I have researched TZ tumors quite extensively and there is not a lot of information about
them. A couple of things I found out.
1. They give off a large amount of psa for their size. PSAs of up to 300 have been recorded with the tumor still contained. (Dr Patric Walsh)
2. They are difficult to diagnos with a biopsy as most biopsy needles won't go that deep. I had 13 biopsies before my TZ tumor was discovered, and that was with a color doppler. I was actually showed the tracks of my previous biopsy and they went all around it.
3. TZ tumors are mostly contained as they are deep within the prostate and need to grow a lot before they reach the margin.
4. Surgery for TZ tumors is very difficult and the possibility of positive margins are very high because most surgeons don't get all the prostate tissue. (Dr Peter Scardino, Dr Duke Bahn, Dr Jelle Barantsz)
Hope this helps.
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.