Biopsy

Right Base

Well, where to start. How old are you? Do you have any problems with urination?

Depending on your age, a PSA of 5.6 is not that high. The increase from 4 to 5.6, if it occured in 12 months would suggest a PSA doubling time of around 35 months or so, about like my own.

The gleason scores, and number of positive cores from your biopsy suggest that it is time to speak closely with a top urologist. the gleason of 7 is on the low side of the faster-growing type of cancer. my own gleason is 6, which I understand means my cancer is "moderate". Yours is a little higher.

It seems that you have quite a few positive cores. I would think that this is pretty important. Nothing to freak out about, should still be quite treatable with a high probability of success.

What did your urologist say?

Markus

I, 56  The urologist that suggested Da Vinci wanted to set up a date for surgery but I wanted to find out more info.

I asked his nurse how many surgeries he performed and she told me 2 a week for 2 yrs

When I asked the doc the same question he told me a total of 50. Needless to say I consulted with my sister in law who is the head of the emergency dept at The University of Chicago. I,m seeing the head of the urology dept on Wed he has done DaVinci surgery since 1999. I also have an appt with the head of urology at Northwestern Hospital in Chicago. I'm concerned with the urgency of the surgery am I doing the right thing by waiting so long?

 

welcome grunt; you are in a great chat room-I am also struggling with MD expertise as defined by number of DaVinci's completed. I have sifted through research sent to me by a urologist family member saying 30 is minimum 70 is better and 150-200 to achieve expertise--I am trying not to give all decision over to the most performed---open or DaVinci they try to spare the nerves--also to avoid positive margains yet I wouldn't choose my surgeon by fewest positive margins. Take your time, talk to experts, post your questions--no decision needs to be rushed-PC is slow growing and your stats do not suggest otherwise.
1588ap

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Age 47 excellent health
First PSA test ever 12/06 was 17.2
Biopsy - Gleason 3+4=7 involving all core biopsies 80% on right and 30% left
Scheduled for DaVinci 2/28/07 near NYC

Grunt,

On your question about Stage etc:

Yes T1 indicates PC which can not be felt on DRE or seen, and T1c is a tumor identified by needle biopsy, done for example because of elevated PSA.

With recent extensive screening more men are now diagnosed at an early stage  and low Gleason score, often T1c and G6.

N figures relate to any spread to lymph nodes.

M figures refer to existance of metastasis.

There is no "normal" PSA reading, but rate of change as discussed here is important. Several things can affect PSA, including size of the prostate. A larger prostate produces more PSA, so size of the prostate needs to be factored in. Your doctor will be able to give you the size and calculate the "PSA Density"

Gleason figures go as high as the worst score of G10. Reading biopsy slides is subjective, and it can be worthwhile obtaining a 2nd reading.

Most men here agree that choice of doctor is the most important consideration, regardless of the treatment method, as expertise makes a huge difference to long term outcome. Unfortunately a high number of treatments does not in itself guarantee a good result.

Books on PC by Lee Nelson and Peter Scardino MD are worth reading, as they are very comprehensive.

 

John