Hi all. My husband is newly diagnosed. He is 55 years young . Psa was 4.2. 2 cores of 12 positive 1 5% Gleason 3+3 and the other 15% Gleason 3+4. He had a bone scan and ct, and we met with the urologist today who said low volume, intermediate risk t1c. Then he mentioned the bone scan showed a small bone growth in his pelvis that, in his opinion had a less than 1% chance of being cancerous. I asked about an MRI to look into it further and he said it wasn't necessary. Has anyone else had an experience like this? Although I haven't seen the report yet he mentioned that it said "cannot entirely rule out metastasis. Help!
Yup, as the others have noted, it is unlikely that there would be any metastasis with his stats. PSA readings in double figures are most often associated with metastasis, so I would not be too concerned since his PSA is "relatively" low.
At the same time, treatment of some type is probably very wise to consider -- either surgery or radiation. If the PC is still confined to the prostate (chances are good that it IS still confined to the gland), odds are very good that either surgery or radiation would cure him.
Also remember that a biopsy only samples around 1/1,000 of the prostate and, thus, is only an educated estimate of the cancer's true nature. In other words, there are times when post-op examination of the removed prostate reveals that the cancer was more aggressive and more involved than suggested by the biopsy.
I only say this to suggest that there is no need to rush into treatment -- but also that, with the Gleason 7, you do not want to wait too long before selecting a form of treatment.
I'm a surgery guy, but I still always suggest that a newly diagnosed patient consult with a HIGHLY experienced radiation oncologist AND a urologist/surgeon with similar stature. Learn the pros & cons of both forms of treatment so he can determine the course of action that best suits his comfort & confidence zone.
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.
Pathology showed Gleason 3 + 3, pT2c, N0, MX, R1
adenocarcinoma of the prostate.
Prostate 98.3 grams, tumor 2 grams. Prostate size 5.0 x 4.7 x 4.5 cm.
Abdominal drain removed the morning after surgery.
Catheter out in 7 days. No incontinence, occasional minor dripping.
Post-op exams 2/13/12, 9/10/12, 9/9/13 PSA <0.1. PSA tests now annual.
Semi-firm erections now happening 14 months post-op & VERY slowly getting a bit stronger.