Went to Hopkins to the Multidisciplinary Clinic this week. Thought we were prepared and was thrown off track with their advise. Since we are so new at this & learning as we go, I will try to explain.
Hopkins found the biopsy slides the same as what we had. Note in signature.
However the PSA jumped from 4.58~ 11/12 to 12.1~ 3/13! In four months? Was told to get another one in a week, they felt it was not right? Any ideas?
They said the prostate was enlarged as well. Biopsy size was 50.7cc on 12/12. Dont know why..maybe age, 62 very healthy.
Best treatment plan was radiation ( no brachy, prostate too large ). Or
I dont know if we were in some kind of denial because the 1st opinion was ok for AS!
Im not sure what to do next? Any suggestions were to go next, thinking RP ? Live in Delaware. Maybe thats a start.
Good Health 2 youL END QUOTE]
Your Gleason score is good, but with over 50% involvement in the cores, AS would NOT be recommended by most doctors. My sense (which is only that of a humble patient) is that RP is your best route.
I say this because I also had an enlarged prostate (4x normal size). The doctors also said I was not a good candidate for brachy, but EBR or RP could cure me. They also advised that, while EBR could cure me, it could NOT relieve the severe urination problems being caused by my BPH.
Do you have any difficulty urinating at this time? Whether you do or not, it's a good bet that your BPH will continue getting worse, along with the associated urination problems.
So I had a daVinci RP and took care of both problems at once. Cancer free (they say I'm cured -- knocking on wood) and urinating like a firehose with NO incontinence.
As for your PSA, did you happen to have a DRE before the blood was drawn? Or did you happen to have sex or ride a bicycle, etc., in the 48 hours prior to the blood draw? Any of those above things can cause a temporary spike in the PSA reading.
Please feel free to give us more updates as time goes on. We'll be happy to offer our insight, comments, acquired knowledge, etc.
You might also want to purchase the 3rd edition of Dr Pat Walsh's great book, "The Guide to Surviving Prostate Cancer."
Good luck to you!
Resident of Highland, Indiana just outside of Chicago, IL.
July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA Sept. 2011 was 5.7.
Local urologist DRE revealed significant BPH, but no lumps.
PCa Dx Aug. 2011 at age of 61.
Biopsy revealed adenocarcinoma in 3 of 20 cores (one 5%, two 20%). T2C.
Gleason score 3+3=6.
CT of abdomen, bone scan both negative.
DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
My surgeon was Dr. Matthew Tollefson, who I highly recommend.
Final pathology shows tumor confined to prostate.
5 lymph nodes, seminal vesicles, extraprostatic soft tissue all negative.
1.0 x 0.6 x 0.6 cm mass involving right posterior inferior,
right posterior apex & left mid posterior prostate.
Right posterior apex margin involved by tumor over a 0.2 cm length, doctor says this is insignificant.
Prostate 98.3 grams, tumor 2 grams. Prostate size 5.0 x 4.7 x 4.5 cm.
Catheter out in 7 days. No incontinence, occasional minor dripping.
Post-op exams 2/13/12, 9/10/12, PSA <0.1.
Semi-firm erections now happening 14 months post-op & slowly getting a bit stronger.