Post Biopsy, Pre Treatment.

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Regular Member

Date Joined Jan 2011
Total Posts : 122
   Posted 1/31/2011 5:26 PM (GMT -6)   
I'm glad I found this forum. I'll give you my stats, you give me your wisdom!
Biopsy results were received 1/12/11. The biopsy was a transurethal with 7 cores as far as I can tell. I live in a small town without many resources and wasn't expecting all this great news. My PSA in November was 4.1. I am 48 years old. From Hillsboro, Ohio.
 Here is the report ver batim
     Prostate, right, biopsy. Adenocarcinoma of prostate, gleason score 3+4=7. Tumor involves 30% of the biopsy specimen. No Perineural invasion identified. Immunohistochemical stains for cytokeratin 34 beta e12 and p63 are supportive of the diagnosis.
   Recieved in formalin are 3 white needle cores of soft tissue ranging from 1.7 to 2.2 cm in length with a diameter of slightly less than .1cm each. The specimen is submitted in toto (3 pieces, one cassette)
Specimen #2
Prostate left biopsies: Prostate tissue, no tumor present. Immunohistochemical stains for cytokeratin 34 beta e12 and p63 are supportive of the diagnosis.
   Received in formalin are multiple white to light tan needle cores of soft tissue ranging from 1.6 to 2.2 cm in length with a diameter of slightly less than .1cm each. The specimen is submitted in toto (4 pieces one casette)
Ok, so I am assuming that one core of the seven is positive?
I have scheduled an appointment with Dr. Ronny Abaza at the Arthur James cancer center for 2/9/11. I am leaning toward the robotic prostatectomy.
 Although the incontinence has me petrified, I want this out of me, pronto. Any info or advice is greatly appreciated!

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 1/31/2011 5:30 PM (GMT -6)   
Welcome to full discussions on PCa and usually nothing held back. Do you have the actual copy of pathology report? Usually we see it differently than what you mention, although you have some nice details within those paragraphs. Usually we see 12 biopsies or alot more in saturation biopsies 30-40 sometimes, seems alittle strange for 7.

Post Edited (zufus) : 1/31/2011 4:34:14 PM (GMT-7)

Tony Crispino
Veteran Member

Date Joined Dec 2006
Total Posts : 8128
   Posted 1/31/2011 5:55 PM (GMT -6)   
Welcome aboard Low!
You are doing what I did four years ago. Research is critical for you at this point and it leads me to tell you to take your time and rush nothing. If your doctors didn't tell you, you have time to study all options on treatment. I this forum has many knowledge resources. This decision will affect you possibly for the rest of your life so make good and sure what you want to do. The first step I would say is have another pathologist look at the slides that were taken in your biopsy. There are some very reputable prostate cancer pathology, namely Jon Epstein at the Johns Hopkins University and David Bostwick at Bostwick Laboratories.

PS: I am your age now. I was diagnosed with an advanced case at age 44. I am doing well and so can you...

Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Da Vinci Surgery ~ 2/17/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.


Post Edited (TC-LasVegas) : 1/31/2011 10:14:06 PM (GMT-7)

Veteran Member

Date Joined Jul 2010
Total Posts : 3596
   Posted 1/31/2011 5:55 PM (GMT -6)   
One, I would call the pathologist and ask him if the cancer was limited to one core. It could have been 10% of all 3 cores in that group..He doesn't say...

Pick up a copy of Dr. Walsh's book "Guide to surviving Prostate Cancer" (Library, eBay, book store) and read it..

There are MANY things to consider before you decide on a treatment..

Most doctors tend to promote whatever treatment they specialize in..Most Urologists are surgeons so they tend to favor that treatment..Pat Walsh, the doctor who wrote the book I recommended is a surgeon...There are other books written by non-surgeons that project a different viewpoint than Walsh.

Doctors tend to minimize the side effects and possible complications of the treatment they are offering. Not all are guilty of this, but many are.

Not all surgeons are created equal..Some do much better than others. If you choose surgery, choose your surgeon carefully.

There are many men on this board who are very close to your situation except they are a few weeks or months or years ahead of you. Read their stories and learn about the bumps in the road that you will surely face...

Best of luck to you ..
Age 68.
PSA at age 55: 3.5, DRE normal. Advice, "Keep an eye on it".
age 58: 4.5
" 61: 5.2
" 64: 7.5, DRE "Abnormal"
" 65: 8.5, " normal", biopsy, 12 core, negative...
" 66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
" 67 4.5 DRE "normal"
" 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT NOW

Veteran Member

Date Joined Sep 2009
Total Posts : 639
   Posted 1/31/2011 6:32 PM (GMT -6)   

The tissue was submitted as Right and Left. The right had 3 cores which had an identified Gleason of 3+4. I suspect that the % is total volume of the submitted tissue for the Right side. Having said that It really wouldn’t make much difference if it were your age and a G-7 it would probably be a good time to think about a large medical center for treatment. Best of Luck


Tony Crispino
Veteran Member

Date Joined Dec 2006
Total Posts : 8128
   Posted 1/31/2011 7:35 PM (GMT -6)   
Fairwind has made an excellent point. There is no way to over stress the importance of having a great surgeon if surgery is your decision. A well known surgeon can heavily help obtain better outcomes not just with the cancer but by reducing side effects. Younger guys tend to heal well but an inexperienced surgeon can mess it all up...


Post Edited (TC-LasVegas) : 1/31/2011 10:14:22 PM (GMT-7)

Regular Member

Date Joined Apr 2008
Total Posts : 158
   Posted 1/31/2011 11:03 PM (GMT -6)   
welcome to the best place you can be given the situation your in, take a minute and breathe low, like tony said your going thru the same thing some of us did ay your age , i was 43 and im tellin ya low , this is something that takes a while to wrap your head around , but once you do, pick a treatment and dont look back, tony and i both went to the same place for our initial treatment, all things said and done , 9 im speaking for me) i would do it the exact same way ,C.O.H.  is the best  , i went robotic and your age is on your side brutha, im 3 yrs out in may, i have been totally continent for 2 1/2 of those yrs, and while it took a while to ragain sexual function ,it did in fact happen , everything works , with out meds now, and its you age and the best surgeon on the planet ( my opinion)  sure it takes a little work , but what doesnt , good luck  low ,   dirt  cool
Diagnosed November 2007   (43 years old )
PSA 3.9 / Gleason 6 / TC1 6 cores 1 shows 25%
Sugery scheduled 5/29/08 - City of Hope - Dr. Mark Kawachi
 "First show of the day"
 and now for the new ive been waiting for
 FINAL PATH REPORT:gleason upgraded to 3+4 T2c bilateral disease,tumor involvment 5%
extra prostatic extention:absent
seminal vesical invasion :absent
pathological staging:pTNM pT2 ORGAN CONFINED
margins free of carcinoma
usable erections ;6-6-08 with little blue pill
continence; 1 pad a day, dry at night
continence a non issue at 10weeks
 1 year p.s.a. undetectable

English Alf
Veteran Member

Date Joined Oct 2009
Total Posts : 2209
   Posted 2/1/2011 1:30 AM (GMT -6)   
Welcome to the forum nobody wants to join
I was also diagnosed at 48

I've not enountered a 7 core biopsy like this before, nor a transureathral biopsy. (That sounds like it probably wasn't very pleasant. Was there any reason they didn't do 12 cores via the rectum?

I think that as others have suggested you need to have it clarified exacty where the tumour was found. It clealry seems to be all on one side and not the other, but there would be a big difference between 1 core having 30% and 30% of all those 3 cores having tmour in them.
Also you could ask what the percentge of Gleason 3 and 4 was. The less 4 the better.

At this stage all you need to do is realise that you do not have to rush into anything. You have to try and avoid worrying too much while you accumulate the information that will help you to make up you mind about how to tackle it.

All the best
Born Jun ‘60
Apr 09 PSA 8.6
DRE neg
Biop 2 of 12 pos
Gleason 3+3
29 Jul 09 DaVinci AVL-NKI Amsterdam
6 Aug 09 Cath out
PostOp Gleason 3+4 Bladder neck & Left SVI -T3b
No perin’l No vasc invasion Clear margins
Dry at night
21 Sep 09 No pads daytime
17 Nov 09 PSA 0.1
17 Mar 10 PSA 0.4 sent to RT
13 Apr CT
66Gy 28 Apr to 11 Jun 10
Tired + weird BMs
14 Sep 10 PSA <0.1
12 Jan 11 PSA <0.1
Erection OK

Regular Member

Date Joined Jan 2011
Total Posts : 122
   Posted 2/22/2011 9:14 AM (GMT -6)   
Thanks for the responses. After an exhaustive search, I haven't found anything special as far as why not to go to OSU James Center for treatment. The doctor (Abaza) and the center seem to be well respected. I can't find many instances of complications after surgery or at least many special complications anyway. It is convenient and covered by my insurance. I seriously considered Cleveland Clinic but am not so sure that's not just a brand name kind of thing.
ED isn't much of a concern to me since Im not that active now anyway and there is more than one way to skin that cat. Incontinence however is another matter. Just hope that effect is minimized. Surgery scheduled for March 14th if I get cardiology clearance (heart attacks in 02 & 03 threw in that little wrench.)

Veteran Member

Date Joined Feb 2011
Total Posts : 713
   Posted 3/6/2011 9:57 AM (GMT -6)   
Hey low, we are practically neighbors! I live in Loveland a mere 45 min from you. I had mine done at Bethesda North Hospital by Dr Delworth. He has done over 1600 robotic surgeries.
Welcome and Good Luck. You can even send me an email any time.
Every minute you fish or ride,adds an hour to your life!

Age 52 Dx age 53 daVinci surgery
prostate volume 24gms
Biopsy 12 cores with 7 positive- left base,right base,left mid gland,right mid gland, left apex.
Gleason score of 7
First PSA 38.7 on10/05/2010
Second PSA 49.9 on11/23/2010
CT negative
Bone scan Negative
daVinci RRP on 01/25/2011 by Dr Mark G Delworth at Bethesda North Hospital.

Regular Member

Date Joined Jan 2011
Total Posts : 122
   Posted 3/6/2011 10:31 AM (GMT -6)   
DaSling, send me an email . My sis lives outside milford and my daughter goes to Raymond Walters in blue ash. Im out here in Hillsboro, about an hr away or so. A mile or 2 from Rocky Fork Lake.

Post Edited (lowandslow) : 3/6/2011 11:32:05 AM (GMT-7)

Forum Moderator

Date Joined Jan 2010
Total Posts : 6848
   Posted 3/6/2011 10:55 AM (GMT -6)   
May I suggest - put the email in your profile - that way only people who are members can see it.
Then edit your post to take it out of the public area.
Just a privacy / spam concern.
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