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kziz
Regular Member


Date Joined Feb 2007
Total Posts : 242
   Posted 2/15/2007 4:10 PM (GMT -7)   
Got test results back today.  Bone scan negative with CT scan showing a few enlarged lymph nodes in deep belly and back.  Onocologist said 5ml to 1 1/2cm.  If we go through with scheduled da vinci and have possible lymph node involvement, then what next?  Or if lymph node involvement is suspected is surgery the route to go? 
Kurt & Courtney
47 year old
Great Health prior to dx
Dx on 1/29/07
PSA 4.1
Gleason 3+3=6, both lobes
Stage T2c, I believe
Tumor involves 20% of cores, both lobes
Live in OK
Da Vinci scheduled 3-15-07 in Austin


pcdave
Regular Member


Date Joined Oct 2006
Total Posts : 444
   Posted 2/15/2007 6:02 PM (GMT -7)   
hi kurt and courtney

talk to your surgeon--he is the one to answer your question with certainty for your situation.only until the surgery is started, you cannot necessarily second guess what is going to be found. i don't think it is a reason not to proceed with the surgery. it is only through surgery that you can really get a fix on the real stage of cancer. there was another recent discussion about lymph nodes that you may have seen.

if you go ahead with surgery, you will want to discuss with your surgeon whether or not he removes the lymph nodes. many surgeons do not do this and at a later date, some PC patients have a recurrence of the cancer and the PSA starts to rise. the best bet is usually to have all of the lymph nodes removed to play it safe. removing those lymph nodes apparently does not have any impact as far as one's health is concerned according to what i have read.

i hope that some members here may have had a lymph node situation like yours so that they can comment about their experiences. all the best.

Dave
68, Biopsy 9/27/06, Stage T1c, PSA 7.1, Gleason 6 [less than 5% in two areas], Gleason 7 (3+4) [less than 20% in third area], negative DRE, bone scan and MRI. Starting proton radiation therapy 2/22/07.

Post Edited (pcdave) : 2/15/2007 6:08:04 PM (GMT-7)


kziz
Regular Member


Date Joined Feb 2007
Total Posts : 242
   Posted 2/15/2007 6:52 PM (GMT -7)   
The lymph nodes in question are not in the pelvic region. They are in the "deep belly" and "back", according to Dr. Since Kurt is has been fighting an E. Coli infection since the biopsy, we are praying that that is the cause of the swollen nodes. Our onocologist said that we needed to make sure the surgeon had his radiologist look at tests and that a biopsy should be done. You feel good one minute, you're on the right track, and then boom!!!! Another "what do we do now" situation.
Kurt & Courtney
47 year old
Great Health prior to dx
Dx on 1/29/07
PSA 4.1
Gleason 3+3=6, both lobes
Stage T2c, I believe
Tumor involves 20% of cores, both lobes
Live in OK
Da Vinci scheduled 3-15-07 in Austin


biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1463
   Posted 2/15/2007 7:15 PM (GMT -7)   
Hey Kurt and Courtney,

Wow, you are having a run. It will smooth out though. Everything seems like a crisis during the time between diagnosis and treatment. You kind of feel like you are sleeping with an elephant and you don't know when he is going to roll over.

Take heart in the fact you have made a good decision on treatment. The cancer will be gone in about a month and you will be on the road to recovery. Plan for those days. Remember that the only things you can take into the OR are a great attitude and your anethitized(sp?) body.....

Jim
Age 72. Diagnosed 11/03/06. PSA 7.05. Stage T2B Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Pathological stage: T2B. Gleason 3+4. Cancer confined to prostate.
PSA on 1/3/07 - 0.04.  Next PSA on 4/4/07.
 
 "Patience is a virtue - especially when dealing with the effects of PCa."


Tamu
Veteran Member


Date Joined Oct 2006
Total Posts : 626
   Posted 2/15/2007 7:47 PM (GMT -7)   
kziz,

I certainly do not know what a doctor knows but just some logic would say with a Gleason of 6 and a PSA of 4.1 and the pelvic lymph nodes do not show any swelling it is unlikley that the ones they are concerned about have anything to do with the prostate cancer. Stage T2c indicates that the biopsy was prompted not by PSA rising but from a DRE and other sypmtons. Is that the case?

Tamu
Diagnosed 7/6/06
1 of 10 core samples, 40%
Stage T1c, Gleason 3+3
Da Vinci on 11/01/06
Catheter out on 11/13/06
56 Years Old
Post Op Path
Gleason 3+3
Approx. 5% of prostate involved
Prostate Confined, margins clear
Undetectable PSA on 12/18/06
No more pads as of 1/13/07


kziz
Regular Member


Date Joined Feb 2007
Total Posts : 242
   Posted 2/15/2007 8:49 PM (GMT -7)   
Dr did DRE first week of Jan and said Neg. But he also told us T2 for stage. PSA jumped from 2.6 to 4.1 in less than 6 months so don't know if that has anything to do with stage. He dropped us when we said we were getting second opinion and needed copies of records. From what we know, biopsy was done due to rise in PSA. However, 2nd opinion dr and onocologist (3rd opinion) all said stage T2. We feel confident in both the 2nd dr and onocologist. I guess we need to call 2nd dr, now #1 dr, and ask his opinion. The more I research, the more confident I am that the nodes are swollen due to infection and not cancer. Thank you Tamu and Biker90 for the info provided. We due plan on heading into the OR with the VERY best attitude. My husband is doing this exercises throughout the day. I guess I just wanted to hear (as we all do) All tests Negative!!! We will survive!!!!
Kurt & Courtney
47 year old
Great Health prior to dx
Dx on 1/29/07
PSA 4.1
Gleason 3+3=6, both lobes
Stage T2c, I believe
Tumor involves 20% of cores, both lobes
Live in OK
Da Vinci scheduled 3-15-07 in Austin


pcdave
Regular Member


Date Joined Oct 2006
Total Posts : 444
   Posted 2/15/2007 9:25 PM (GMT -7)   
kziz

your first doctor should be reported to the medical society in your state. it is totally unprofessional for a doctor to get mad and drop you as a patient because you request your medical records from him to get a 2nd opinion. 2nd opinions are a way of life and most insurance companies prefer or demand them for major surgery. you are probably better off without him.

you should ask your present doctor (#2 who is now #1) why he said stage T2. i still contend that with a gleason 6, a PSA of 4.1 and a negative DRE that it is T1c even if the cancer is in two lobes. otherwise, i should also be T2 and not T1, but my urologist specifically told me T1 when i questioned about having cancer in both lobes. you should show your doctor the staging table that i posted in my "staging" message and point out to him the column headings for stage T1 and T2.

dave
68, Biopsy 9/27/06, Stage T1c, PSA 7.1, Gleason 6 [less than 5% in two areas], Gleason 7 (3+4) [less than 20% in third area], negative DRE, bone scan and MRI. Starting proton radiation therapy 2/22/07.

Post Edited (pcdave) : 2/15/2007 9:41:12 PM (GMT-7)


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8122
   Posted 2/15/2007 9:38 PM (GMT -7)   
Hi Courtney,
If your first doctor dropped you because you wanted a second opinion, when this is all done and Kurt is well, you should report him to your state medical board. What you are going through is something everyone should get a second opinion on. My original Dr said he was surprised at the fact as many as 50% take his diagnosis of PC without secondary consultation. He provided me a list of specialists across the country. He gave me copies of the pathology reports, the PSA results, and pamplets, on the same day he gave me the diagnosis, and without me asking for any of it. He told me what he recommended, how he would do it, if I chose to go with him, and what the treatments side effects were. Your first doctor does not need to face another PC patient if he is concerned about being second guessed. My first urologist was very good and had great bedside manner. When I told him I was going to the City of Hope, he wished me the best and stated he thought that was a great choice. He said he would still be there if I needed him for anything, follow up, consultation, or just plain someone to talk to. He is in his upper 30's and is going to be one of the finest doctors you could ever have. I chose CoH because of the comfort factor of knowing that the doctor was simply reknowned for this treatment.

On the T2 stuff. I too was DRE negative, but had biopsy show both sides. My first doctor stated that is was possible that the needle penetration caught a bit or the cancer from the other side (the one right core was 20% involved, while three cores from the left were 70, 80, 80), so he did not eliminate the possibility of a lesser grade, but cautioned that the clinical staging was not the important staging, but rather the surgical staging. It was because the two sides were likely involved, PSA13.5, Gleason 7, and my young age that he was recommending prostatectomy.

Tony

Keep up the good work on researching. You are WAY doing the right things. Thank you for your comments tonite on my surgery tomorrow. I had a nice dinner with my mom and dad, and my wonderful wife. Soon I'll be contacting you with my progress.

Post Edited (TC-LasVegas) : 2/15/2007 9:44:33 PM (GMT-7)


ChiOKC
New Member


Date Joined Feb 2007
Total Posts : 6
   Posted 2/16/2007 11:40 AM (GMT -7)   

Courtney:

It is very disturbing to hear that your first Dr has taken such a position. But I feel that you are doing the right thing pressing on however, do not look back what is done is done you are better off without him.

I have been seeing Dr Law locally he has been as TC-LasVegas’s Dr is he has encouraged me to get second even third opinions. After my pathology report came back he visited with me and the wife for an hour and a half discussing all manners and methods of treatment.

I hope that Kurt gets over this E. coli thing soon. Is that a complication of any of the PC testing? I think I read about another member that had it as well.

Are you guys still considering having Dr F in Austin perform your surgery?

I have a consult with him scheduled for 23 Feb.

One of my coworkers told me that Midwest Regional is running TV commercials stating that they are in the top three in the nation for RRP’s with a 3 or 4 star rating have you seen or heard of this? I am looking into this and will let you know what I find out.


Rog & Roz

55 years old

Great Health prior to Dx

Dx on 1/12/07

PSA 4.2

Right, core biopsy: Gleason grade 3+3 or 6/10, in one of five core biopsies

Left, core biopsy: Gleason grade 3+3 or 6/10, in one of five core biopsies

Looking at da Vinci Surgeons in OKC and Austin

Live in OKC, willing to travel


lawink
Veteran Member


Date Joined Oct 2006
Total Posts : 621
   Posted 2/16/2007 12:45 PM (GMT -7)   
Courtney - Wishing you good luck with your continuing journey. You must feel very in control now that you've requested the second opinion. I can't even imagine someone with an attitude like #1 doctor being trusted to operate on my obdy.

Our #1 doctor was very good but only put one option in front of us. It was only because we'd heard of this surgery being done laproscopically that we requested a second opinion, but it was #1 doctor that referred us to his colleague that he knew was one of the few in our city that performed it.

Keep us posted! We're all pulling for you and your hubby.

;o) Linda & Bob
Bob (60) had laproscopic prostate surgery on Sept 27, 2006 - 2/12 malignant biopsy samples - gleason 3 + 3 = 6.  Follow up PSA results and pathology results received Nov 14th are NO MORE CANCER!  Gleason changed to a 3 + 4; cancer completely confined to prostate; (even a second more aggressive, previously undetected cancer)      PSA UNDETECTABLE.   Next PSA check Feb 27, 2007.
 
Bob also takes Hydroxyurea to control Polycythemia (elevated red & white cells & platelets) has secondary condition . . Myelofibrosis) -- If anyone has experience or knowledge of these, please post us.


kziz
Regular Member


Date Joined Feb 2007
Total Posts : 242
   Posted 2/16/2007 2:58 PM (GMT -7)   
ChiOkc, I have not seen the ads on TV, but have heard them on the radio. All I heard was that they have just begun doing this procedure, which is what we have heard from other docs here. All of our docs have said that it takes a min of 200 procedures before a surgeon is truly compotent with the robotics. That is why we have chosen Dr. F. He has performed over 800 and rising. We were discouraged by all docs in having this procedure done locally. You want the BEST. Dr. F's is the BEST in this part of the country. Atleast that is what our onocologist said. I didn't even have to say his name, just a doc in Austin and he said Dr. F is good! I thought Dr. Law was one of the docs here performing the robotic procedure? We are scheduled for surgery on March 14th in Austin. We had a consult set up on the 20th, however we canceled it when we learned that he will do the consult on the day before the procedure. One less trip to texas. We are waiting to decide if we will return to him to have cath removed. Info he sent us said we could have it removed locally and he would do post surgery consult via phone or internet. We will see how things go. Hopefully, the swollen lymph nodes and e coli will not delay us. As for the e. coli, we are not sure. We spent New Years in Mexico and both came home sick, so it could have been left over from that and aggrevated by biopsy or just a coincedence or who knows. It is rare that people get that sick following a biopsy, but it does happen. Courtney
Kurt & Courtney
47 year old
Great Health prior to dx
Dx on 1/29/07
PSA 4.1
Gleason 3+3=6, both lobes
Stage T2c, I believe
Tumor involves 20% of cores, both lobes
Live in OK
Da Vinci scheduled 3-15-07 in Austin


kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 2/16/2007 9:13 PM (GMT -7)   
Another Okie here. Good Luck. KW
    43
    PSA 5.7 - Discovered during Annual Physical with Family Practice Dr.
    Gleason 7
    Biopsy - 3 of 12 positive (up to 75%) all on left side of prostate
    RRP on Oct. 17, 2006 - Nerves on right side saved.
    All Lab's clear.  No Cancer outside prostate
    Cathiter in for 3 weeks due to complications in healing. Removed Nov. 9, 2006
    First Post op PSA on Dec. 11, 2006  Undetectable 0.00
    Office visit on Jan. 19th due to continued excessive urine leakage.
    Scheduled Feb.20th Cystoscope with possible Cottigen injection into bladder neck to help control leaking.
   

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