I thought of another question. I know there is no set criteria for following an AS approach, but does location of positive samples play a factor?
He’s positive in 4 of 12..one in each quadrant.
What does mean vs if the positive samples had been clustered in say only one area or on one side? Or does it mean anything at all?
I think what I’m learning from all this reading is that I need to quit reading! Lol
Thank you very much to all of you who have responded. It’s very comforting to have people to communicate with.
Star, the main thing is: what you know for sure right now, or so far. And based on the info at hand so far. you know that he is very low risk. If indeed he is all G6 - and that is something we never know whether we have biopsies or not- then he is very
low risk. And the chance of ever dying from PC - with or without treatment- is very low indeed. The majority of older men who die of heart attacks or car wrecks or whatever have PC and never even knew it, especially these low risk types of PC.
Now, of course, whether he has not had no biopsy, or 12 cores, or 36 cores, you still can not ever know for sure that there is not some nasty G9 or 10 hiding in there somewhere. Same thing could be said about
any person and any cancer. Who ever really knows what is going on inside of us at a level too low to be detected? And needle biopsies are such a shot in the dark, they can miss a cancer cell. But there is no reason to think that just because you know there are some G6s in there that there might also be some G10s. All you actually know is: G6. So all you actually know is: the odds are greatly in your favor right now. Along with a PSA not all that high(at least it is not 20 or 100), and I assume a negative DRE( correct? ), which would also bode in his favor.
So, if I was a G6, I would breath a sigh of relief and not be in any hurry for any treatment whatsoever, and apparently your Dr. Sleeper is of the same opinion, more or less. ( as a retired CRNA -anesthesia- I think your Dr. Sleeper should have been an anesthesiologist rather than urologist ;) ) In the mean time, your slides are being further checked for risk, and later there is the Johns Hopkins(Epstein) thing. Until one of those gives you some clear evidence of additional risk, I would not be in a hurry to do anything. BTW, if he truly is G6 ( and no reason to think otherwise) I would be really surprised if the MRI showed anything. If it does not, that will just be another reason for Y'all to relax.
PSA 10.9 ~112013
Bx on 112013 at age ~65yrs, with 5 of 12 pos, G9(5+4), T2B.
RALP with lymph nodes at Vanderbilt 021914. (nodes clear, SV+, G9 down graded to 4+5, 1 focal margin )
only rare pad use after 1 year
PSA <.01 on 6/14 and all until 9/15 = .01, still .01 9/16, .02 on 3/17,6/17,10/17, .06 1/18, .06 4/18, <.05 7/18, .06 10/18, .06 04/19
Post Edited (BillyBob@388) : 10/22/2019 7:31:33 AM (GMT-6)