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Regular Member

Date Joined Mar 2010
Total Posts : 57
   Posted 1/17/2011 5:51 PM (GMT -6)   
Hi all,
Haven't posted since our trip to Zihuatanejo (which was FANTASTIC....31 days of BLISS!!)
My husband has been in AS since he was diagnosed in Feb. 2009.  PSAs have been a bit erratic....the most recent last week being 2.74!!  I don't place much stock in the PSA readings, as I didn't realize he had been taking Green Tea Extract supplements up until the week before the PSA test.  A word of caution....some of the really potent antioxidants can artificially "mask" PSA levels, and lead to a false sense of security.
As it had been a year since diagnosis, and given my husband's young age, I really didn't feel comfortable with him delaying treatment any longer without having a follow-up biopsy.  I emailed a prominent expert in AS to ask how many biopsy cores were sufficient for a repeat biopsy for someone on AS.  He (surprisingly) replied within minutes, and said that he uses the "Vienna Nomogram", and that perhaps more importantly, is to ensure that cores are taken from the anterior and anteriolateral aspect of the prostate.
Ten cores are standard for a biopsy here, but after referring to the Vienna Nomogram (which takes into consideration the age and prostate volume of the patient), it was determined that 14 cores would be sufficient for my husband.
He had his biopsy done last Thursday, and the Radiologist performing the biopsy had no problem with accommodating our request for additional core samples.   As with the last biopsy, all went without a pain, no bleeding, and minimal discomfort.  We should find out the results in a week or two, depending on how back-logged the pathologists are.  My husband is prepared to proceed with Brachy in May or June (he has to wait AT LEAST that long after biopsy to let the insult to the prostate subside), if need be.
Even though I haven't contributed much, I've really appreciated being able to "lurk" on the forum.  What great people, and what a great resource for those of us struggling through this journey!!  Thank you!!
Just a refresher....I am a Radiation Therapist, and would be happy to help those of you who have questions or concerns regarding the process/side effects of RT.   Obviously, as I'm not an RO, I can't give any prognostic info, but I'd be happy to help you out with "the basics"!!
Thanks again to all!!! :-)
-Husband's 1st PSA done (age 45) at routine physical  PSA 3.8
-DRE at physical indicated no abnormality other than slightly enlarged
-Consult with urologist Jan. 2010---DRE negative, PSA 3.89
-Biopsy Feb. 10, 2010:  T1c, Gleason 3 + 3, 2/10 cores pos. (5% in one core, <5% on other core) 1% of core volume positive, gland size     38.84
-consult with "open" prostatectomy uro March 2010
-2 consults with rad. onc. for Brachy March, Apr. 2010....also discussed AS
-latest PSA reading April 8 4.63
-consult with "robotic" uro Apr. 12....tentative surgery date booked July 8
-Have also booked tentative Brachy date of July 20th.
-undecided as yet
_April 27th PSA 5.02!!  Repeat May 19th.  If still high, then a course of antibiotics and repeat.  If still high, proceed with treatment.

Veteran Member

Date Joined Jan 2009
Total Posts : 2243
   Posted 1/17/2011 6:27 PM (GMT -6)   
Good to hear from you Kuls and it sounds like you all had a great vacation. It also looks like you have a plan of action and are moving forward. Since you gave us permision to ask about RT, can you tell me if I am about 10 months out of SRT will the urinary frequency at night ever diminish? Best to you and yours.

Forum Moderator

Date Joined Sep 2008
Total Posts : 4274
   Posted 1/17/2011 6:57 PM (GMT -6)   
Hi Kuls, nice to hear from you again.  I wish you and hubby the best on the biopsy results.  Good luck.
Tudpock (Jim)
Age 62 (64 now), G 3 + 4 = 7, T1C, PSA 4.2, 2/16 cancerous, 27cc. Brachytherapy 12/9/08. 73 Iodine-125 seeds. Procedure went great, catheter out before I went home, only minor discomfort. Everything continues to function normally as of 12/8/10. PSA: 6 mo 1.4, 1 yr. 1.0, 2 yr. .8. My docs are "delighted"! My journey:

Veteran Member

Date Joined Mar 2010
Total Posts : 1152
   Posted 1/17/2011 7:19 PM (GMT -6)   
Hi kuls,

My husband had low volume (1 core, 10%) 3+3 cancer on biopsy and post surgery he had low volume (second pathologist estimated 0.7ccs of cancer) 3+4 cancer. We found out that his index tumour was an anterior predominant tumour - these are hard to pick up on a biopsy that is typically done from the rectum and the posterior of the prostate.

After researching anterior predominant prostate cancer we found that 25% of PCa is anterior predominant and this cancer is best sampled from a perineal biopsy. This was something that we were completely unaware of prior to this research and I am happy that AS experts are highlighting this because given where most biopsies are sampled from (the rectum) many anterior tumours are missed. This is one reason why I am a little wary about relying too much on biopsies including the %s of cancer in the biopsy.

Wish you all the best with the results!

Husband's age: 52. Sydney Australia.
Family history: Mat. grandfather died of PC at 72. Mat. uncle died of PC at 60. He has hereditary PC.
PSA: Aug07 - 2.5|Feb08 - 1.7|Oct09 - 3.67 (free PSA 27%)|Feb10 - 4.03 (free PSA 31%) |Jun10 - 2.69. DRE normal.
Biopsy 28Apr10: negative for a diagnosis of PC however 3 focal ASAPs “atypical, suspicious but not diagnostic” for PC. Review of biopsy by experienced pathologist, 1/12 core: 10% 3+3 (left transitional), 1/12 core: ASAP (left apex)
Nerve sparing RP, 20Aug10 with Dr Stricker. Post-op path: 3+4 (ISUP 2005). Neg (margins, seminal vesicles, extraprostatic extension). Multifocal, with main involvement in the fibro-muscular zone. T2C.
Post RP PSA,
Lab 1: Sep10 – 0.02|Nov10 – 0.03|Dec10 – 0.03
Lab 2: Nov 10 - 0.01|Dec10 – 0.01
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