Anxiety about biopsy results

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tutor_paul
Regular Member


Date Joined Jan 2017
Total Posts : 55
   Posted 12/30/2017 4:28 PM (GMT -6)   
Happy New Year to all!

As my sig indicates, I started this journey about a year ago with about as "entry level" a PCa diagnosis as one can have. I had my 2nd biopsy Dec. 17. Uro found nothing on DRE at that time, and described ultrasound as "unimpressive." In fact, as he's walking out the door he says over his shoulder "you probably don't even have to come in for your January 4th appointment for the results of this... If there is little or no change, I'll just call you."

Well, here we are on the eve of the New Year and the phone has not rung. I don't really have a question about all this, but just wanted to vent about my uro having such an absurd approach to delivering results. Either don't give out the results until an appointment (preferred, obviously) or call regardless of the results. Who the F teaches these guys on messaging techniques? It is raising my anxiety level by the hour and effectively wrecked the holidays. Just ridiculous.

Thanks for allowing me the rant!

Paul
Age: 54
PSA 05/15: 2.09
PSA 11/15: 2.17
PSA 11/16: 2.97
PSA 12/16: 4.13, Free: 11.9%
PSA 06/17: 3.50
PSA 07/17: 4.00 (Inadvertent check as part of annual physical)
PSA 09/17: 3.56

12 Core Biopsy 12/08/16. Pathology: 1/12 (Left mid) 3+3(Score=6); 10% of Tissue

Oncotype DX Genomic Prostate Score = 5

02/17: MpMRI... 1 lesion in vicinity of BX positive core; PI-RADS 3.

On AS since 12/16

ddyss
Regular Member


Date Joined Apr 2017
Total Posts : 316
   Posted 12/30/2017 7:08 PM (GMT -6)   
Everything points towards a smooth sailing !
I’m no doc , don’t understand why you would even need a second biopsy.
Don’t worry be happy!
Easier said than done.
DX@ 48 Yrs PSA 03/15 4.45 DRE: Firm Right Base
04/18 Biopsy Right: Base 4+3, Middle 3+4, Apex: HPIN
Left 6 cores : -ve
5/20 MRI: Pirads 5, ECE:+ve
RALP 05/26 Mt. Sinai Miami - Dr. A. Bhandari
Path:
Gleason downgraded to 3+4 !! Stage T2C
Prostrate Size: 49grams Tumor:20%
LN/SV/ECE: -ve PNI: +ve
Cath Removed : 6/1
Full continence: 7/4
PSA History :
7/7 <0.1
10/2 <0.006

Bohemond
Veteran Member


Date Joined Apr 2012
Total Posts : 980
   Posted 12/30/2017 7:12 PM (GMT -6)   
Paul,
I suspect your doc is just trying to say in his own clumsy way that all will be fine when the pathology report comes back. But I'm with you. You need to see, and have a copy of the full report for your files and for future reference if ever needed. Some patients don't want this level of information. Not unsurprisingly, those aren't the kind of patients who turn up on a board like this. Your doc may just need to know that you, like most of us here, are an involved patient who sees doctors as respected partners on our decisions, but not the guardians of our medical information.
Jim
Age 71
-2002-PSA 9.4, 5 of 10 cores positive - 30-50%.
-RP April 2002. PT3B N0 MX Gleason=7 (3+4), 75% left lobe; small focus rt lobe.
-PSA low of 0.01; slow rise to 0.4 (Aug 2009).
-SRT Jan/Feb 2010. One lymph node targeted. Casodex 3 months during SRT -PSA 0.00 through Apr 2014;
-0.02 Oct 2014; 0.04 Apr 2016; 0.23 Oct 2016; 0.51 Jan 2017; 0.64 Mar 2017, 0.92 Jun 2017, 1.54 Oct 2017

Sr Sailor
Regular Member


Date Joined Sep 2015
Total Posts : 488
   Posted 12/30/2017 7:20 PM (GMT -6)   
The urologist doesn't do the pathology. It seems to me that he has to wait for the results, which may take some time, especially this time of the year.
DOB 1940
Dec 2012: GP felt a nodule and hardened prostate; confirmed by urologist
PSA: 11.9 ng/ml
Biopsy (3/1/2013): Several Gleason 4+5 loci (prostate=45 ml)
Stage: T2c
Transferred to RO
Casodex 1 month; then Lupron 5/13 through 12/14 (18 months total)
Jul-Sep 2013: SBRT (CyberKnife; 3 x 6.5 Gy) followed by IMRT (25 x 1.8 Gy)
Lowest PSA thereafter: 0.1 (3/20/15)
Latest (9/17) PSA = 1.4 ng/ml

oldbeek
Regular Member


Date Joined Sep 2017
Total Posts : 209
   Posted 12/30/2017 8:39 PM (GMT -6)   
Some docs just have any bed side manners. At the first injection with trimix my URO injected 30 units. The script said start at 20 units. Went rock hard in 10minutes with pain level 15. He said , oh yea Trimix causes sever pain in 30% of men as he is walking out, if that does not go down in 3 hrs call me. I said what about taking Sudafed? He says what will that do. See you in 3 months, Bye. This is after he sort of rushed me into RP without expressing the full story of side effects. My GP has even expressed dismay about this guys attitude. Hope the news is good at your appt.
76 very active. Physically fit. PSA 6, MRI Targeted biopsy 6/17 Gl 4+3 9%, Chose RP without consultation 7/28/17 Post RP <.02 PSA ,16 lymph nodes & nerves removed, pT3a, pin, negative margins, Total ED using bimix, still one pad a day

mspt98
Regular Member


Date Joined Dec 2008
Total Posts : 377
   Posted 12/30/2017 9:10 PM (GMT -6)   
You’re probably in the clear, I had had many prostate ca patients for general strengthening as a therapist so I knew his routine, for negative biopsies his nurse would call, for the positive biopsies he made the call. When it was my turn for the biopsy I had already made “bucket list” plans for a trip to San Francisco and I had to go so I scheduled the second biopsy the day before I left, hoping I could get through a carefree trip. Alas, my son called 4 days later saying the doctor had called wanting to talk to me. I knew then for sure.. but it’s been awhile for u, I’m sure ure in the clear
My age= 52 at time of diagnosis
DRE=negative,
PSA went from 1.9 to 2.85 in one year, biopsy ordered,
2 cores positive, one 5%,one 25% G=6
Bilateral nerve sparing robotic surgery on 09/11/08, pathological stage T2A,
No signs of spread, organ confined,
all PSA'S 0 since surgery, diagnosed with low T, doing TRT now, still using trimix for ED

Subdenis
Veteran Member


Date Joined Aug 2017
Total Posts : 581
   Posted 12/31/2017 5:25 AM (GMT -6)   
Anxiety and the diagnosis of cancer go hand in hand in my experience. A gift a friend gave me some years ago is to pause, reflect, and ask yourself two questions. What do I know and what do I think?

You know you had a second biopsy, you know the first found one core of G6. You don't know what the new pathology report says. The trouble comes from what you think. I can guess some of the random thoughts of it must be bad that is why he didn't call! We could think he didn't call because there are no results yet.

Unfortunately, I suspect you will stress until you know, that is how I tend to operate. As the old tv show cop said, just the facts ma'am! Stressing will not change the facts, try to let go and wait for new facts. happy new year. Denis
65YO healthy man, PSA 5/17 4.6, MPMRI, 5/17 lesion. 13 core biopsy 3 positive 3+3 and 1 positive in a lesion, All cores less than 30% 8/17 - the second opinion Yale pathology shows a small amount of (3+4) in one core, < 5%, decipher test shows intermediate risks, looking at treatment options. decided on HDR BT, first treatment 1/2/18 Denis

Redwing57
Veteran Member


Date Joined Apr 2013
Total Posts : 2501
   Posted 12/31/2017 8:01 AM (GMT -6)   
Denis, that's a great approach. My mantra became, "I'm ok until I'm not ok. Even then, it'll be ok.".

Same idea, what do I know? We have only the information in hand, and can use that to make some projections if so inclined (I do like math, graphs, and so on!).

tutor_paul, to save your mind and not waste your good days worrying about possible future bad days, simply recognize this disease is a long process; it's a marathon run at a snail's pace from (possible) diagnosis through (possible) treatment.

If the data in hand say you are ok, then rejoice. Some day new data may indicate you're not ok, so deal with that then, and only then.
55@Dx 4/16/13
Bx: 6/12 pos, G9=5+4 (80%, 60%), 4+5 (2@100%, 80%, 10%), PNI+
cT3a (3T mpMRI: Bilateral EPE, NVB+, SV-, LN-)

Pre:
Date PSA fPSA
9/12 4.1 15%
3/13 5.2 12% PCA3=31

Tx:
IGRT by IMRT, 44 done 8/28/13: 50.4 Gy pelvic nodes, 79.2 Gy prostate
ADT2 3 yrs: Lupron/Casodex, ended 3/16

PSA <0.1 : 8/13 - 5/16;
steadying! - 0.2-8/16, 0.5-12/16, 0.7-3/17, 0.8-5/17, 0.8-7/17, 0.7-10/17

tutor_paul
Regular Member


Date Joined Jan 2017
Total Posts : 55
   Posted 12/31/2017 8:30 AM (GMT -6)   
Many thanks for all the responses. It is great to have a shoulder to whine on in this forum. I feel somewhat embarrassed to even post considering how my health compares to others here with much more serious issues. But you guys always come through.

It really is great advice to not worry about something until one has something to worry about. Easier said than done obviously, but certainly something to strive for. And yes, Redwing, viewing this as a marathon can be a good coping mechanism.

-Paul
Age: 54
PSA 05/15: 2.09
PSA 11/15: 2.17
PSA 11/16: 2.97
PSA 12/16: 4.13, Free: 11.9%
PSA 06/17: 3.50
PSA 07/17: 4.00 (Inadvertent check as part of annual physical)
PSA 09/17: 3.56

12 Core Biopsy 12/08/16. Pathology: 1/12 (Left mid) 3+3(Score=6); 10% of Tissue

Oncotype DX Genomic Prostate Score = 5

02/17: MpMRI... 1 lesion in vicinity of BX positive core; PI-RADS 3.

On AS since 12/16

Howard3569
Regular Member


Date Joined Nov 2014
Total Posts : 341
   Posted 12/31/2017 11:13 AM (GMT -6)   
Consider changing doctors.
Surgery Nov, 14 2014 Negative margins, negative lymph nodes, negative vessels
Gleason 3+7 PSA .08 Dec 14, 2004; <0.05 on March and July 2015; 0.05 on Oct 2015 and 0.07 on January 2016, .06 on July 2016 and .10 on Oct 2016

Mike_T
New Member


Date Joined Dec 2015
Total Posts : 19
   Posted 1/1/2018 1:27 PM (GMT -6)   
I'm with Howard3569. My first 2 urologists knew what they were doing but lacked the patient skills I needed, which caused me anxiety. My latest doctor who did my surgery gets it and it's made all the difference.
Age: 61
11/15 PSA 1.7, DRE detected a lump
5/17 MRI
7/17 Biopsy 10-12 cores positive/17 samples, Gleason 4+3
10/17 RALP
Stage T3a

ejc61
Regular Member


Date Joined Dec 2016
Total Posts : 91
   Posted 1/1/2018 4:28 PM (GMT -6)   
ddyss said...
Everything points towards a smooth sailing !
I’m no doc , don’t understand why you would even need a second biopsy.
Don’t worry be happy!
Easier said than done.


I believe a follow up biopsy is pretty standard when on AS.

Paul. Feel free to rant. Stay strong.
PSA:2/16-5.2; 5/16-2.8,FPSA-13.2%;10/16-4.6,FPSA-11.5%; 1/17-4.4
dx:3/17;age 55
bx:3/12 positive; all 3+3=6;5%,5%,20%
PSA density 0.16; volume 28; T1c; non-palp DRE
bx confirmed by Johns Hopkins
OncotypeDX-GPS-19 (GPS+NCCN classification)-Very Low Risk
mpMRI: 7/17 Emory/Atlanta;(2) lesions(Pi-Rad 3, Pi-Rad 2),otherwise none or normal results.
PSA:7/17-1.9; 10/17-2.08
AS Program-Emory/Atlanta

ddyss
Regular Member


Date Joined Apr 2017
Total Posts : 316
   Posted 1/2/2018 11:31 PM (GMT -6)   
ejc61
With Gleason 6 and pirads 3 (2/17) with one lesion , I would think getting another MRI before a second biopsy would make better sense.

Paul - hope your doc reached out to you by now and hope all webt well.
DX@ 48 Yrs PSA 03/15 4.45 DRE: Firm Right Base
04/18 Biopsy Right: Base 4+3, Middle 3+4, Apex: HPIN
Left 6 cores : -ve
5/20 MRI: Pirads 5, ECE:+ve
RALP 05/26 Mt. Sinai Miami - Dr. A. Bhandari
Path:
Gleason downgraded to 3+4 !! Stage T2C
Prostrate Size: 49grams Tumor:20%
LN/SV/ECE: -ve PNI: +ve
Cath Removed : 6/1
Full continence: 7/4
PSA History :
7/7 <0.1
10/2 <0.006
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