Originally Posted by jackiestephens
My husband's PSA was going up for over 5 years. He is 73. He has had 5 previous biopsies all negative. Finally when his PSA was 50 this year he asked if the urologist if could do anything else but another biopsy. The doctor did an MRI which showed a nodule. He had never sent a patient for an MRI before and didn't even know if they could do one here in our town. After the MRI the doctor then knew where to biopsy and the cancer was found. The doctor said, "I hadn't biopsied that spot because it was hard to get to and would have been painful" (anterior). He says cancer there is rare. Cancer was found in 50-60% of cores. Gleason is 7 (4+3). The doctor said free PSA was irrelevant. He something about the PSA was above 3 (the thickness?) I don't remember. The doctor gave us a book which prompted me to ask if any previous biopsies had shown atypical cells. He said he didn't know but would check. Yes, in 2007 he had high grade pin cells found. Shouldn't the doctor have told us or done something? We don't know yet if the CA has spread. My husband had a chest xray and bone scan on Friday. We know the chest xray showed a mass but we don't know what it is. He also had a CT scan but we don't know the results. We are frightened and don't trust the doctor. We live in a fairly small town but would go anyplace to get good care. How do we know where to go?
I am surprised to read that the local doctor did not know about local clinics with MRI facilities. He is showing ignorance and incompetence in regards to our sickness, the prostate cancer.
Wondering if he has done a DRE.
I agree with your sentiment in not trusting the doctor and procuring for another specialist. Particularly with the many factors you report.
His biopsy cores should also be rechecked in a proper laboratory. You can request the doctor or you can do it yourself sending the samples by courier to reliable laboratories, such as Bostwick and Johns Hopkins. You may include all other information in the package if you want to receive their opinion on treatments too. Get the addresses using a net search engine.
His Gleason score of 7 (4+3) is intermediate but the grade 4 is aggressive. Probably the “3” in your doctor’s commented, was related to cancerous cells grade which above 3 requires detailed diagnoses (metastases, etc.) of more concern.
Allen is recommending you additional tests with PET because of the missing information regarding metastases, but these types of image studies are done only at certain clinics, which may be not feasible to your location. Bone scintigraphy scans tend to be more reliable when a patient’s PSA is higher than 10 (Your husband is 50). Even though, to get the best test is always preferable.
The CT scan will give a “picture” of the area in the pelvis but it may be negative if the abnormality in tissue caused by the cancer is smaller than 1.5 mm in size. This is a status known as micro metastases.
We all become frightened when confronted with a positive diagnosis of cancer. Becoming educated on the matter will help you to confront anxiety. There are many articles in the net that can help you to understand about treatments for 73 years old. You should also give consideration for any other existing health problem (or future) which could be prohibitive to some sorts of therapies.
I recommend you to get as many tests as your husband can now before committing to anything (DRE, PAD, lipids, testosterone, bone density scan, ECG, etc.). These will serve you with a better diagnosis of his present status, it can be useful as base data in future care and it will help in reaching to a better decision on any treatment.
You can also obtain books (Amazon can deliver used or new copies if you live in a remote place). I suggest these three that provide information on diagnosis, hormonal treatment, surgery and radiotherapy;
1) “Primer on Prostate Cancer, The Empowered Patient’s Guide” by Dr. Stephen Strum and Donna Pogliano
2) “Beating Prostate Cancer: Hormonal Therapy & Diet” by Dr. Charles “Snuffy” Myers
3) “Guide to Surviving Prostate Cancer” by Dr. Patrick Walsh (second edition June 2007)
You can also prepare a list of question searching the net with this sentence; “Questions to Ask the Doctor by cancer information from the American Society of Clinical Oncology"
I hope you find a specialist that your husband can trust and feel confidence.
Wishing you both the best.