Biopsy Results Help

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Jac12
New Member


Date Joined Sep 2007
Total Posts : 3
   Posted 9/10/2007 6:15 PM (GMT -7)   

 

New to Board - Hello Everyone,

 

I would greatly appreciate any comments/insights to my recent biopsy results.  My PSA jumped from 3.9 to 4.5 in June 07 and my uro recommend having a biopsy.  Here is my situation.   I had a TRUS biopsy performed on June 15, 07 with the following results -

 

1 of 12 positive (with less than 1% of tissue). Right Base with no perineural invasion seen.

Stage T1c  Gleason 3+3=6

DRE Negative

PSA 4.5

Age 64

 

My uro indicated I was low risk and recommended robotic surgery.  Since there was only one core positive with less than 1% of the tissue involved, I decided on having a second opinion  and met with a another uro.  After reviewing the initial biopsy pathology report, the second uro wanted to send the path slides to Johns Hopkins for review.  The Johns Hopkins report came back stating the prostate tissue with a small focus of atypical glands is suspicious for carcinoma.  However due to atrophic features, a definitive diagnosis cannot be made.  Johns Hopkins recommended a repeat biopsy should be performed.  The Johns Hopkins report further stated that the pathology testing process in the initial biopsy is also found positive in the majority of high grade prostatic intraepithelial neoplasia and occasional benign glands of cancer.  Therefore, a positive P504S staining does not equate to prostate cancer. 

 

Per the JH recommendation, repeated the biopsy on Aug 23 07 by the second uro.  This time 16 samples were taken with a focus of 4 samples from the Right Base.  I received the results from the second biopsy on Aug 28th which stated all 16 core samples were negative with no tumor seen in any area of the prostate. 

 

Up until the second biopsy, I had been strongly considering surgery or proton treatments.  The second uro recommended coming back in Jan 2008 for a PSA test and decide what to do at that time depending on the PSA results.  I'm not one for WW and was wondering if anyone has had a similar experience with their biopsies.

 

Thanks for any comments or suggestions.

 

Jac

 

 

 


spinbiscuit
Veteran Member


Date Joined Apr 2006
Total Posts : 818
   Posted 9/10/2007 7:13 PM (GMT -7)   
Hello Jac,

Yes there have been several; although I can't recall went or who. Certainly an elevated PSA is alarming, but surgery is a serious matter. I think your urologist (#2) is giving you sound advice. Plus if Dr. Partin did the core analysis at hopkins; you had the best study possible. Good luck on you next PSA test. Please keep us informed.

Glen
Diagnosed at age 60
PSA went from 2.2 to 3.8 in 14 months
2 of 14 cores positive at 10%
Gleason 6(3+3), negative DRE, neg. margins
DaVinci surgery on 02/23/06
Last PSA 08/26/07 @ 18 months "0"


Tamu
Veteran Member


Date Joined Oct 2006
Total Posts : 626
   Posted 9/10/2007 7:24 PM (GMT -7)   
Hi There Jac,

I also sought out a second opinion following my biopsy becuase I had 1 of 10 core samples being positive. The slides from my biopsy read by the pathologist at the university medical center I went to for the second opinion indicated atypical instead of carcinoma. My urologist at the medical center said that contradicting slide reads occurs about 4% to 5% of the time as it is not all science. As he said you do not want to take out a healthy prostate. My slides were then sent to Dr. Jon Epstein at John Hopkins. My urologist said that in the hundreds of slides that were read by Dr. Epstein at this medical center and were read as carcinoma the post surgery path results comfirmed he was right every time. He read my slide as being carcinoma and the post op path report confirmed it. You should feel totaly comfortable that your slides have been evaluated by the best and the recommendation to follow up with a second biopsy in a few months sounds to be very prudent.

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
Began injections in April '07
Undetectable PSA on 6/25/07


biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1463
   Posted 9/10/2007 8:05 PM (GMT -7)   
Hey Jac,

I had the same situration except my PSA was 7.1. The first biopsy showed atypical cells so a second was schedulled a month later. It came back definite cancer. As Tamu inidcated you sure don't want to remove a healthy prostate but you need to keep ahead of the game if it is cancer. Sounds like your second uro has it right but you have to do what you feel is right.

Jim
Age 73. Diagnosed 11/03/06. PSA 7.05. Stage T2C Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Pathological stage: T2C. Gleason 3+4. Cancer confined to prostate.
PSAs from  1/3/07 - 7/18/07 0.00. 
T level on 4/2/07 - 48     On 7/16/07 - 613
Started Tri-Mix on 8/7/07.  .02 ml and 50 mg Viagra.  It works!!!
Next PSA and T tests on 10/17/07
 
"Patience is essential, attitude is everything."
 


IdahoSurvivor
Veteran Member


Date Joined Aug 2007
Total Posts : 1015
   Posted 9/10/2007 8:56 PM (GMT -7)   

Hi Jac,

Welcome to a great forum!  I'm glad you explained your condition so well and am sorry you have to go through this.  We're not professional cancer specialists in this forum, but we're here to help and discuss and to make you feel "at home."

From my recollection, your PSA is borderline for your age, but not alarming.  I am 54 and when I called my urologist's office with my PSA results of 4.3 received from my family doctor, the nurses at the urologist were not alarmed at first.  When they looked at my charts and saw that my PSA had jumped from 1.2 to 4.3 in a few months, they scheduled an appointment.   After an inconclusive DRE and some deep thought, my urologist decided to schedule a biopsy and we found some cancer.  Your change from 3.9 to 4.5 does not sound like a large "jump" to me.

You have been very wise about your approach, in getting second opinions and another biopsy.  Jan 2008 for the next biopsy is only four months away and I don't think you are in any danger from waiting.  For example, my urologist/surgeon said I could wait 4-6 months to do my surgery after cancer was positively identified and she wasn't worried about it spreading during the wait.

Please hang in here with us.  We'd like to follow your journey with you and you may be of help to others that join the forum with your similar diagnosis.

All the best,

Barry (a.k.a. Idaho)


Da Vinci Surgery July 31, 2007… 54 on surgery day
PSA 4.3  Gleason 3+3=6  T2a  Confined to Prostate

Waiting to take that first post-op PSA

My awareness web site: http://pca-info.blogspot.com

 


Jac12
New Member


Date Joined Sep 2007
Total Posts : 3
   Posted 9/11/2007 5:30 AM (GMT -7)   
Thanks everyone for your comments! This is a great forum for support and information and I really appreciate the prompt help. Guess I will stay with my 2nd uro’s recommendation to wait until Jan 2008 for a new PSA test and make a decision at that time depending on the new PSA results.

Will post an update in January.

Jac

JuRon9
Regular Member


Date Joined Aug 2007
Total Posts : 22
   Posted 9/11/2007 6:11 AM (GMT -7)   
Hi Jac,
You didn't state what size your prostate was. As men get older often the prostate enlarges and may have benign tissue that can cause a small rise in psa. Also, if your prostate is larger than normal, even 16 biopsies samples can miss a small tumor. It is wise to monitor your psa rise if any and maybe do a follow up biopsy in the near future. Also, don't be in a hurry to choose a treatment option as there are always side effects to all of them that you will have to live with the rest of your life. Also many of the treatment options haven't had any long term studies to show the effectiveness of them. So choose them at your own risk.

Ron
62 W/M healthy DX PCA 6/1/2003
PSA 6.7 Gleason (3+4)=7, T1c.
6 biopsies sent: One positive- Right Apex involving 70% of specimen. Perineural invasion.
LRP 7/1/2003-Path. T2b Surgical margins clear, prostate 65.5 grams.
Largest cancer dimension: 1.7cm
location of largest tumor: Left posterior
Cancer Volume: 1.14cc
Extraprostatic extension: Negative
Seminal Vesicle invasion: Negative
PIN : present
% Gleason 4: 30%
Post TNM: pT2b
4 years still <0.1. Now 66yrs. old


Jac12
New Member


Date Joined Sep 2007
Total Posts : 3
   Posted 9/11/2007 8:50 AM (GMT -7)   

Hi Ron,

During my first TRUS biopsy in June 07, the prostate was measured at 62 grams.  My first uro started me on Avodart at that time.  When I had the second biopsy performed in August 07 by my second uro, the prostate was down to 39 grams.  My second uro told me to stay on Avodart.

Jac

 

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