Just diagnosed with PC

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

An38
Veteran Member


Date Joined Mar 2010
Total Posts : 1152
   Posted 6/8/2010 5:24 PM (GMT -6)   
Hello all,
 
My husband was diagnosed yesterday with PC.
He took it really well and in the next few weeks we will be making decisions on what to do next.
I have questions and would like your opinion.
As you can see from the footer the diagnosis is Gleason 3+3 in 10% of one core, and suspicious areas in another core but the flip side of this is that his psa has been rising rapidly and at 52 the recommendation in many sits and in Dr Strum's book is that he should be treated aggressively.
 
1) What is the ideal timeframe to make decisions on what to do next? I know it's meant to be months not weeks.
2) We live in Sydney, Australia - how do we find where the most experienced professionals are. We heard good things about our urologist but we found out  my husband he had cancer through mail, he never returns a phonecall and he just seemed quite casual about surgery at the only time we met him.
3) How many opinions/options did you explore - how many doctor's did you see before making a decision? We have Dr Strum's book, this site, quite a few links and PCI tools as resources.
 
This has all been a bit of a shock, the best part of it though is that we took many of your opinions into consideration about having a second expert opinion on the slides. If not, we would not have known it was cancer. Thank you Bill for the name of the expert pathologist and thanks to all those who pushed us to go in that direction.
 
An
 
 
 
 
 
 


Husband's age: 52
 
In 2007 my husbands PSA levels were 2.5.
In Feb 2008 they were 1.7
In Oct 2009 they were 3.67 with a free PSA ratio of 27
In Feb 2010 they were 4.03 with a free PSA ratio of 31.
 
Referred to urologist. DRE normal.
Biopsy 28/4/2010: results, negative for a diagnosis of PC however 3 focal ASAPs on left side of prostate at base, apex and at transition resulting in the conclusion  "...small acinar proliferation is suspicious but not diagnostic for prostatic adenocarcinoma."
 
Review of biopsy by experienced pathologist, results,
1 out of 12 core diagnosed with 10% of Gleason score 3+3 cancer (left transitional) 
1 out of 12 cores with ASAP (left apex), suspicious but not diagnostic of cancer


Radical
Veteran Member


Date Joined Mar 2009
Total Posts : 739
   Posted 6/8/2010 5:58 PM (GMT -6)   
Hi An38
 
As they say sorry to see you here, but you have come to the right place for help.  I am located on the Gold Coast Qld.  I had my surgery at St Vincents In Sydney, and can highly recommend Dr Philip Stricker, he is the leading surgeon in Oz.  I chose the robotic, although expensive, it was well and truly worth it, and as you can see by my stats, I am doing really well.  All bodily functions back to normal, and feeling great. I have attached the link for Dr.Stricker below. 
Please keep us posted as to your progress....................Cheers Kev
 
http://www.prostate.com.au/
Age 51yrs
6 out of 8 cores positive 3 X 60% / 3 X 10%
PSA 4 Gleason Score 3+4=7 Stage T1c
Robotic Surgery 24/12/08
Upgrade Gleason Score 4+3=7 Gleason Differential 60%/40%
Stage T2c Three small foci total volume <10%
Neg Margins and Nodes
Nil - Extraprostatic Extentions
Dry less than 1 week. ED- okay with Meds.
PSA at 18mths no change remains 0.03
"Everyday in Everyway I get better"


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2692
   Posted 6/8/2010 7:10 PM (GMT -6)   
I don't think you have to be big hurry with your stats.

It is more inportant that you take some time to learen all that you can about PC, and the treatments that are available. At your husbands young age, and your low gleason, you most likely will be able to be successfully treated with all of the available treatment options.

We recommend second opinions if you can get access to other resources in Australia. We have several members who should be able to help.

Sorry you qualified to join us, but we are glad to be able help in any way that we can.

Good luck !
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


larch
Regular Member


Date Joined Apr 2010
Total Posts : 47
   Posted 6/8/2010 10:46 PM (GMT -6)   
An

Some time ago the consensus answer may have been aggressive therapy.

These days, I suspect there is no consensus, and many would suggest active surveillance over either radiation or surgery.

With a larger tumor or a Gleason 7, different answers, but no easy answers for you.

Personnally, I would go the AS route.

Larch

BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 6/8/2010 11:12 PM (GMT -6)   
Hello again An,
With just 10% of one core positive for Gleason 3+3 I would not be rushing into action. The PSA at the 4 mark is not really that high although over range for a 52 year old (other causes such as BPH should be looked for). The percentage of free PSA is another factor definitely in his favour. If I had his stats would be inclined to delay treatment and spend a lot more time getting advice and opinions and learning a lot more about the disease. Kev's suggestion of Dr Stricker is a good one............as is another within that Urology group, Raji Kooner (link below). You should really look at active surveillance as a treatment choice, at least for the time being. Also at some future stage should he elect to have surgery a lot of the talk of robotic surgery (even though I had it) is marketing hype.

www.roboticprostatesurgery.com.au/

Bill
Biopsy
4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment: [/color]
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
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 PSA May '10 <0.01


www.yananow.net/Mentors/BillM2.htm


Never underestimate old people ............ you don't get to be old by being stupid.

Post Edited (BillyMac) : 6/8/2010 10:19:53 PM (GMT-6)


Rolerbe
Regular Member


Date Joined Dec 2008
Total Posts : 235
   Posted 6/9/2010 11:01 AM (GMT -6)   
Sorry to have you here, but you've come to a good place. You really do have a lot of options: more or less aggressive, more or less invasive, etc. Take some time to sort it out. Also, do not be afraid to see as many specialists as you need to until you find one that fits you in temperament, experience, communication style, etc. There is a lot of stress to this sordid game and the right MD for you can really help reduce the anxiety and second guessing that comes with the territory.
51 YO
PSA at Dx: 8.2
DaVinci RALP: 10/31/08 -- Great MD in New Haven, CT
Negative margins, no extra-capsular involvement
One nerve spared
PSA at 0 for just over a year now.
 
 


reputo
Regular Member


Date Joined Apr 2010
Total Posts : 26
   Posted 6/9/2010 1:30 PM (GMT -6)   
With a similar biopsy I took 6 months to decide, but wish I had taken longer and had done more research on this and other sites -- especially regarding side-effects and rehab.
Age: 57
Biopsy: June 2009. Gleason Score: 3+3.
Zoladex 10.8 mg subq implant on Nov 2, 2009
da Vinci RRP March 2010 Virginia Mason Hosp.
Pathology: margins clear
6-week post-op PSA .06
April '10, Cialis 10 mg 2xweek, 1/4 of the time results in partial erection
Bladder neck dilation May 2, 2010


Aimzee
Veteran Member


Date Joined May 2010
Total Posts : 1406
   Posted 6/9/2010 2:00 PM (GMT -6)   

Hello An!

I am new to this forum and found out my husband has Prostate Cancer in April.  I mentioned on the thread, "How Many Wives Get Depressed" that we had the multi-disciplinary session yesterday with four doctors. Their recommendation is the Da Vinci (robotic) method of surgery.

I hope you can meet with that doctor recommended to you.  You do seem a lot more calmer than I am.  We are also at  the beginning of this journey.  I wish you and your husband the best in getting the right answers!

I have new stats which I will add later or tomorrow.  

Take care,

Aimzee.


Husband Ron, age 63
Had Progesterone shots for 6 months.  January PSA was .05. 
PSA 6.5
On Cipro (antibiotic) for 16 days
Bone Scan/CT Negative
Biopsy 4/20/10  12 samples... 3 positive on right side
Gleason 6 (3+3)
Very likely to have Perineal  Prostatectomy in June, 2010.
 
(I do the posting for both of us.)


texguy
New Member


Date Joined Jun 2010
Total Posts : 1
   Posted 6/9/2010 3:34 PM (GMT -6)   
Age 57:
PSA 2.9 Biopsy April 2010
Gleason 6 (3+3) 14 samples 1 core positive left lateral Apex 1.0 mm high grade intraepilthellal Neoplasia. CT/Cat scan Negative.

My doctor recomended the Robotic Surgery. My concern is incontinents and ED. I was reading about Proton Radiation which is non invasive but it seems that the people having this done have more positive cores and higher PSA. Another doctor told me to see Dr. John Davis at MD Anderson that he was one of the best in the world for Robotic surgery. I'm confussed on which way to go. Any suggestions would be appreciated.

Steve

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2692
   Posted 6/9/2010 3:51 PM (GMT -6)   
Steve,

With your PSA, Gleason, and biopsy results, it would appear that you may not need to do anything for a while, until the doctors can decide the characteristics of your PC.

Take plenty of time to study and learn about PC and the options. Get secind and third opinions from different specialties. Definitely a radiation oncologist, and probably a PC oncologist who has no reason to recommend any tx.

I would certainly investigate brachytherapy if I was in your shoes and the PSA starts to rise.

Good luck, and welcome to HW
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


creed_three
Veteran Member


Date Joined Jan 2007
Total Posts : 762
   Posted 6/9/2010 4:37 PM (GMT -6)   
Hello,
We too are in Australia and Stricker was my husband's surgeon 3 years ago, so I second Kev's comments as well as Bill Mac's. He has an email service where you can email him for comments/suggestions if you want google it. However, we consulted three specialists in the end. One was good and did the biopsy,  but recommended someone more qualified if we chose the surgical path due to hubby's age (and when we told him who were were considering, he concurred, but there were several others he could have referred us too). One specialist was bad - didn't follow up. In the end, after wide research we chose the person we felt the most experienced with younger men. However we insisted on evidence and read all we could, and asked outrageous, complex questions!  We also took 4 months to decide, but my husband chose the aggressive path at the time due to higher Gleeson. Your situation is different, and you must be still in a great degree of shock at the moment. Take your time to work through the options with your hubby, and let the dust settle before making any major decisions. It never hurts to have a second or third opinion even if you have a good first consult with whomever you choose. We found in Australia, the good surgeons in all States are widely known by those with knowledge in the area and there are several with excellent reputations. Wide reading and searching on the internet is helpful.  Good luck. Lana.
PS My hubby was lucky to have a good and complete recovery like the other Aussies who have posted above.  
Creed_three (Lana) - with husband "CJ" now aged 52.5 yrs (49 years at diagnosis).
PSA (2002) 2.1. (2006) 3.5.  1 x 5% core of 12 positive at biopsy. Open Radical Prostatectomy with nerve sparing April 2007 Sydney, Australia. Gleeson 3 + 4 = 7. 2 x small multifocal lesions. Contained. Undetectable <.1 PSA since: June 2007-0.01, Oct 2007-0.02, April 2008-0.02: Oct 2008-0.03, Nov, 2008-0.02, April 2009-0.03, April 2010 - 0.03. 


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 6/9/2010 5:21 PM (GMT -6)   
My brother was diagnosed with somewhat comparitive stats, towards the definition of 'indolent PCa', my brother has done W.W.-surveilence for about 5-6 yrs. now and no movement on psa level and no treatment, watches his diet. It seems to have been reasonable for him to do this.

#2- Michigan guy Rick K. treated about 13 yrs. ago- psa 11.0 and two positive PCa biopsies rated then as Gleason 5 (2+3), today would be a 6 score no doubt. He did drugs only with fabulous results, ADT3 hormone therapy for 13 months, then quit drugs and stay on proscar for maintenance. His manhood functions all returned to normal in short time. Did so well he had rebiopsies done 2 more times(over the years) and nothing found. Great results lasted 12 yrs. until recently psa showed upward trend, so he resumed second round of ADT3 drugs for 13 months and will quit and monitor. It was his decision to try this way back and it does not necessarily seem insane. I have talked with him and he is elated with his journey doing this. He can still have any major treatment done if and when he elects too, surgery can still be done after using these drugs, might be harder to do, but is possible and all other treatments.

The world of PCa is much more complex and stranger than you may believe. One size does not fit all, many avenues can have results. Great you have Dr. Strums book, my photo for endorsing it is on the inside cover of 2nd edition  (the guy from Davisburg, Michigan)..that would be me. Also Terry Herbert is on the back cover  (www.yananow.net) website moderator.


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

Post Edited (zufus) : 6/9/2010 4:25:53 PM (GMT-6)


An38
Veteran Member


Date Joined Mar 2010
Total Posts : 1152
   Posted 6/10/2010 8:42 PM (GMT -6)   
Hello all,

And thank you for your responses.

It is a real source of comfort for my husband and I that this forum exists at all - I don't know what people did before we had the internet.

Bill, I was also interested in knowing why my husbands psa level was 4 with the 10% of cancer in one core. It turns out that some of his cores shown active and chronic inflammation and it seems from the report that other parts of his prostate are atrophying. I think that may be a reason, what do you think?

I think without the inflammation and the atrophy that psa numbers would be lower and that we would not have had reason to do the biopsy at all because the numbers would be so low.

We are just digesting the news at the moment. Will probably start setting up appointments with specialists over the next couple of weeks. The multidisciplinary approach also seems like a good idea.

An
Husband's age: 52
 
In 2007 my husbands PSA levels were 2.5.
In Feb 2008 they were 1.7
In Oct 2009 they were 3.67 with a free PSA ratio of 27
In Feb 2010 they were 4.03 with a free PSA ratio of 31.
 
Referred to urologist. DRE normal.
Biopsy 28/4/2010: results, negative for a diagnosis of PC however 3 focal ASAPs on left side of prostate at base, apex and at transition resulting in the conclusion  "...small acinar proliferation is suspicious but not diagnostic for prostatic adenocarcinoma."
 
Review of biopsy by experienced pathologist, results,
1 out of 12 core diagnosed with 10% of Gleason score 3+3 cancer (left transitional) 
1 out of 12 cores with ASAP (left apex), suspicious but not diagnostic of cancer


Drums
Regular Member


Date Joined Mar 2010
Total Posts : 134
   Posted 6/10/2010 9:56 PM (GMT -6)   
An,
As others said, I think you and your husband have some time to decide. Part of my decision to treat aggressively was along the lines of - what does someone want to hear after being told they have cancer? I think it would be, "We caught it early and it's treatable." Both of those apply in your husband's case. So, why wait for it to get worse? Another thought is that the younger you are, the better you can tolerate the treatment side effects. My uro radiation oncologist both indicated AS was a reasonable choice for those 75 and above, because this is generally a slow developing cancer and of life expectancy at those ages. As always, individual cases may dictate different courses and there will be side effects, but the main idea is to get rid of the cancer. It's not going to go away on its own.
Bill
Age 52 at diagnosis, father died of PCa
 
PSA: 10/16/09 - 2.8; 1/11/10 - 3.8
Biopsy 11/25/09, 11 core samples - HG PIN on right side
Biopsy 2/17/10, 11 core samples - left side, adenocarcinoma, Gleason 6, one core at 5%
Notified of dx on 3/12/10 (27th wedding anniversary) via phone by the nurse! (dropped this Uro!)
MRI 3/17/10 and bone scan, 3/23/10, indicate: gland volume is 27mL, PCa is confined to prostate, seminal vesicles and vas deferens are unremarkable.
 
RALP conducted 19 May 2010 by Dr. Lee at U. Penn Presbyterian
Pathology report on 10 Jun 2010: Gleason 6; gland involvement by carcinoma < 2%; tumor in peripheral zone on BOTH sides; no capsular, extracapsular extension, lymph node, or seminal vesical involvement; and no positive margins.
 
Incontinence: first four days after catheter removal - only1-3 pads/day (but urethra was inflammed); 2d week (after inflammation) - 8-10 pads/day (sometimes more!); 3d week - 4-6 pads.


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 6/10/2010 10:36 PM (GMT -6)   
An,
Please don't see this as medical advice but rather something to think about. It may well be that past inflammation has caused the atrophy (wasting) within the gland. If he has some current inflammation (as evidenced by the biopsy cores) that may well be a cause for the higher PSA reading. Perhaps he might ask his doc for a course of antibiotics and check the result. I have read that if you biopsied all 60 year olds then half of them would be diagnosed with PCa. Likewise a smaller group (perhaps a third) of 50 year olds would give the same result. The facts are that most PCa is indolent and those with it will die of other causes in old age. It is said that all men will get PCa ...... it is the normal course of aging. Some may get it at 40 while others not till they're 150 (by which time they are long gone from something else). I recall reading that breast cancer is much the same. That's the trouble with this disease ....... much of the time it is a judgement call. I don't know if you've seen it yet but it would be worthwhile reading the many personal experiences of Gleason 6 fellas on YANANOW.

www.yananow.net/Chart-Gleason.htm#6

Drums
"It's not going to go away on its own."
That's not strictly correct. If you look at the above site you will see there are quite a few stories where the "tumour" has disappeared. There are quite a few Gleason 6's who adopt a strict dietary regime whose PSA not only falls but no longer have "cancer". I personally know a Gleason 7 guy, who was diagnosed 3+4, 3 of 12 positive for low percentage. He adopted a strict diet plan and his PSA dropped (it initially was 7 point something). After a year another biopsy said Gleason 6, PSA 4. After 2 years PSA about 3, another biopsy (he specifically requested these biopsy cores be taken from exactly the same area as the initial test) showed no abnormality. To me, it was a real risk if grade 4 cells were present but it just goes to show we have a lot to learn.
Bill

Post Edited (BillyMac) : 6/10/2010 9:42:51 PM (GMT-6)


Aimzee
Veteran Member


Date Joined May 2010
Total Posts : 1406
   Posted 6/10/2010 11:33 PM (GMT -6)   

Zufus, do you know anything about Beaumont Hopsital in Royal Oak / Troy, Michigan.

What is confusing to my husband is that his urologist told him the robotic approach wouldn't be good for him because of past hernias, stomch surgery, gall bladder, etc.  Then four specialists recommend the Da Vinci surgery.  He is very confused by all of this.

Also, my husband is starting to expereince depression.  The car broke down three times this week and the total repair bills were over $1,000.  He is really stressing out.  I wish I could make this all go away!

Thank you for the advice I have been reading.

Aimzee


Husband Ron, age 63
Had Progesterone shots for 6 months.  January PSA was .05. 
PSA 6.5
On Cipro (antibiotic) for 16 days
Bone Scan/CT Negative
Biopsy 4/20/10  12 samples... 3 positive on right side
Gleason 6 (3+3)
Very likely to have Perineal  Prostatectomy in June, 2010.
 
(I do the posting for both of us.)


Drums
Regular Member


Date Joined Mar 2010
Total Posts : 134
   Posted 6/11/2010 9:55 AM (GMT -6)   
Bill,
I'm with you 100%. I really believe diet makes a difference. But I think its a matter of playing the odds. Even the effectiveness of the medicines we take are all based on statistical success. Our personal genetic composition will dictate how we react to whatever we intake, including food or medicines. So my thoughts were to increase the odds in my favor as much as possible. Even in the last few months my lab numbers have changed remarkably. In Nov 09: total cholesterol - 189, HDL - 43, LDL - 108, triglycerides - 190, glucose - 104. But this last Apr: total cholesterol - 146, HDL - 47, LDL - 83, triglycerides - 80, glucose - 90. All due to diet change. But I also took the RALP route to be even more sure. It's whatever each one of us can live with.
Bill
Age 52 at diagnosis, father died of PCa
 
PSA: 10/16/09 - 2.8; 1/11/10 - 3.8
Biopsy 11/25/09, 11 core samples - HG PIN on right side
Biopsy 2/17/10, 11 core samples - left side, adenocarcinoma, Gleason 6, one core at 5%
Notified of dx on 3/12/10 (27th wedding anniversary) via phone by the nurse! (dropped this Uro!)
MRI 3/17/10 and bone scan, 3/23/10, indicate: gland volume is 27mL, PCa is confined to prostate, seminal vesicles and vas deferens are unremarkable.
 
RALP conducted 19 May 2010 by Dr. Lee at U. Penn Presbyterian
Pathology report on 10 Jun 2010: Gleason 6; gland involvement by carcinoma < 2%; tumor in peripheral zone on BOTH sides; no capsular, extracapsular extension, lymph node, or seminal vesical involvement; and no positive margins.
 
Incontinence: first four days after catheter removal - only1-3 pads/day (but urethra was inflammed); 2d week (after inflammation) - 8-10 pads/day (sometimes more!); 3d week - 4-6 pads.


English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2218
   Posted 6/11/2010 10:25 AM (GMT -6)   
An

I think you and hubby have plenty of time to make decisions. Yoy're getting lots of help here by the look of it so I can'ty add much.


Aimzee:

about your worry that surgeons have recommend da vinci after others have said he should have perineal. I think you just have to press them by asking them why they think this is okay. I feel like they should be asked to physcially touch the parts of his body they want the robot to operate and explain why it is okay. I presume Ron has scars on the outside that indicate where he was operated on previously so that if they are near the five or six locations where the robot arms are going to go in it should make you wonder. My robot scars are nowhere near the hernia scars I have seen on others, so it may depend on how much ahd to be done to repair Ron's hernias.
Take plenty of time with this.

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)


reputo
Regular Member


Date Joined Apr 2010
Total Posts : 26
   Posted 6/11/2010 12:43 PM (GMT -6)   
IMHO PSA is an indicator of whether to do a biopsy. PSA is a signal used to trigger further investigation.
Age: 57
Biopsy: June 2009. Gleason Score: 3+3.
Zoladex 10.8 mg subq implant on Nov 2, 2009
da Vinci RRP March 2010 Virginia Mason Hosp.
Pathology: margins clear
6-week post-op PSA .06
April '10, Cialis 10 mg 2xweek, 1/4 of the time results in partial erection
Bladder neck dilation May 2, 2010


Aimzee
Veteran Member


Date Joined May 2010
Total Posts : 1406
   Posted 6/12/2010 8:23 AM (GMT -6)   
English Alf said...
An

I think you and hubby have plenty of time to make decisions. Yoy're getting lots of help here by the look of it so I can'ty add much.


Aimzee:

about your worry that surgeons have recommend da vinci after others have said he should have perineal. I think you just have to press them by asking them why they think this is okay. I feel like they should be asked to physcially touch the parts of his body they want the robot to operate and explain why it is okay. I presume Ron has scars on the outside that indicate where he was operated on previously so that if they are near the five or six locations where the robot arms are going to go in it should make you wonder. My robot scars are nowhere near the hernia scars I have seen on others, so it may depend on how much ahd to be done to repair Ron's hernias.
Take plenty of time with this.

Alfred

Thank you, Alfred!  We didn't think to do that, so I will make note of your recommendation.  We go on Tuesday for a meeting with the doctor that will do the da Vinci surgery.  Yes, he does have scars.  His last hernia operation was in 1982, and he doesn't think he had mesh put in.  My sweetie is really confused.  I wrote more information on my signature which may help you to see where he's at.
 
Oh, I looked up the doctor and he is 38 years old.  He's been with the hospital for 4 years and it seems that he does the robotic surgery regularly.  Is that enough experience?  I am not sure we can find out more about this doctor from a source without paying.  What did most of you do when you found your doctor?
 
I appreciate your responses.  Maybe I should start a thread about our experience.  So far, the journey has been very, very confusing!
 
Thank you,
Aimzee
Husband Ron, age 63
Had Progesterone shots for 6 months.  January PSA was .05. 
PSA 6.5
On Cipro (antibiotic) for 16 days
Bone Scan/CT Negative
Biopsy 4/20/10  12 samples... 3 positive on right side
one core left base (5% ` 0.5 mm)  two cores of left lateral mid
(20% ~ 2mm, 10%, 10% ~ 1mm)
Gleason 6 (3+3)
Surgery to be scheduled: THE DA VINCI ROBOTIC method
 
(I do the posting for both of us.)


Aimzee
Veteran Member


Date Joined May 2010
Total Posts : 1406
   Posted 6/12/2010 8:25 AM (GMT -6)   

An, what is the latest with your husband?  Have you made any decisions yet?  I hope you will get the best treatment possible!

Aimzee


Husband Ron, age 63
Had Progesterone shots for 6 months.  January PSA was .05. 
PSA 6.5
On Cipro (antibiotic) for 16 days
Bone Scan/CT Negative
Biopsy 4/20/10  12 samples... 3 positive on right side
one core left base (5% ` 0.5 mm)  two cores of left lateral mid
(20% ~ 2mm, 10%, 10% ~ 1mm)
Gleason 6 (3+3)
Surgery to be scheduled: THE DA VINCI ROBOTIC method
 
(I do the posting for both of us.)


An38
Veteran Member


Date Joined Mar 2010
Total Posts : 1152
   Posted 6/14/2010 4:16 AM (GMT -6)   
Hi Aimzee,

Thanks for your concern, no we haven't finalised any decisions. I think we will probably do a course of antibiotics to start with to see whether the trend of the PSA is flat or rising.

Not that I am a doctor but I would be very concerned about doing robotic surgery of any type for something as serious as this to try and take out the entire prostate, leaving no bits behind through a web of scar tissue due to multiple operations. I have read somewhere that abdominal operations leave scar tissue. There has been a lot of marketing hype around Da Vinci procedures as the machine is extremely expensive and urologists are therefore very keen to use it. Also 4 years experience does not seem to be ideal - it would be good to know exactly how many procedures he has performed. Don't want to scare you, just my opinion.
 


Husband's age: 52
 
In 2007 my husbands PSA levels were 2.5.
In Feb 2008 they were 1.7
In Oct 2009 they were 3.67 with a free PSA ratio of 27
In Feb 2010 they were 4.03 with a free PSA ratio of 31.
 
Referred to urologist. DRE normal.
Biopsy 28/4/2010: results, negative for a diagnosis of PC however 3 focal ASAPs on left side of prostate at base, apex and at transition resulting in the conclusion  "...small acinar proliferation is suspicious but not diagnostic for prostatic adenocarcinoma."
 
Review of biopsy by experienced pathologist, results,
1 out of 12 core diagnosed with 10% of Gleason score 3+3 cancer (left transitional) 
1 out of 12 cores with ASAP (left apex), suspicious but not diagnostic of cancer

Post Edited (An38) : 6/14/2010 3:27:40 AM (GMT-6)

New Topic Post Reply Printable Version
Forum Information
Currently it is Wednesday, September 26, 2018 9:45 AM (GMT -6)
There are a total of 3,006,758 posts in 329,393 threads.
View Active Threads


Who's Online
This forum has 161849 registered members. Please welcome our newest member, Michael007.
200 Guest(s), 13 Registered Member(s) are currently online.  Details
ezhoe, JayMot, Startech, Highwayman, PeterDisAbelard., island time, Calibren, Garion, Darla, Katia, garyi, Hallieb, (Seashell)