It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Cancer: Prostate Message Board

  • New Member - New PC diagnosis

  • Post New Thread   Reply Reply
    Thread Tools Search this Thread
    Old 01-20-2022, 12:24 PM   #1
    digitalprostate
    Junior Member
    (male)
     
    digitalprostate's Avatar
     
    Join Date: Jan 2022
    Location: Texas
    Posts: 16
    digitalprostate HB User
    New Member - New PC diagnosis

    Recently diagnosed with PC after a prostate biopsy. My recent high PSA over the last (2021) year got me to the biopsy.

    Annual physical in 2020 PSA was 4.28 Annual physical in 2021 PSA was 7.7, Urologist followup was 6.62 and 6.29.

    I am 67 and according to my urologist, my prostate is normal in size no BPH or lumps. After my biopsy on JANUARY 11, 2021, it was determined that I had Prostatic Adenocarcinoma. Here are my 10 point biopsy results:

    1.) Benign Prostatic tissue
    2.) Benign Prostatic tissue
    3.) Benign Prostatic tissue
    4.) Few atypical Glands
    5.) Benign Prostatic tissue with focal chronic inflammation
    6.) Benign Prostatic tissue
    7.) Benign Prostatic tissue
    8.) Prostatic Adenocarcinoma Gleason score: 3+4=7 (Grade Group 2) inv 25% of 1 core. Length of cancer 2.5mm

    9.) Prostatic Adenocarcinoma Gleason score: 3+3=6 (Grade Group 1) inv 20% of 1 core. Length of cancer 3.0 mm

    10.) Prostatic Adenocarcinoma Gleason score: 3+3=6 (Grade Group 1) inv 20% of 1 core. Length of cancer 4.0 mm

    While I have been assured that this wont kill me, I am not nervous to take action now. My urologist is part of a large independent group and I have faith in him. I live in Houston and as you know have the likes of MD Anderson.

    My urologist says this is certainly not a hurry thing, and knows that my wife and I have been researching and well read on this process. His recommendation and I/we have agreed is to move towards radiation. Yes, I know it is my decision but am seeking the experience of those of you that come here before me for your knowledge, experience from your case and what you think of my results/diagnosis.

    Thanks,

    Ed

     
    Reply With Quote
    Sponsors Lightbulb
       
    Old 01-20-2022, 01:41 PM   #2
    duckinator
    Junior Member
    (male)
     
    Join Date: Oct 2020
    Location: MO
    Posts: 34
    duckinator HB Userduckinator HB User
    Re: New Member - New PC diagnosis

    Welcome, and sorry you are here!
    Like you stated you have plenty of time to research this. First step would be consider having your biopsy slides sent to Dr. Epstein for a second opinion. Well worth the $300 if your insurance wont cover it.

    https://pathology.jhu.***/patient-care/second-opinions
    __________________
    PSA at 4.2 10/2019
    Diagnosed PCa 11/21/2019 small volume 3+3 thus AS

    2021 - PSA 4.72
    3TmpMRI then fusion biopsy
    3+4 in a 7mm lesion , 3+4 nearby, and 3+3 on other side.

    Started SBRT 6/2/2021

     
    Reply With Quote
    The Following User Says Thank You to duckinator For This Useful Post:
    digitalprostate (01-20-2022)
    Old 01-20-2022, 01:57 PM   #3
    digitalprostate
    Junior Member
    (male)
     
    digitalprostate's Avatar
     
    Join Date: Jan 2022
    Location: Texas
    Posts: 16
    digitalprostate HB User
    Re: New Member - New PC diagnosis

    Quote:
    Originally Posted by duckinator View Post
    Welcome, and sorry you are here!
    Like you stated you have plenty of time to research this. First step would be consider having your biopsy slides sent to Dr. Epstein for a second opinion. Well worth the $300 if your insurance wont cover it.

    https://pathology.jhu.***/patient-care/second-opinions
    Thanks, yes I have that open in my browser.

    Thanks

     
    Reply With Quote
    Old 01-21-2022, 01:25 AM   #4
    Prostatefree
    Senior Veteran
    (male)
     
    Join Date: Dec 2019
    Posts: 606
    Prostatefree HB UserProstatefree HB UserProstatefree HB UserProstatefree HB UserProstatefree HB UserProstatefree HB UserProstatefree HB UserProstatefree HB UserProstatefree HB UserProstatefree HB UserProstatefree HB User
    Re: New Member - New PC diagnosis

    All sounds good. Keep doing what you are doing. With what you have shared, you are a candidate for radiation, imo.

    Early detection early treatment is the mantra for all treatable cancers.

     
    Reply With Quote
    The Following User Says Thank You to Prostatefree For This Useful Post:
    digitalprostate (01-21-2022)
    Old 01-21-2022, 01:11 PM   #5
    Terry G
    Senior Member
    (male)
     
    Join Date: Dec 2019
    Location: Butler PA
    Posts: 177
    Terry G HB UserTerry G HB UserTerry G HB UserTerry G HB UserTerry G HB UserTerry G HB UserTerry G HB UserTerry G HB UserTerry G HB User
    Re: New Member - New PC diagnosis

    Ed, Sorry you’re here; but, so glad you’re looking to make an informed decision. I’m a radiation guy (SBRT) who is very happy with my decision. Today’s modern and guided radiation is safe and effective. No matter what treatment choice you decide I always recommend seeking out the best practitioner and team you can find. With MD Anderson near by I know where I would be headed.
    __________________
    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
    To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.

    PSAs post.SBRT 1.1, 1.1, .9, 1.8, 2.7, 1.0, 0.3, 0.6, 0.8, 0.4

     
    Reply With Quote
    The Following User Says Thank You to Terry G For This Useful Post:
    digitalprostate (01-21-2022)
    Old 01-22-2022, 02:52 AM   #6
    music4ever
    Junior Member
    (male)
     
    Join Date: Feb 2021
    Location: Michigan
    Posts: 36
    music4ever HB Usermusic4ever HB Usermusic4ever HB User
    Re: New Member - New PC diagnosis

    When checking out radiation also consider Brachytherapy seed treatment. You seem to have caught it early enough where this could be an option. The advantage is they plant low dose radiation seeds in your prostate and they are not shooting higher radiation doses through your body and hitting rectum + bladder + healthy cells which is what can happen with SBRT (although it is very targeted now). Brachy is a specialty you would want to find a center/RO that does that often. Good luck!
    __________________
    1/2021 - 53 y/o Dx Prostate cancer Gleason 7 (3+4) over 6 cores on right side. Prolaris report "Unfavorable Intermediate" risk - PSA 3.9. 2019-PSA 3.51, 2017-PSA 2.55
    3/2021 - Radical Prostatectomy (robotic).
    3/2021 - Post-op pathology provided pT3a pN0 MX, Stayed Gleason 7 but moved up to 4(70%) + 3. Small positive focal margin on right side. EPE. Decipher genomic test (.97) suggests "high risk" prostate cancer.
    4/2021 - PSA 0.08, 6/21 - PSA 0.06, 9/21 - PSA 0.09 - 6 month follow-up, 10/21 - PSA 0.07, 12/21 - PSA 0.11, 2/22 - PSA 0.15
    3/2022 - Salvage Radiation IMRT (20 fractions) @U of MI, 3 month Lupron shot.

     
    Reply With Quote
    The Following User Says Thank You to music4ever For This Useful Post:
    digitalprostate (01-22-2022)
    Old 01-22-2022, 05:31 AM   #7
    CentralPaDude
    Member
    (male)
     
    Join Date: Dec 2021
    Location: Central PA
    Posts: 90
    CentralPaDude HB UserCentralPaDude HB UserCentralPaDude HB UserCentralPaDude HB UserCentralPaDude HB User
    Re: New Member - New PC diagnosis

    Sorry you find yourself here, I’m just a little bit ahead of you, with a 3+3=6 case.

    Question on your biopsy…10 cores seems a low number. Was there a reason for that number? Also, was it MRI guided? Guided via some other means? Or on a standard grid?

     
    Reply With Quote
    The Following 2 Users Say Thank You to CentralPaDude For This Useful Post:
    digitalprostate (01-22-2022)
    Old 01-22-2022, 05:54 AM   #8
    digitalprostate
    Junior Member
    (male)
     
    digitalprostate's Avatar
     
    Join Date: Jan 2022
    Location: Texas
    Posts: 16
    digitalprostate HB User
    Re: New Member - New PC diagnosis

    Quote:
    Originally Posted by CentralPaDude View Post
    Sorry you find yourself here, Im just a little bit ahead of you, with a 3+3=6 case.

    Question on your biopsy10 cores seems a low number. Was there a reason for that number? Also, was it MRI guided? Guided via some other means? Or on a standard grid?
    All I can tell you about the cores is, shortly after he inserted the MRI wand? he stated to the assistant that this was going to only be a standard 10 core test. Not sure what he saw or didnt see to come to that. He has always been reluctant when I brought up why not an MRI prior to a biopsy, his response is you will eventually have to have a biopsy to determine cancer.

    My next steps are: 1.) I asked that my samples be Oncotype 2.) waiting for meeting with his group Oncology Dr. After I do these 2, I intend to do the following: 1.) have samples and Oncotype sent to Johns Hopkins for their evaluation and 2.) after the Johns Hopkins analysis, schedule appointment with MD Anderson, if possible.

    My thought is, I dont want to only get stuck with a recommendation of each groups procedure that they "like" doing, so that is why I will get the testing of the samples, present to the Oncology guy of my urologists group, then Johns Hopkins, then MD Anderson.

    I think If I can pull this off I will be better suited. The main reason I am considering MD Anderson over my current urologists group is: MD Anderson if 5 minutes from my house, the other is 30 minutes away.

     
    Reply With Quote
    Old 01-22-2022, 06:09 AM   #9
    Prostatefree
    Senior Veteran
    (male)
     
    Join Date: Dec 2019
    Posts: 606
    Prostatefree HB UserProstatefree HB UserProstatefree HB UserProstatefree HB UserProstatefree HB UserProstatefree HB UserProstatefree HB UserProstatefree HB UserProstatefree HB UserProstatefree HB UserProstatefree HB User
    Re: New Member - New PC diagnosis

    I recommend cancer centers of excellence for prostate cancer. Most importantly, they accept cancer as a risk and as their primary focus. Smaller urology groups, for a variety of reasons, are more susceptible to harboring myths about prostate cancer.

     
    Reply With Quote
    The Following 2 Users Say Thank You to Prostatefree For This Useful Post:
    digitalprostate (01-22-2022)
    Old 01-22-2022, 06:33 AM   #10
    digitalprostate
    Junior Member
    (male)
     
    digitalprostate's Avatar
     
    Join Date: Jan 2022
    Location: Texas
    Posts: 16
    digitalprostate HB User
    Re: New Member - New PC diagnosis

    So here is another question, in reading the document "Tests to Diagnose and Stage Prostate Cancer" from the ACS, I read that Gleason scores below 6 are seldom used.

    Question 1: if Gleason score below 6 are seldom used, wouldn't that unnecessarily place folks in the higher intermediate-grade grouping?

    Question 2: Not asking anyone to be a Dr. or suggest medical advice, but in looking at my Gleason scores, two are listed as Group 1 (3+3=6) and one is listed as Group 2 (3+4=7). My Dr. says I am not low risk, do you think that is because of the one that is group 2?

    Trying to understand all of this can give you a headache!

     
    Reply With Quote
    Old 01-22-2022, 08:02 AM   #11
    CentralPaDude
    Member
    (male)
     
    Join Date: Dec 2021
    Location: Central PA
    Posts: 90
    CentralPaDude HB UserCentralPaDude HB UserCentralPaDude HB UserCentralPaDude HB UserCentralPaDude HB User
    Re: New Member - New PC diagnosis

    Quote:
    Originally Posted by digitalprostate View Post
    All I can tell you about the cores is, shortly after he inserted the MRI wand? he stated to the assistant that this was going to only be a standard 10 core test. Not sure what he saw or didnt see to come to that. He has always been reluctant when I brought up why not an MRI prior to a biopsy, his response is you will eventually have to have a biopsy to determine cancer.
    Well, Im not glad he found cancer, but Im glad he found the cancer that you have.

    That would have been an ultrasound wand he inserted.

    I had a 12 core biopsy on a grid, and then a separate 3 additional cores that were sampled based on a prior MRI. The 12 were negative, 2 of the 3 based on the MRI were positive. The MRI was crucial to my getting a correct diagnosis.

    If MD Anderson is in your hood, that sounds like a no-brainer to switch to them for treatment.

    Best of luck!

     
    Reply With Quote
    The Following User Says Thank You to CentralPaDude For This Useful Post:
    digitalprostate (01-22-2022)
    Old 01-28-2022, 04:45 AM   #12
    digitalprostate
    Junior Member
    (male)
     
    digitalprostate's Avatar
     
    Join Date: Jan 2022
    Location: Texas
    Posts: 16
    digitalprostate HB User
    New number after Epstein reviews slides

    So after feeling somewhat good about things, my second came back from Johns Hopkins and now I am down somewhat!

    1-3) Benign Prostatic tissue with partial atrophy - same no changes

    CHANGE: 4.) Benign prostatic tissue with partial atrophy and prostate tissue with focus of benign crowded glands.

    5-7) Benign Prostatic tissue - same no changes

    CHANGE: 8.) Prostatic Adenocarcinoma Gleason score: 4+3=7 (Grade Group 3) inv 70% of 1 core, 70% pattern 4.

    NEW: NOTE: The diagnosis of carcinoma is supported by the failure of immunoperoxidase staining for high molecular weight cytokeratin and p36 to demonstrate basal cells in the atypical glands. Also favoring the diagnosis of cancer is that stains for racemase (a marker preferentially expresssed in prostate cancer) are positive.

    CHANGE: 9.) Prostatic Adenocarcinoma Gleason score: 3+4=7 (Grade Group 2) inv 20% of 1 core. Less than or equal to 5% Gleason pattern 4.

    10.) Prostatic Adenocarcinoma Gleason score: 3+3=6 (Grade Group 1) inv 20% of 1 core.

    NEW: The pattern 4 in this case lacks large cribriform morphology.


    Lots of new terminology written for Dr.s, new confusion for me! Any thoughts are appreciated in the changes.

    Thanks, made request online appointment for MD Anderson.

    Ed

     
    Reply With Quote
    Old 01-28-2022, 06:33 AM   #13
    DjinTonic
    Senior Veteran
    (male)
     
    Join Date: Dec 2019
    Location: NC
    Posts: 561
    DjinTonic HB UserDjinTonic HB UserDjinTonic HB UserDjinTonic HB UserDjinTonic HB UserDjinTonic HB UserDjinTonic HB UserDjinTonic HB UserDjinTonic HB UserDjinTonic HB UserDjinTonic HB User
    Re: New Member - New PC diagnosis

    "CHANGE: 8.) Prostatic Adenocarcinoma Gleason score: 4+3=7 (Grade Group 3) inv 70% of 1 core, 70% pattern 4."

    This core, which sampled a lot of cancer, was 70% pattern 4, so it unequivocally ups the biopsy from a Gleason Grade of 7 (3+4) to 7 (4+3), ups the Gleason Grade Group from "2--Favorable Intermediate" to "3--Unfavorable Intermediate," and puts a definitive kibosh on any thought of active surveillance. (The Gleason score and Grade Group of a biopsy is that of the highest/worst lesion found.)

    You may be advised to have a bone scan and other imaging to rule out obvious metastases. The latter will give your docs some indication as to whether the cancer is prostate-confined or extends into adjacent structures, although imaging is not definitive.

    Start reading up on treatment modalities, start a list of questions for your docs. Post questions here and we'll try to answer and point you to good information. As you get answers, you'll have additional, more detailed questions--that's the nature of things :-)

    If you opt for radiation therapy, and your imaging reveals no mets, you may want to discuss with your docs having a genomic test (e.g., Decipher, Prolaris, OncotypeDx) done on your biopsy slides to evaluate your genomic risk for mets. The test result may inform your primary treatment. On the other hand, if you opt for surgery, it's advisable to wait and have the genomic test done based on tissue from the whole prostate, because the post-op test is certain to sample the worst-grade lesions, whereas the biopsy test can sample only the worst lesions in the small amount of tissue sampled (and which is why many men have their Gleason score upgraded following surgery).


    All the best that you'll soon be looking at your cancer in the rear-view mirror!

    Djin
    __________________
    69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx, PCA3-
    7-05-13 TURP for BPH (90→30 g) path neg. for PCa, then 6-mo. checks
    6-06-17 Nodule on R + PSA rise on finasteride: 3.6→4.3
    6-28-17 Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM
    Nodule negative for PCa. Bone scan, CTs, X-rays: neg.
    8-7-17 Open RP, negative frozen sections, Duke Regional Hosp.
    SM EPE BNI LVI SVI LNI(5L, 11R): negative, PNI+, nerves spared
    pT2c pN0 pMX, G9 (4+5) 5% of prostate (4.5x5x4 cm, 64 g)
    Dry; ED OK with sildenafil
    Decipher 0.37 (Low Risk), uPSA: 0.010 (3 mo.)...0.023 (4 yr. 6 mo.)

     
    Reply With Quote
    The Following User Says Thank You to DjinTonic For This Useful Post:
    digitalprostate (01-28-2022)
    Old 01-28-2022, 07:15 AM   #14
    digitalprostate
    Junior Member
    (male)
     
    digitalprostate's Avatar
     
    Join Date: Jan 2022
    Location: Texas
    Posts: 16
    digitalprostate HB User
    Re: New Member - New PC diagnosis

    Thanks, I just got off the phone with the Radiation Oncologist with the outfit where my urologist is. First conversation, he agrees while the minor uptick listed from JH's, we are headed in the right direction to quickly nip this.

    He agreed that we have time to wait for the geno test (i know thats not the correct name) but for now, I am off of the ceiling! LOL!

    Thanks for your thoughts.

     
    Reply With Quote
    Old 01-28-2022, 10:24 AM   #15
    IADT3since2000
    Senior Veteran
    (male)
     
    Join Date: Nov 2007
    Location: Fountain Valley, CA, USA
    Posts: 3,151
    IADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB User
    Re: New Member - New PC diagnosis

    Hi digitalprostate. I am sorry you have joined our club, but we have many fine members.

    MD Anderson is one of the most respected institutions treating prostate cancer in our nation and has been for many years.

    Good luck,

    Jim

     
    Reply With Quote
    The Following User Says Thank You to IADT3since2000 For This Useful Post:
    digitalprostate (01-28-2022)
    Reply Reply




    Thread Tools Search this Thread
    Search this Thread:

    Advanced Search

    Posting Rules
    You may not post new threads
    You may not post replies
    You may not post attachments
    You may not edit your posts

    BB code is On
    Smilies are On
    [IMG] code is Off
    HTML code is Off
    Trackbacks are Off
    Pingbacks are Off
    Refbacks are Off




    Sign Up Today!

    Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

    I want my free account

    All times are GMT -7. The time now is 01:56 AM.





    © 2022 MH Sub I, LLC dba Internet Brands. All rights reserved.
    Do not copy or redistribute in any form!