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  • New Guy - Had MRI - Next up biopsy

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    Old 01-09-2022, 07:28 AM   #31
    ASAdvocate
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    Re: New Guy - Had MRI - Next up biopsy

    My suggestion is that you research aquablation, which is the latest and greatest treatment for BPH. The providers believe that men on AS are good candidates, as their cancer may never grow, or not for many years, and their treatment would fix the BPH problems while allowing them to avoid overtreatment for their PCa.

    https://www.urologytimes.com/view/waterjet-ablation-offers-minimally-invasive-option-bph

     
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    Old 01-09-2022, 08:46 AM   #32
    Terry G
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    Re: New Guy - Had MRI - Next up biopsy

    One of the reasons for hanging around this site for me is that I continue to learn interesting treatments. Aquablation certainly sounds like an option that should be looked at for guys suffering from BPH or BPH/PCa. Thanks ASA.
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    Old 01-09-2022, 08:46 AM   #33
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    Re: New Guy - Had MRI - Next up biopsy

    Thanks for the comments.

    Spoke too soon about scot-free from the biopsy. Had to go to the ER last night when unable to void, and now have a catheter and leg bag. Urine was clear before and now, and no signs of infection either, in the bladder or overall. Sigh.

     
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    Old 01-09-2022, 04:11 PM   #34
    Terry G
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    Re: New Guy - Had MRI - Next up biopsy

    Dude…Sorry to hear all those needle samples have left you with a very angry prostate. Once it settles down you can focus on your treatment options. Seems like the prostate cancer is the lesser of the two evils you face. Good luck keep investigating and keep us posted. Terry
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    Old 01-09-2022, 08:25 PM   #35
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    Re: New Guy - Had MRI - Next up biopsy

    I may have mentioned my own situation earlier in this thread, but I'm too lazy to scroll upward & check.

    In 2011 I was dx'd with 3 positive cores (out of 20) of Gleason 3+3. I also had an extremely severe case of BPH. Turned out that, at almost 100 gm, my prostate was about 4x normal size. Terrific urination problems -- weak stream, had to go very frequently because I could not empty all at once, etc.

    When I got my diagnosis, I met with both a surgeon & a radiation oncologist at Mayo Clinic in Rochester, MN. Both agreed that their particular specialty could cure the cancer. But the radiation oncologist, who was very nice and very honest, stressed that radiation could NOT cure my BPH.

    So he recommended surgery because that would cure both ailments. I ended up having surgery at Mayo & recently hit the 10 year post-op mark with a PSA of 0 and also zero urination woes. Since the surgery, I have a very strong urine stream and rarely get up more than once a night (if even that much).

    So there IS a lot to be said about a PC patient who also suffers from BPH. Surgery worked like a charm for me & I very much wish the same results for others in the same boat.

    Last edited by HighlanderCFH; 01-09-2022 at 08:28 PM.

     
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    Old 01-10-2022, 07:32 AM   #36
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    Re: New Guy - Had MRI - Next up biopsy

    Thanks Highlander,

    I'm going to talk to the Uro about HoLEP when I meet with them next week. It'd be nice to not have to deal with the prostate any more.

    Based on the biopsy (2 cores, one over 50% 3+3=6) MRI with clear view of lesion, PSA of 5.8, volume of 140cc so PSA density well under 0.15, it looks like I am in the Low Risk bucket with surveillance recommended. So if I get the HoLEP, that still leaves radiation possible for down the road (hopefully never).

    That foley catheter is a pain. I feel for people who have to live with it for long periods of time (my dad did, for a couple of months).

    But I also have to see, the ability to hike up the pants leg and empty the bag out is kind of slick.

     
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    Old 01-10-2022, 06:08 PM   #37
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    Re: New Guy - Had MRI - Next up biopsy

    Dude…Getting your prostate to a more manageable size seems like a good first step. Glad to see a guy investigating all his options rather than making an uninformed decision.
    __________________
    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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    Old 01-11-2022, 01:30 AM   #38
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    Re: New Guy - Had MRI - Next up biopsy

    Fyi, HoLEP is a major surgical procedure. I mention it because you had stated a bias against surgery.

    A big benefit of HoLEP is the removed tissue can be examined for PC.

     
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    Old 01-11-2022, 10:58 AM   #39
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    Re: New Guy - Had MRI - Next up biopsy

    Quote:
    Originally Posted by Prostatefree View Post
    Fyi, HoLEP is a major surgical procedure. I mention it because you had stated a bias against surgery.

    A big benefit of HoLEP is the removed tissue can be examined for PC.
    Yes, I was thinking at the beginning that I'd need to treat cancer. The idea of a RP and wearing diapers forever was not appealing.

    Now, I'm thinking about the PBH. My father just had to have a TURP for urinary retention, so I figure that's coming eventually. I like the idea of cleaning out the prostate and getting a full look at the tissue for PC. But it is all up in the air right now. just weighing my options.

    Following a HoLEP, it doesn't seem like there is much left in the capsule that could be cancerous, if the tumor is localized to the prostate tissue proper.

     
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    Old 01-12-2022, 12:14 AM   #40
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    Re: New Guy - Had MRI - Next up biopsy

    I don't wear diapers.

    I do have one lasting loss from my RP. The prostate is an erogenous zone and it is now gone. I do miss that aspect of it, but the idea I may be free of any future prostate issues is more than enough to compensate for that loss, for me.

     
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    Old 01-15-2022, 04:58 PM   #41
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    Re: New Guy - Had MRI - Next up biopsy

    Ended up having the foley catheter in for 6 days before making the 2 hour trek to Hershey to get the voiding trial (sounds better calling it "The Trial of Void"). A-OK on that now, but there was some serious irritation from the catheter. Meet with the CNRP next week to review the pathology results, which of course I've already seen. Curious to hear her thinking.

     
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    Old 01-18-2022, 05:10 PM   #42
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    Re: New Guy - Had MRI - Next up biopsy

    I am also newly diagnosed as of December 19, yes just before xmas! And our stats are amazingly similar for the MRI, It did lead to MRI guided biopsy which turned up 3+4 gleason( moderately agressive). But everyone is different. For me, the next step was radiation vs. surgery but unanimously 4 dr. recommended surgery due to my age and 180 prostate size(I beat you). So, selected Johns Hopkins in Baltimore with Dr. Partin a leader in his field and I am scheduled for Feb 22. Will update after that time. My motto for the outcome is Life, Lover, and laughter. My urologist thought that was a good attitude. Find a good surgeon and put yourself in their hands and can't hurt to pray.

     
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    Old 01-19-2022, 08:05 AM   #43
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    Re: New Guy - Had MRI - Next up biopsy

    Before doing anything for BPH, I would have a genomics test done on your biopsy slides (e.g. OncotypeDx or Decipher Biopsy). Results for the Decipher Biopsy test have demonstrated that about 10% of G6 (3+3) men with prostate-confined cancer are high risk for forming lesions of a higher Gleason grade that can go on to metastasize within 5 years. G6 (3+3) cancer can grow out of the prostate (while not metastasizing); in those men the chance of being high-risk for mets goes up to 16%.

    On the chance that you are in the high-risk group, I would seriously consider treating your cancer, keeping surgery in mind.

    Djin
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    Old 01-19-2022, 08:09 AM   #44
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    Re: New Guy - Had MRI - Next up biopsy

    richard6, sorry you find yourself here, best of luck with your plan, sounds solid. Congrats on your award-winning prostate volume.

    Djin...good advice, thanks. Will carry forward to my meeting.

    I'm not in a rush to do anything at the moment. Playing the long game. All advice appreciated.

     
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    Old 01-19-2022, 01:35 PM   #45
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    Re: New Guy - Had MRI - Next up biopsy

    Quote:
    Originally Posted by DjinTonic View Post
    Before doing anything for BPH, I would have a genomics test done on your biopsy slides (e.g. OncotypeDx or Decipher Biopsy). Results for the Decipher Biopsy test have demonstrated that about 10% of G6 (3+3) men with prostate-confined cancer are high risk for forming lesions of a higher Gleason grade that can go on to metastasize within 5 years. G6 (3+3) cancer can grow out of the prostate (while not metastasizing); in those men the chance of being high-risk for mets goes up to 17%.

    On the chance that you are in the high-risk group, I would seriously consider treating your cancer, keeping surgery in mind.

    Djin
    Hi DJin, those stats for decipher and Gleason 6 are of interest to me.

    Can you cite a link to your source?

    TIA

     
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