Well I just got the results from the Pathology report.
Left Apex Gleason 3+3 = 6 35%
Left mid Benign
Left base Gleason 3+3 +6 7%
Right base Benign
Right mid high grade neoplasia
Right Apex Gleason 3+4 = 7 #0%
DAMN. Now im just waiting for a bone scan and cat scan and then the consultation with the Uro.
Then second opinions and pick a treatment.
DAMN
I'm really sorry that you have now been officially admitted into our club. However, while the admission fee is steep, we are a good bunch of guys and gals as you already know.
I've looked over your past posts to refresh my memory, noting your roller-coaster PSA. As a now fairly savvy layman, it looks to me like most of your PSA is due to infection rather than prostate cancer. That last move from 24 to 40 after the Cipro probably simply means that Cipro was not the right antibiotic, though using it first was a logical move.
I'll put some more comments in green.
Quote:
Originally Posted by wirebender
Well I just got the results from the Pathology report.
Left Apex Gleason 3+3 = 6 35%
Left mid Benign
Left base Gleason 3+3 +6 7%
Right base Benign
Right mid high grade neoplasia
Right Apex Gleason 3+4 = 7 #0%
DAMN.
I'm thinking these results are from a local pathologist and not the Bostwick Lab. As you commented earlier, that would be a great place to send the pathology samples to get a second and expert opinion. I'm surprised that no percentage was given for the one core that was the most aggressive. It would also be good to see if the percentage of Gleason grade 4 cancer could be identified.
Actually, I'm somewhat puzzled by the biopsy. These days taking only six cores is not standard practice, as I understand it. I believe that 10 to 12 cores is now a well established standard. Do you have any insight why fewer cores were taken? If you objected like hell during the biopsy, that might be the answer.
Now im just waiting for a bone scan and cat scan and then the consultation with the Uro.
Bone scans are not done per current guidance in most cases, but your PSA is above 20, so getting a scan is within the guidelines. The PSA also warrants the CT scan as it is above the threshold of 25 identified in the guidelines of the American Urological Association.
Then second opinions and pick a treatment.
DAMN
You are entitled to a whole string of expletives!
Mark
Did you get the DRE result, and do you care to share it?
I wish you luck with all of this. In view of the likely infection and the somewhat questionable biopsy report, there's room for play here.
Hi again Jim
Thanks again for your response. You and the other veterans on this board help out so much with your knowlage and feedback. Thanks also for officially welcoming me to the club, but I dont remember filling out a application.
Yeah, we were all hoping that the cipro would have showen that I had a infection and not PC but that doesn't look like the case. I could have a infection also but the cancer is still there.
Reguarding the DRE, all of them where normal and at a normal size.
First of june this year, Normal DRE PSA 31
Two weeks later Normal DRE PSA 24
Three week Later PSA 40
At the time of the Biopsy all looked good with the ultrasound. I also instructed the uro to send the slides to the Boswick labs for a second test.
I have a Bone scan and Cat scan next week, with a follow up apt. with the uro the following week to get the outcome of the tests and discuss treatment options.
I have already sent off my info to the cancer center where Dr. Gimm is and with in two hours they called back and said that he wanted more info and I was given Dr. Gimms E-Mail adress so I could ask him questions directly. I thought that was cool. I also plan on getting a second opinion from the team at Fred Hutch in Seattle.
Reguarding the Biopsy, It was nothing that I want to do over and did grind my teeth and moan, but I'm sure the Uro took Twelve samples. ??? So where are they on the Path report. Thats anouther thing to ask the Uro on
Monday.
Thanks again for all your input. I'm sure I'm going to need it through this journey.
Hi again Jim
Thanks again for your response. You and the other veterans on this board help out so much with your knowlage and feedback. Thanks also for officially welcoming me to the club, but I dont remember filling out a application.
Yeah, we were all hoping that the cipro would have showen that I had a infection and not PC but that doesn't look like the case. I could have a infection also but the cancer is still there.
Reguarding the DRE, all of them where normal and at a normal size.
First of june this year, Normal DRE PSA 31
Two weeks later Normal DRE PSA 24
Three week Later PSA 40
At the time of the Biopsy all looked good with the ultrasound. I also instructed the uro to send the slides to the Boswick labs for a second test.
I have a Bone scan and Cat scan next week, with a follow up apt. with the uro the following week to get the outcome of the tests and discuss treatment options.
I have already sent off my info to the cancer center where Dr. Gimm is and with in two hours they called back and said that he wanted more info and I was given Dr. Gimms E-Mail adress so I could ask him questions directly. I thought that was cool. I also plan on getting a second opinion from the team at Fred Hutch in Seattle.
Reguarding the Biopsy, It was nothing that I want to do over and did grind my teeth and moan, but I'm sure the Uro took Twelve samples. ??? So where are they on the Path report. Thats anouther thing to ask the Uro on
Monday.
Thanks again for all your input. I'm sure I'm going to need it through this journey.
Hi again Jim
Thanks again for your response. You and the other veterans on this board help out so much with your knowlage and feedback. Thanks also for officially welcoming me to the club, but I dont remember filling out a application.
Yeah, we were all hoping that the cipro would have showen that I had a infection and not PC but that doesn't look like the case. I could have a infection also but the cancer is still there.
Reguarding the DRE, all of them where normal and at a normal size.
First of june this year, Normal DRE PSA 31
Two weeks later Normal DRE PSA 24
Three week Later PSA 40
At the time of the Biopsy all looked good with the ultrasound. I also instructed the uro to send the slides to the Boswick labs for a second test.
I have a Bone scan and Cat scan next week, with a follow up apt. with the uro the following week to get the outcome of the tests and discuss treatment options.
I have already sent off my info to the cancer center where Dr. Gimm is and with in two hours they called back and said that he wanted more info and I was given Dr. Gimms E-Mail adress so I could ask him questions directly. I thought that was cool. I also plan on getting a second opinion from the team at Fred Hutch in Seattle.
Reguarding the Biopsy, It was nothing that I want to do over and did grind my teeth and moan, but I'm sure the Uro took Twelve samples. ??? So where are they on the Path report. Thats anouther thing to ask the Uro on
Monday.
Thanks again for all your input. I'm sure I'm going to need it through this journey.
Well, just thought I would give a update to the post. I got the second opinion from the Boswick labs and they confirmed the cancer.I had the bone scans and the cat scan and both showed all clear. I'm did alot of happy feet on that one. Had my Seminal Gland biopsy at the request of Dr. Peter Grimm and that showed no sign of cancer. HAPPY FEET! The last visit with Dr. Grimm he thinks that it is a anterior ( hope I got that right ) cancer that causes wild psa swings, but with the high psa he thinks we should treat this agressively, and I agree.
So I had my first shot of Lupron this week and will follow up with anouther one in three months. Along with that I'm taking Bicalutamide (Casodex ) for twenty days. Then in two months Dr. Grimm wants to start some sort of external radiation, then seeds but not necessarily in that order. I'm still waiting on Loma Linda for a consutation date so I may go that route. I do like Dr. Grimm and with his experiance in Brachytherapy I dont think I could go wrong having him doing my therapy.
Jim, you mentioned that they normally do twelve core biopsy. I asked my Uro and he said he did take twelve. Not sure why they only showed six.
Just thought I would give another update on my journy into prostate cancer in hope that it helps those newly diagnosed.
Its been three months since I had the Lupron shot and I seem to have got most of the side effects. The hot flashes have been controlled very well with half a tab of megastrol twice a day, happy about that! However the Insomia, joint pain, loss of consentration, fatique, and depression has been a pain. I had my PSA check last week and it went from 40 three months ago to 0.69. I was amased it came down so fast.
Dr. Grimm from the Prostate Cancer Treatment Center will be doing the Brachytherapy on the 10th of September, and will I be getting anouther Lupron injection at the same time. Then six weeks later, five weeks of IBRT.
After seeing my PSA drop so fast after the hormone shot I started to second guess myself on the decision on Bracytherapy and thought about talking to someone about just doing the hormone therapy. After reading over the threads on this site AGAIN, I will stay with the bracytherapy.
I want to thank all of you that have shared your journeys with us newly diagnosed. With out all of your inputs and knowlage I would have been truely Lost.
I'm glad to hear that your treatment will be done by Dr. Grimm. I'm impressed that his team publishes their results, and I'm also impressed that the results look excellent.
About the side effects of the hormonal blockade you are now on, you wrote:
Quote:
The hot flashes have been controlled very well with half a tab of megastrol twice a day, happy about that! However the Insomia, joint pain, loss of consentration, fatique, and depression has been a pain.
Have you tried aerobic and strength exercise? That combination has helped many of us achieve better sleep, less fatigue, better concentration and a good mood. If you haven't been exercising, ease into it gradually. Antidepressant drugs, if needed, can help from what I've read. The joint pain should ease shortly; that's my impression and my own experience.
Hi Jim
I too am very impressed with their results and have all the confidance in Peter and his team.
I haven't been doing any exercising to speek of. Its all I can do to get through my Twelve hour shifts. I know I have to get out of this funk and get back to my normal routine buts its hard. I just lost my brother ,and seven days later his wife passed. My wife is the executor of the state and we aren't getting any help from the rest of the family. So going through all of the belongings and taking care of all the legal stuff is exhausting. Don't mean to whine. I am honored that they picked us to take care of things, but the timing could have been better.
Thanks again for your response Jim. I'll let you all know how the proceedure went.
Do you have any insight why fewer cores were taken? If you objected like hell during the biopsy, that might be the answer. 
