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vam4710
Regular Member


Date Joined May 2010
Total Posts : 89
   Posted 6/1/2010 2:58 PM (GMT -6)   

Well.... didn't know if I should continue my old thread so that the people that responded could find me. Hopefully you all will because I will need to bounce off you guys now more than ever!

 

June 01, 2010.... Just came back from my URO with my biopsy results.

1 out of 12 cores positive @ 25 %  Gleason 3+4=7.  Doc felt nothing two weeks ago during the DRE and the ultrasound showed nothing.  The only thing I had to go on was my PSA and then, the PCA3 which came in @ 39.  Doctor asked me today who originally pushed me to get tested. I told him about my family history and that the last PSA of 2.75 didn't sit well with me.

He looked me straight in the face today after I told him that and said “You’ve just saved your life."  Although my Gleason is a 7, he said it's very slow growing. Had I waited another 5 years and just fluffed it off, we would be looking at a totally different outcome.  Funny enough, I wasn't nearly as stressed out as I was when I had to go for the biopsy, but it hit me once I walked out into the parking lot!  I'm going in for Da Vinci in 5 weeks.... would have been sooner, but I still need to heal from the biopsy.  I am also scheduled for a CT and Bone scan this Friday of which he assured me would more than likely be negative.  He told me that he would be using the newest version of the robot.  I am definitely having my moments as the day goes on. My head is in a fog and I’m sure as the date approaches I’ll be full blown out of my mind!

 

I'll keep you guys posted as the days progress....

THANKS TO ALL FOR BEING THERE FOR ME


Diagnosis June 1, 2010 @ age 50
PSA April 2010 2.75 up from 2.14 in Sept. 2010
Biopsy May 25, 2010 -  1 of 12 cores positive; Gleason 3+4 = 7  25%
CT and Bone scan -SCHEDULED
Da Vinci Surgery in less than 6 weeks


medved
Veteran Member


Date Joined Nov 2009
Total Posts : 1096
   Posted 6/1/2010 3:19 PM (GMT -6)   
With low psa and caught early, you have a very high likelihood of a cure. Soon enough this should all be just a (bad) memory. Many experts would say, with your stats, the CT and bone scan is a waste of time/money/unnecessary radiation. It is not uncommon, but is real "defensive medicine." (Now if the doc did a QCT scan -- a bone density test -- that would be very sensible -- but sadly the overwhelming majority of urologists would never think to recommend that, so patient does not get it unless patient insists on it).
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
 


Ziggy9
Veteran Member


Date Joined Jul 2008
Total Posts : 981
   Posted 6/1/2010 3:19 PM (GMT -6)   
Your doctor is quite the drama queen. It's doubtful that if you had waited 5 years that there would be such an outcome. It's possible but not that likely. With only a single core and a psa of 2,75 I wouldn't be surprised to see your gleason possibly be down graded to a gleason 6 by another pathologist. Even at 7 that's way better than 8+.

Do not schedule any kind of treatment while your head is in the fog. There's no reason to panic and go under the knife in 5 weeks. Your PCa is no where as bad as you or your dramatic uro says it is. So educate yourself on all options and possible side effects first. There are no do overs after all and in many cases the side effects are worse than the "cures" I'd get a second opinion too for your doctor appears not only too anxious and dramatic to my seasoned ears but in way too much of a hurry. BTW how many radical surgeries has he performed with this new DaVinci? You DO have plenty of time to weigh your options. Don't let anyone push you into anything just days after a dx.
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 
 
 
 

Post Edited (realziggy) : 6/1/2010 5:40:00 PM (GMT-6)


Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
   Posted 6/1/2010 3:42 PM (GMT -6)   

VAM,

You have a very small amount of cells in your prostate which have gone through a natural progression and finally evolved to the next stage which they call "prostate cancer."  You just walked in the door with your biopsy results and you are already scheduled for a prostatectomy in 5-weeks??  Please don't take this wrong, but I would encourage you to take a step back...your doctor absolutely seems like he is rushing you.  Please consider these bullets:

  • A very commonly followed practice is to note which laboratory performed your pathology report; if it wasn't a lab which specializes in reading prostate samples, then please consider the small additional expense of getting a second opinion at Bostwick Labs (or some similar facility with prostate expertise).  Here is Bostwick's easy-to-use link:  https://www.bostwicklaboratories.com/global/services/laboratory-services/second-opinions.aspx
  • The American Urological Association (AUA) specifically does not recommend CT or bone scans for men with your case characteristics (they do recommend them for men with PSA > 20ng/mL or for Gleason score>7).  Why is your doctor going against his Association's best practices?
  • There is statistically significant differences (documented in published medical journal studies) in outcomes between more experienced and less experienced surgeons; most widely studied is the "learning curve" associated with the DaVinci method.  If you end up going this route, I would strongly urge you to find the most experienced surgeon that you can find.  Many men travel minor or even major distances to find the "best."

best wishes...


BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 6/1/2010 4:57 PM (GMT -6)   
My doc told me that he wouldn't perform surgery until I healed for 8 weeks. I was a 7 at biopsy also, 4 of 8 cores positive at 30%.
Dx with PC Dec 2008 at 56, PSA 3.4


Biopsy: T1c, Geason 7 (3+4) - 8 cores taken with 4 positive for PCa, 30% of all 4 cores.

Robotic Surgery March 2009 Hartford Hospital, Dr Wagner
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes negitive - tumor volume 9%
nerves spared, no negitive side effects of surgery

One night in hospital, back to work in 3 weeks

psa Jun 09 <.01
psa Oct 09 <.01
psa Jan 10 .07 re-test one week later .05
psa Mar 10 .28 re-test two weeks later .31
psa May 10  .50

Aril 10 MRI and Bone Scan show lesion on lower spine, false positive. 
 
Started HT 5/25/10 with 3 month shot of Trelstar. SRT scheduled for late July


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 6/1/2010 5:01 PM (GMT -6)   
I agree with Realziggy completely here in his answer to you. You need to slow this process down, definitely need to get at least another opinion. Five weeks isnt good healing time between the biopsy and the surgery, very surprised anyone would be pushing you that soon. If you have surgery too soon, it can cause complications

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 - 31 days, 5/24 put in Cath #17


60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2222
   Posted 6/1/2010 7:42 PM (GMT -6)   
Vam
We are here to support you and to offer opinions, some of which might not be exactly what you want to hear. But at the end of the day you are the person who makes the call. best to you and keep us posted.
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


logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 5815
   Posted 6/1/2010 8:11 PM (GMT -6)   
I know you are happy and excited about the nature of uour PCA, maybe not happy but relieved that if you have it it is curable, which it definitly is. I agree with the above comments. We are not hear to knock peoples uros, but a second opinion, ie, biopsy slides,with your stats, treatment options. I had surgery, and, arguably it is the most comprehensive treatment, with the caveat of ED and incontinence. If it was me, Id look at watchful waiting, which u probably wont do, but look real hard at proton therapy and brachytherapy, the side effects can be less. Again I like surgery if its warrented, but I fear some buyers remorse if u jump so quick.I jumped quick, 8wks post biop, but I ended up with a significant up grade with teriary 5, which sealed, the already done deal.
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.


vam4710
Regular Member


Date Joined May 2010
Total Posts : 89
   Posted 6/1/2010 8:14 PM (GMT -6)   
I appreciate all the comments and opinions, please keep them coming. I do agree that 5 weeks maybe too soon and I will push that back on my URO. In the meantime I will get a second opinion on the biopsy. From what I have seen here.... there have been others with a Gleason 6, a PSA less than mine, who have gone through surgery.... I do know that even when the second opinion comes in and all is said and done,,,, I still have this %$@! thing growing inside me, no matter how slow.. and as much as I'd like to wait, I want it gone!
Diagnosis June 1, 2010 @ age 50
PSA April 2010 2.75 up from 2.14 in Sept. 2010
Biopsy May 25, 2010
1 of 12 cores positive; Gleason 3+4 = 7  25%;  Stage T1c
CT and Bone scan -SCHEDULED
Da Vinci Surgery in less than 6 weeks


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6946
   Posted 6/1/2010 8:38 PM (GMT -6)   
I had multiple opinions, and finally went DaVinci - yes, the surgeon required me to wait 8 weeks after biopsy as a MINIMUM. It was actually one or two more due to hospital scheduling.

Honestly, I would have done seeds without any hesitation at your numbers. The actual surgery and (at least for me) certain ED at too young an age were serious downsides of DaVinci. My numbers were too far along for anything but surgery, in the opinion of everyone but the radiation oncologists, but they promised much lower success rates.

I am back in for followup IGRT (another cost of finding it late).

Not being a doctor, you just get my experienced opinion.

RCS
Veteran Member


Date Joined Dec 2009
Total Posts : 1247
   Posted 6/1/2010 8:45 PM (GMT -6)   
Vam,
 
I had the same feeling of just wanting the cancer out .... I think that hapens to some of us. 
 
Having said this, I agree with the advice given by others .... you can afford the time to get a second opinion and research other options. Besides brachy, there are other new radation options like cyper knife, proton and photon therapy, that some of the guys on this forum are going to use.  You might want to look for these posts ...
 
Best wishes on what ever treatment option you choose.  I am glad you caught your PC early.
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 prostatic 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
 
 
 


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 6/1/2010 8:52 PM (GMT -6)   
Vam,

Your response is so typical. I think every one of us said or thought the same thing at some point after diagnosis.

That being said, don't jump at the first log floating by. Take some time here. You really have months not weeks to decide what your best course of action is.

I am here to tell you incontinence and ED are real side effects. Mu URO's did not really get me to understand those words. Yeh, yeh , I thought, I'll be fine. I am not saying surgery isn't a great option for a younger man, and that you will be ok. Just make sure you understand what the side effects of all the treatments can be. Find the one that best suits your biopsy results with the least amount of side effects.

I would recommend a visit to a major cancer center and get an absolute second opinion from a team that has the experience and reputation. Places like Mayo, Johns Hopkins, Cleveland Clinic, etc.

I think when it is all said and done, you won't be sorry. This is a big step. You have a lot of years left to live. Make sure you take the time to make a decsion that is best for you, for your family, and your future.

Good luck. I am pleased to hear you say that you are listening to the advice being given here. It may not always be wrapped pretty, but it comes from experience and from guys who care. But as was said, it is your decsion ultimately.
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


Red Nighthawk
Regular Member


Date Joined Oct 2009
Total Posts : 289
   Posted 6/1/2010 8:53 PM (GMT -6)   
Vam,
How many da vinci surgeries has your uro done? You need to know if he has done hundreds, perhaps over 700 to even consider having him operate on you. My story is very similar to yours. My uro was all set to schedule da vinci surgery. Fortunately, my lovely wife had the nerve to ask him how many he had done. He said he had done 20 last year and 20 this year. I knew then I had to leave him. You would be wise to follow the suggestions of the guys here who have gone down this road you, unfortunately, find yourself on. Slow down, take a breath, say some prayers, and start to study and research your options. If you decide da vinci surgery is your choice, then find a surgeon who has done at least 700. Good luck and please keep us informed while on your journey.
Age: 62
Pre-op PSA: 4.1
Post-op pathology:
Gleason grade: 3+4=7, present in both lobes, at least 1.1 cm, and occupying less than 5% of prostate by volume. pT2c NX MX
No lymphatic/vascular invasion present.
Seminal vesicles and extraprostatic soft tissue free of tumor.
Inked margins are free of tumor.
High grade prostatic intraepithelial neoplasia is present
Robotic RP: Sept. 15th, 2009 1 day in hospital, cath out on 9th day
Post-op PSA: at 4 weeks ---> .04
at three month intervals -> .03; .02 (the trend is my friend!)
ED: Improvement is very slow but there are positive signs. Doc has NOT put me on ED drugs yet but I am starting to anyhow.
One pad/day for the first six weeks. Two pairs of underpants, just to play it safe, for a few months.
Surgery: Dr. Jim Hu. Brigham & Women's Hospital, Boston


BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 6/1/2010 9:08 PM (GMT -6)   
First Uro that I talked to recommended DiVinci surgery. When I asked he told me that he had done 15 "total" and expected it to take 4-6 hours. I was out of there in no time. Guy that I went with had done more than 400.
Dx with PC Dec 2008 at 56, PSA 3.4


Biopsy: T1c, Geason 7 (3+4) - 8 cores taken with 4 positive for PCa, 30% of all 4 cores.

Robotic Surgery March 2009 Hartford Hospital, Dr Wagner
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes negitive - tumor volume 9%
nerves spared, no negitive side effects of surgery

One night in hospital, back to work in 3 weeks

psa Jun 09 <.01
psa Oct 09 <.01
psa Jan 10 .07 re-test one week later .05
psa Mar 10 .28 re-test two weeks later .31
psa May 10  .50

Aril 10 MRI and Bone Scan show lesion on lower spine, false positive. 
 
Started HT 5/25/10 with 3 month shot of Trelstar. SRT scheduled for late July


vam4710
Regular Member


Date Joined May 2010
Total Posts : 89
   Posted 6/1/2010 9:09 PM (GMT -6)   
Red Nighthawk said...
Vam,
How many da vinci surgeries has your uro done?

Thanks for the reply RED... he's done over 500... he is also the co-chief of Urology Oncology and did his residency and training @ Sloan Kettering in NY


Diagnosis June 1, 2010 @ age 50
PSA April 2010 2.75 up from 2.14 in Sept. 2010
Biopsy May 25, 2010
1 of 12 cores positive; Gleason 3+4 = 7  25%;  Stage T1c
CT and Bone scan -SCHEDULED
Da Vinci Surgery in less than 6 weeks


Timm
Regular Member


Date Joined Feb 2010
Total Posts : 83
   Posted 6/1/2010 9:33 PM (GMT -6)   
Vam
 
I'm not a Doctor and I do not have anywhere near the knowledge that these member have but if your sold on the surgery, you should be able to get a another dia. in six weeks. Granted, most of these doctors have a little used car salesman in them, just type in PC. into I-tube and watch these guys hawking there wares, at 3-4 thousand a shot, so would I. This does'nt make the bad doctors, just rich.
  Your numbers look good and as I understand it you will be 8 wk. out from biopsy. Make sure your surgent is experienced and keep posting, the members will talk you though it. I had absolutely no patients and in the end went for the first available surgery opening and so far so good. At the end of the day it' always your call and the fog, does go away.
 
        Tim
  .
58 yrs.
PSA 6.94  12/10
Bio. 8 of 12 cores pos. 2/1
Gleason   3+4=7
Da Vinci    4/14
Tumor volume  9%
Extraprostatic extension- within margins
Margins    clear
T2c NO Mx
PSA. 6wks. post sugery .01


English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2215
   Posted 6/1/2010 11:43 PM (GMT -6)   
VAM
(Sorry I've forgotten your family history, but, from the way you mention it and its relevance, I'm assuming a dad or uncle etc has died from PCa, and done so relatively young)

Yes I think you need to take time to work out what you want to do and what you need to do, though in my own case I know that I was able to concentrate on things 100% for two weeks or so and make my mind up. That said I was still operated on 14 weeks after the biopsy, and it was made clear that it would be possible to alter my wishes right up till the last minute.

I think it might help all guys if one choice regarding PCa was taken out of our hands and that there was some kind of protocol introduced that no prostatecomies/surgery could be performed until a minimum of say ten weeks had elapsed since biopsy. (That way you would get an automatic 8 to 9 weeks to think etc to help make sure you were making the right decision.)

As for your stats, well my own stats show what the problem with biopsies can be. Two positive cores of twelve and a Gleason of 6, which put me very close to borderline, but I opted for surgery and then the post op pathology turns up what the biopsy needles couldn't reach, namely cancer mostly on the far side and in the baldder neck, close up against the underside of the bladder and in the seminal vesicles. And an upgrade to 3+4. (So I really would have been in a mess 5 years on if I'd not found what I did in 2009.)
I guess many guys will be hedging there bets and choosing surgery on ther basis of the worry about what might be going on inside them that the biopsy didn't or can't show. I actually said something to the uro alomng the lines that I'd rather have surgery a year to soon than a week too late!

Continue the thinking stage, and get as many answers as is possible. And work out how to balance what you do regarding the questions none of us can answer about the unknown factors. (The "known unknowns")

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 of urine
Stopped wearing pads on 21st Sept 2009
Pre-op style intercourse on 24th Oct 2009 !! No use of tablets, jabs, VED etc. but...
Nov 17th 2009 PSA = 0.1
Can still get erections okay, and almost no leaking of urine, but since December 2009 I don't have orgasms, instead I just have intense pain in place where prostate used to be.
Mar 17th 2010 PSA = 0.4!!! referred to radiation therapist
April 13th 2010 CT scan.
April 28th 2010 Started Radiation Therapy (66Gy - 33 sessions)


rhb47
Regular Member


Date Joined Mar 2010
Total Posts : 208
   Posted 6/2/2010 7:08 AM (GMT -6)   
Hi Vam,
 
One important note about second opinions-Jonathan Epstein (world famous pathologist from John Hopkins) says many pathologists overdiagnose prostate cancer and about 1.5% of their patients each year are found to have been misdiagnosed.  My husband's surgeon won't even operate without a second biopsy opinion.  You've been diagnosed with cancer, but you'll want to make double sure before you commit to any treatment.  Like the other posters advised, I would slow down and read up on the subject-particularly Dr. Strum and Dr. Walsh.  I would also really check up on your surgeon-he's operating in an area where you want someone with experience-your outcome will be determined by his expertise. 
 
Renee
Husband diagnosed 3/10
Age 56, PSA 4.7, free 7.6%
Biopsy 5 of 10 cores positve-all right side-25% to 57%
Gleason 6
DaVinci surgery with Dr. Vip Patel scheduled 8/9/10
 


Burlcodad
Regular Member


Date Joined Nov 2009
Total Posts : 254
   Posted 6/2/2010 7:21 AM (GMT -6)   
Hi V
 
Hope your head has cleared up a bit today.  As others have said, take time to read and learn and then time to contemplate.  You may find that you change your mind several times and then come back to your original thought.  Or you may go in a completley different direction.  Only you can decide what is right for you - my advice is just to be as educated and clear headed as you can when you make that decision. 
 
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
 
 
 


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 6/2/2010 11:57 AM (GMT -6)   

Sorry I missed the Sloan Kettering name.

Sounds like you are already at a major cancer center.  That is good news.

I still recommend getting a second opinion.

Hope and Prayer
Regular Member


Date Joined May 2010
Total Posts : 59
   Posted 6/2/2010 1:46 PM (GMT -6)   
Vam--
Are you in NY? My father was Gleason 6 and a low PSA as well. He opted for seeds 10 years ago and has maintained a 0 PSA since then and does not have issues that surgery may cause. First reaction is to "get it out" but quality of life may be very different with seeds (or other tx mentioned above) than surgery. I would definitely get a second and even third opinion. We met with several doctors for both my dad and bf. I wish you the best!!
Boyfriend dx at age 44 with Stage 4 PC on 11/09. Gleason 4+5, 11 of 12 cores +; PSA 51.34
DaVinci surgery on 12/09

Gleason 4+5 confirmed. Lymph and vesicle invasion, right nerves spared.
pT3c N1 Mx
HT: Casedox and Lupron started 1/10

PSA 1/13/10 23.15 2/8/10 .37 3/18/10 <.05 5/14/10 <.02

Bone metastasis

Radiation: 42 sessions ending 6/10


vam4710
Regular Member


Date Joined May 2010
Total Posts : 89
   Posted 6/2/2010 1:53 PM (GMT -6)   
Hope and Prayer said...
Vam--
Are you in NY? My father was Gleason 6 and a low PSA as well. He opted for seeds 10 years ago and has maintained a 0 PSA since then and does not have issues that surgery may cause. First reaction is to "get it out" but quality of life may be very different with seeds (or other tx mentioned above) than surgery. I would definitely get a second and even third opinion. We met with several doctors for both my dad and bf. I wish you the best!!

In Northern NJ.... I read about seeds and did some research....at my age, if there is any reoccurance down the road, my options would be limited. Thank you very much for the reply and i wish the best for both your dad and boyfriend!


Diagnosis June 1, 2010 @ age 50
PSA April 2010 2.75 up from 2.14 in Sept. 2010
Biopsy May 25, 2010
1 of 12 cores positive; Gleason 3+4 = 7  25%;  Stage T1c
CT and Bone scan -SCHEDULED
Da Vinci Surgery in less than 6 weeks


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4223
   Posted 6/2/2010 3:36 PM (GMT -6)   
Vam,
You are getting good advice here from patients that have been throught it all. Please get a 2nd opinion and review all options before making a decision, and get a 2nd opinion on your biopsies slides from Botwitch.
JohnT

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


Hope and Prayer
Regular Member


Date Joined May 2010
Total Posts : 59
   Posted 6/3/2010 9:45 AM (GMT -6)   
I could understand that! Once you radiate, you cannot have surgery or most doctors will not do it. For BF, we went to Sloan and Mt. Sinai. Decided on surgery at Mt. Sinai and treatment at Sloan. We met with Dr. Samadi at Mt. Sinai, Dr. Eastham at Sloan regarding surgery and Dr. Zelefsky at Sloan for radiation. We also met with Dr. McKiernan at Columbia for further opinion. I hope this helps.
Boyfriend dx at age 44 with Stage 4 PC on 11/09. Gleason 4+5, 11 of 12 cores +; PSA 51.34
DaVinci surgery on 12/09

Gleason 4+5 confirmed. Lymph and vesicle invasion, right nerves spared.
pT3c N1 Mx
HT: Casedox and Lupron started 1/10

PSA 1/13/10 23.15 2/8/10 .37 3/18/10 <.05 5/14/10 <.02

Bone metastasis

Radiation: 42 sessions ending 6/10


April6th
Regular Member


Date Joined May 2010
Total Posts : 264
   Posted 6/3/2010 1:53 PM (GMT -6)   
A lot of good recommendations in this thread. I agonized over the decision on what treatment only for a week after my two consultations were concluded. I decided to go with the da Vinci 8 weeks and one day after my biopsy. Most of my decision was based on fact and logic but just wanting to get that cancerous prostate out of my body as soon as possible was a factor too.

What made my decision a little easier was I got three personal recommendations on which robotic surgeon to use-and that carried a lot of weight. Two recommendations were from friends (who had prostatectomies) and the third recommendation was from my diagnosing Uro who only did open (for 20+ years). All recommended the same surgeon and that is who I picked.

I guess my point is that if you decide on robotic, maybe there is a local support group in your area where you can go and get personal recommendations for surgeons in your area and hear about others PCa journey. There might be a robotic surgeon in your area (other than your current Uro) who is generally regarded as the go to guy, with the most experience and the best results
Here are some of my stats:
Age:54
Father diagnosed with PC at age 72 - wasn't contained to prostate when found in 1992.
My PSA rose from 3.2 to 5.1 over the course of 1.5 years with Free PSA at 25% for the last two tests.
DRE showed no evidence of tumor but Uro thought my prostate was a little large for someone my age
PCa diagnosed 4/6/10 after biopsy on 4/1/10
1 out of 12 biopsy samples was positive with 5% of biopsy sample cancerous
Gleason 3+4
Da Vinci surgery scheduled for 6/1/10

Post Edited (April6th) : 6/3/2010 1:58:48 PM (GMT-6)

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