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  • Newly Diagnosed

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    Old 12-29-2020, 05:55 PM   #16
    Mushin
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    Re: Newly Diagnosed

    Update: I met with a Urologist at John Hopkins yesterday, for second opinion. I signed the papers to have my slides sent to them. My wife and I have decided that, I should enroll in the AS program at Hopkins for now.
    __________________
    Born 1964
    Family history of PC- 1 brother, 1 uncle on father's side, 1 uncle on mother's side
    First Biopsy Feb 2020, No PC, 4 of 12 Atypical cells
    Second Biopsy Nov 2020. Diagnosis 11/20/2020, 1 of 12 core, 3+3, Grade 1 PSA Jan 2021 3.81, PSA June 2021 4.7.

     
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    Old 01-01-2021, 01:30 AM   #17
    ASAdvocate
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    Re: Newly Diagnosed

    Excellent. I have been in that program since 2009. It has the best statistics for retention and almost no prostate cancer mortality.

    You will be in good hands.

     
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    Old 01-01-2021, 08:42 AM   #18
    Terry G
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    Re: Newly Diagnosed

    Sounds like an excellent choice. “Active” is the key here. Best wishes.
    __________________
    Rising PSA:
    11/13 1.95; 9/15 3.28; 10/16 5.94
    TRUS 1/17
    Bx: Three of twelve cores adenocarcinoma Gleason 6 (3+3) all on left side, no pni.
    DOB 7/21/47; good health; age 69 @ Dx
    Treated 6/17 SBRT @ Cleveland Clinic by Dr. Tendulkar
    Reduced ejaculate only side effect; everything works
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    PSA’s post.SBRT 1.1, 1.1, .9, 1.8, 2.7, 1.0, 0.3, 0.6, 0.8

     
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    Mushin (01-04-2021)
    Old 06-15-2021, 04:32 PM   #19
    Mushin
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    Re: Newly Diagnosed

    I did an MRI today at Hopkins as part of the AS and my follow up appointment is Monday 28th. Here is the result below. I will appreciate if anyone can help interpret it. My Psa keeps going up and down, 3.81 in January, and 4.7 last week.

    Impression
    IMPRESSION:
    Enlarged BPH gland with a solitary left-sided peripheral zone lesion. No findings of extraprostatic disease.

    Features of chronic bladder outlet obstruction with trabeculations

    Small volume of free fluid in the pelvis, nonspecific

    Dominant nodule lesion #1, overall PI-RADS = 2/5

    Overall Assessment Categories (PI-RADS V2):
    Likelihood that a clinically significant cancer is present based on MRI parameters
    1. Very low (clinically significant cancer is highly unlikely to be present)
    2. Low (clinically significant cancer is unlikely to be present)
    3. Intermediate (the presence of clinically significant cancer is equivocal)
    4. High (clinically significant cancer is likely to be present)
    5. Very high (clinically significant cancer is highly likely to be present)

    Images and interpretation personally reviewed by: William D. Craig, MD,MBA

    Narrative
    EXAM: MRI PROSTATE W/WO CONTRAST

    INDICATION: prostate cancer surveillance
    PSA 4.7
    Prior biopsy: Potential focus of neoplasia. No Gleason score given.

    COMPARISON: None.

    TECHNIQUE:
    Imaging at 3 Tesla.
    Coil: Body Matrix coil
    Sequences: Large field of view images of the pelvis were obtained: axial T2 weighted with fat suppression, 3D T2 weighted, and axial T1 weighted with fat suppression after contrast administration. Small field of view imaging of the prostate was performed
    with axial, sagittal, and coronal T2 weighted imaging. Diffusion weighted imaging (DWI) was performed with apparent diffusion coefficient (ADC) mapping. Axial T1 weighted imaging pre-contrast and dynamic contrast enhanced (DCE) imaging was performed
    following injection of 0.1 mmol/kg gadolinium IV.

    FINDINGS:

    IMAGE QUALITY: Diagnostic.

    HEMORRHAGE:
    No areas of high T1 signal suggesting hemorrhage.

    PROSTATE VOLUME:
    Prostate measures: 6.1 cm TV x 3.9 cm AP x 6.1 cm CC, volume 76 cc.

    PERIPHERAL ZONE:
    Some faint patchy areas of decreased T2 signal with a solitary measurable focus

    Lesion #1:
    - Side: left
    - Level: base
    - Zone: peripheral zone
    - Location: posterior
    - Diagram - sector: PZpm
    - Size: 6 mm on T2-weighted imaging
    - Relation to capsule: does not abut capsule
    - Series 501 Image 15

    Assessment categories:
    - T2 = 4/5
    - DWI-ADC = 2/5
    - DCE = negative
    - Overall PI-RADS = 2/5

    TRANSITION ZONE:
    Moderate hypertrophy with heterogeneous T2-signal with a prominent median lobe creating mass effect upon the bladder base. No worrisome nodule/lesion seen.


    SEMINAL VESICLES: Normal, symmetric.

    NEUROVASCULAR BUNDLES: Normal, symmetric.

    BLADDER NECK: Normal

    MEMBRANOUS URETHRA: Normal

    LYMPH NODES: None enlarged.

    BONE MARROW: Normal signal intensity.

    OTHER: Trabeculated bladder wall.

    Small amount of free fluid, indeterminate.

    Component Results
    There is no component information for this result.
    __________________
    Born 1964
    Family history of PC- 1 brother, 1 uncle on father's side, 1 uncle on mother's side
    First Biopsy Feb 2020, No PC, 4 of 12 Atypical cells
    Second Biopsy Nov 2020. Diagnosis 11/20/2020, 1 of 12 core, 3+3, Grade 1 PSA Jan 2021 3.81, PSA June 2021 4.7.

     
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    Tags
    active surveillance, low risk



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