point is for that test.  (The usual tension between sensitivity of the test and specificity).  I suspect it is better to look at this test not as generating "positive" or "negative" results, but instead as a  continuum.  Your score is pretty close to the typical cut point.  In other words, it is a little high but not very high.  That is good news because there is evidence that a higher PCA3 test result may correlate with a more aggressive cancer.  And your score is more likely to correlate with a less aggressive cancer - if it is cancer at all.

 

As others have said here, I would get the biopsy.  It is a low risk procedure and if you don't get the biopsy, the wondering will probably drive you nuts.  IF you do have prostate cancer, you want to find it while it is curable.  The good news is that, given your psa score and your PCA3 results, if you do have prostate cancer, there is a very high likelihood that you have a low grade and readily curable cancer.

 

Best wishes,

Medved
 

 

Funny enough.... I never new too much about a free psa percentage until I got here.... I called my doctor today and said that the lab doesn't break it down that way.... my URO will be doing all my PSA testing from this point forward. I will make sure I ask him so that I can get those numbers also.

THANKS!


medved
Veteran Member


Date Joined Nov 2009
Total Posts : 1100
   Posted 5/19/2010 4:00 PM (GMT -6)   
<lab doesn't break it down that way....>

Nearly any lab (certainly any of the major labs) will do a free psa test, but the doctor has to request it. It is relatively common for docs not to order free psa percentage unless total psa is at least 4 ng/ml. However, there is evidence to support the use of free psa percentage at lower total psa levels too (I have seen a study supporting the validity of free psa percentage with total psa as low as 2.5 ng/ml).

Best wishes,
Age 46.  Father died of p ca. 
My psa starting age 40: 1.4, 1.3, 1.43, 1.74, 1.7, 1.5, 1.5
 


vam4710
Regular Member


Date Joined May 2010
Total Posts : 89
   Posted 5/19/2010 4:37 PM (GMT -6)   
medved said...
<lab doesn't break it down that way....>

Nearly any lab (certainly any of the major labs) will do a free psa test, but the doctor has to request it. It is relatively common for docs not to order free psa percentage unless total psa is at least 4 ng/ml. However, there is evidence to support the use of free psa percentage at lower total psa levels too (I have seen a study supporting the validity of free psa percentage with total psa as low as 2.5 ng/ml).

Best wishes,

Thank you again MED..... I wish I would have know this. I will definetly request the staff at the doctor's office do this next round.


Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1267
   Posted 5/19/2010 5:28 PM (GMT -6)   
Hi Vam,

As you can see from my signature below, I was Dx'd with a 1.5 PSA. The only reason I got the biopsy was that my dad had prostate cancer, and my PSA had been rising. I was not a happy camper when the biospy showed cancer --- today I see biopsy day as one of the best days of my life. I have a 90% chance of being cured. Pull a group of 68 year olds off the street at random and, as a group, their prognosis is not as good as mine. That's the way I look at it. And, unlike those guys, I'm getting a PSA checked every three months. Is life good, or what?

So, do not pass go. Do not collect $200. Go right to the uro and have the biopsy. If it is negative, that's great news. If it is positive you'll not be happy --- I was a basket case --- but in a year you'll be treated, on the mend, and ecstatic that you had the biopsy, that the cancer was caught and dealt with.

Sheldon AKA Sleepless
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
From "knock out" to wake up in recovery less than two hours.  Actual surgery 70 minutes
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"
 
Oct 1st 09 -- dry at night, during day some stress issues.
Oct 31st padless 24/7 
 
First post op PSA Sept 09  less than 0.02
PSA on Oct 23 test again less than 0.02
PSA on Jan 8 less than 0.02
PSA on April 9 less than 0.02 
 
  


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4275
   Posted 5/19/2010 6:02 PM (GMT -6)   

Hi Vam:

I'm late to the party on this one but I do agree with most of the other posters that a biopsy is in order.  Some biopsy issues that you should discuss with your uro before you get to the procedure date:

1.  How many samples will he take?  There have been a couple of posters of late that had as few as 6 samples.  That's not good....12 is pretty common, but 16 is more state of the art.

2.  What is his/her thought on comfort during the biopsy?  Some men find that its "no big deal" but others have found the pain excruciating.  I had IV anesthesia so it was a piece of cake for me.  You might want to think about the comfort issue and address it with your doc.

Good luck and let us know what you find out.

Tudpock


Age 62, Gleason 3 + 4 = 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 4/10/10.  6 month PSA 1.4 and now 1 year PSA at 1.0.  My docs are "delighted"!

deer hunter
Regular Member


Date Joined Jan 2010
Total Posts : 250
   Posted 5/19/2010 6:02 PM (GMT -6)   
I think you have enough informtion to dewll over sorry you had to join us but its a big boat
BESTOF LUCK on the biopsy you need to do them.

DEERHUNTER
dx age 57 01/06 open RP 4/06 psa in 01/06 8.1  surgery path report Gleason 3+4=7 poorly differentiated  tumor was 90%involved in both lobes surgical margins postive. in the right apex and right radial margins tumor grade G3  perineural invasion present high grade of PIN found  T2c NX MX PSA 0706  .01 10/06 .02 01/07 .03 04/07 .04  06/07 .05  07/07 .08 07/07 bone scans pelvic ct neg. 08/07 proscintic scan neg.9/07 psa.10 net with rad onc. wanted to do SRT but i did not do it 10/07  saw a new dr at Emory University [my old dr urg. suggested second opinion ]  bone scans negs ct scans pelvics neg. biopies of the bladder and adrinal glands neg.another proscintic scan neg.12/07 Psa .11 clinial trial Emory injected with protons to try and find the cancer cells no luck 3/08 psa .17 06/08 psa .23 psa 09/08 psa .32 12/08 psa .39 3/09 psa .39 6/09 psa .43  meet with medical onc. he said  i might have waited to long to start SRT 7/09 psa .50  another bone scan ct scan all neg.MRI neg. meet rad. psa the last of 7/09was .55 onc. 7/09 started casdex 50mg 1 day for 30 days 2 shots of lupron started rad treament 10/09 40 treatments 75 gm 12 shots each time all aroud pelvic finished 12/09  psa .07 and psa 01/10.05 next dr visit 03/10 wait and see 3/10 psa.05


vam4710
Regular Member


Date Joined May 2010
Total Posts : 89
   Posted 5/19/2010 7:51 PM (GMT -6)   
Thanks again to all..... I must admit once again, I'm glad I joined this group.... so much info and so much to learn. Not to put another thought in my head, cause Lord know I have enough.... looking at some of the "signatures" here, I almost wonder if maybe I should have looked into a biopsy a while back. Some of you guys have such a low PSA and still were DX'd with PCa. I watched mine for 10 years with no radical changes until the last 22 months with a 1.05 jump.

vam4710
Regular Member


Date Joined May 2010
Total Posts : 89
   Posted 5/19/2010 7:55 PM (GMT -6)   
Tudpock18 said...

Hi Vam:

I'm late to the party on this one but I do agree with most of the other posters that a biopsy is in order.  Some biopsy issues that you should discuss with your uro before you get to the procedure date:

1.  How many samples will he take?  There have been a couple of posters of late that had as few as 6 samples.  That's not good....12 is pretty common, but 16 is more state of the art.

2.  What is his/her thought on comfort during the biopsy?  Some men find that its "no big deal" but others have found the pain excruciating.  I had IV anesthesia so it was a piece of cake for me.  You might want to think about the comfort issue and address it with your doc.

Good luck and let us know what you find out.

Tudpock

Hi Tudpock...... He mentioned 12 samples. And unfortunatley, I changed my insurance last season and this one doesn't cover IV anesthesia .... needless to say, I'll be going back to the old one next year. So for this procedure, I'm going to at least opt for a valium to put me in happy land.


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