Positive Biopsy Results

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Positive Biopsy Results

by Snubnosed_in_Alpha on Tue Oct 18, 2005 12:00 AM

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Well, I put off the prostate biopsy as long as I could. But I finally had it done and just learned today that they found cancer. It was a 12 point biopsy, and 10 of the 12 samples showed microscopic cancer. So there are no nodules or tumors, but it appears that it is spread throughout the prostate. I'm 48. The doctor recommends a radical prostatectomy. Ouch. I would certainly welcome comments.

Now What?

by Badge414 on Tue Oct 25, 2005 12:00 AM

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Hi Mark, Now you have your biopsy results, but what was the Gleason score? What was the grade of the samples? I assume he explained that to you, that the cancer is graded from one to five, and the two most prevalent grades are added together to get the Gleason score, highest possible being 10. The Gleason score could indicate which procedure is best. Go look at message 13 to you dated 8-10-05 in response to your posting on 8-8-05, prior to your biopsy. I had the radical prostatectomy but the two nerves were not spared, he could not see the left one, but the right one was taken on purpose because of the size of the tumor there. Mine was a Gleason 9, so there was no time to wait for hormone therapy or radiation. If the Gleason score were 6 or less, I would opt for radiation, as that is a total cure as long as it has not spread to lymph nodes. If the Gleason score is less than 7, hormone therapy could be used to shrink the size of the tumor prior to surgery, but in your case the doctor does not say there is a tumor? I doubt that, I would say that it is a tumor, but perhaps not a large one. Hormone therapy is not a cure, but radiation is, and if it has not spread too far outside the capsule, surgery could remove it all. Mine was also in the seminal vesicules, but not in the lymph nodes. As long as you do not have a large tumor, the two nerves running along the prostate COULD be spared so that you can still maintain an erection. I can't. Be prepared for incontinence after surgery, I had a catheter into the bladder for 21 days after surgery. I had the hose taped to my leg, and I could hook the bag to my bathrobe pocket. I have a picture of me so attired shovelling snow off my car, bag and all! Jim

rp

by Oncrx on Thu Oct 27, 2005 12:00 AM

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No question RP is major surgery. If your tumor is localized and you are fairly young, I would consider other options. You didnt say what your PSA or gleason score was and this will help determine treatment. Radiation therapy or watch and wait are appropriate options to RP. Ask about brachytherapy which is a form of RT. I believe I would consider RP a last resort, not a first one in localized disease.

Treatment Options?

by Snubnosed_in_Alpha on Thu Oct 27, 2005 12:00 AM

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Jim, Thanks so much for your continued concern. My biopsy turned up 10 out of 12 positive samples. They are pretty much anywhere you look--left apex, right middle, whatever. All Gleason scores but one were 3+3=6. The exception: 3+4=7. My most recent PSA was 4.5--up from 3.0 a year earlier. I'm considering options. I'm very reluctant to go for RRP, which, of course, is what my surgeon doctor recommends. I'm in the ATlanta area and have discovered Radiotherapy Clincis of Georgia. I'm taking a very good look at that as a possibility. I've also interacted with some people at WebMD at the Prostate Cancer Support Group (been there?). This has led to many, many good resources, including the yananow.net site. Any feedback that you have is welcome. In fact, email me if you wish at linville@bellsouth.net. Gratefully, Mark

Re: rp

by Snubnosed_in_Alpha on Thu Oct 27, 2005 12:00 AM

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Thanks. I guess the way I am thinking right now is that there is a presumption against having RP: the burden of proof is on anyone arguing that this is my best course of action. But that presumption might be overturned.

Options

by Badge414 on Thu Oct 27, 2005 12:00 AM

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Hi Mark, Your Gleason score of 7 is good, and the rise in PSA from 3.x to 4.x in one year is also a good indicator. It means that your cancer is slower growing, so you have time to explore options. I agree that a radical prostatectomy is the last resort rather than the first consideration. I had it, but it was necessary in my case with a Gleason 9. The doubling rate is another indicator of the severity of the cancer, the length of time it takes for the PSA to double. Prior to surgery, mine doubled in just 3 months. As you may have heard, there is an increased risk of colon cancer for those who have had External Beam Radiation, and it can disrupt the colon, burn holes in it, and do other bad things, but it can completely kill off the cancer resulting in a cure. It can also cause impotence, just like surgery can. I'll send you some information directly. There are some new radiation methods now. Jim

Re: Now What?

by Snubnosed_in_Alpha on Thu Oct 27, 2005 12:00 AM

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Jim, It looks as though I replied to the wrong message before. I'm pasting that reply--meant for you--in here to be sure that you see it. Mark Jim, Thanks so much for your continued concern. My biopsy turned up 10 out of 12 positive samples. They are pretty much anywhere you look--left apex, right middle, whatever. All Gleason scores but one were 3+3=6. The exception: 3+4=7. My most recent PSA was 4.5--up from 3.0 a year earlier. I'm considering options. I'm very reluctant to go for RRP, which, of course, is what my surgeon doctor recommends. I'm in the ATlanta area and have discovered Radiotherapy Clincis of Georgia. I'm taking a very good look at that as a possibility. I've also interacted with some people at WebMD at the Prostate Cancer Support Group (been there?). This has led to many, many good resources, including the yananow.net site. Any feedback that you have is welcome. In fact, email me if you wish at --- Message edited by CancerCompass staff: for personal protection, email address removed. Please review CancerCompass Member Guidelines at http://www.cancercompass.com/common/guidelines.html ---. Gratefully, Mark

Treatment Options

by Badge414 on Thu Oct 27, 2005 12:00 AM

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One option you can rule out is Chemotherapy, I had that after sugery failed to get it all, and that was devastating. Chemo works only for the fast growing cancer, in fact it kills ALL fast growing cells, like hair, fingernails, and the lining of the digestive tract. Be thankful that you do not have to do that. Hormone therapy is the least disruptive, I'll telll you about that later. Jim P.S. Yes, I saw your first posting in response to my question about your Gleason score.

Prostate

by Oncrx on Thu Oct 27, 2005 12:00 AM

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At your age and with your PSA/gleason you have 3 options. RT, RP or watch and wait. Some docs recommend RP because it is the cure for localized disease, but it frequently comes with a cost. Ask your doc to show you data that compares the risks and benefits of the 3 options.

Need Some Advice

by Verdi_Baritone on Wed Dec 07, 2005 12:00 AM

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I just joined this message Board for infromation and support. My psa was 4.3 and the biopsy map showed that of 12 cites, one was malignant with a gleason score of 4+4 =8 it was in the right apex. the areas adjacent were benign. I am considering robotic system which facilitates laposcopic prostatecomy. What is your opinion. Rick from Philadelphia
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