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Question:
…… I asked my Dr. about this, and he agrees – he says I may have the lowest PSA he’s ever encountered to test positive. Not the way I want to get in any record books. Sorry – by looking at the title of this strand – I thought you were talking about getting a new penile implant – excuse me :-)
I never heard a thread called a strand before…. but I get your drift. — Sinrod Stained Glass www.sinrodstudios.com Coney Island Memories www.sinrodstudios.com/coneymemories
Response:
…… I asked my Dr. about this, and he agrees – he says I may have the lowest PSA he’s ever encountered to test positive. Not the way I want to get in any record books.
Sorry – by looking at the title of this strand – I thought you were talking about getting a new penile implant – excuse me :-)
Response:
Thanks to all who responded to my earlier post. Someone (AW) responded that my results looked somewhat "screwy" – here’s the corrected results: PSA 1.4 Gleason 3+3 1 of 10 cores positive, about 5% …… I asked my Dr. about this, and he agrees – he says I may have the lowest PSA he’s ever encountered to test positive. Not the way I want to get in any record books. I picked up Walsh’s book this weekend – now I’ll have something to read during the CAT and bone scans Wednesday. And thanks, everyone, for the support and the stories of your adventures. I hope that I’ll soon be able to post my own happy surgery and recovery stories. Tom
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Now…. a question to others……. my PSA is 8.8…. Gleaseon 3 + 3 = 6, Grade T1c, one of 12 cores positive, less than 5% tissue involvement….. But…… my doc is not doing bone or CAT scans? Again, why the difference? My doc even says he will not take out the nodes……. All the different opinions among docs surely does make this confusing…..
I don’t often say this, but you ought to ask your doctor why before you ask us. I suspect that he suspects that 8.8, 6, T1c, and 1/12th is an indication that you probably have nothing outside the prostate; ergo no other testing or biopsies are needed. He’s probably right, but only statistically.
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Tom, You will hear this advice many times and it is most critical to your recovery. Whatever treatment you decide is the best for you make sure that you find the absolute best qualified doctor that is available to you to perform the procedure. There is considerable debate on this board and in general about which treatment offers the best results but there is never any debate about the need for the best doctor to do it for you. If you have any doubt about your doctor keep looking. He should have lots and lots of experience in whatever treatment you choose. Best of luck to you, Nick – Hide quoted text — Show quoted text – I was just diagnosed with Prostate Cancer yesterday, so I guess that
Response:
I was just diagnosed with Prostate Cancer yesterday, so I guess that makes me the newest member to "The Club".
Welcome Tom. It’s one hell of an initiation, isn’t it! Here’s what info I DO have: 49 yrs. old – Philadelphia PA PSA 1.6 I believe the Dr. said 1 of 10 nodes(?) tested positive at something like 2% (but I wasn’t taking notes – guess I should have). Gleason? – No idea
It’s the worst thing you’ve ever encountered. That said, your stats look a lot better than most of ours. You’re very lucky. It looks like you got it early.
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– Hide quoted text — Show quoted text – I was just diagnosed with Prostate Cancer yesterday, so I guess that makes me the newest member to "The Club". Well, PC is new to me, which means that I don’t know what I don’t know …… and don’t know what to ask my doctor. I’ve scanned though some of the past posts and found references to some reading material, some websites, and a ton of great discussion. I’ll be checking them out, and reading back in this NG as far as I can in the next few days. I’ll be seeing my family Dr. this Friday (was diagnosed by my Urologist yesterday), and would appreciate any suggestions regarding what info I should ask about. I’m getting my CAT & Bone scans next week, so if all goes OK I guess I have about 10 days to learn about, and decide, on the various treatment methods.
Tom I was so upset and lost when I had my diagnosis. Although friendly and supportive, I found my family doc to be almost worthless, in terms of info and direction. Maybe it’s because he is a very young man? I went to work like a demon reading and asking all I could to gather info. I think that it was this NG that provided 90% of the most valuable info that I used to make my decison om course of treatment. I am 53, 8 weeks post RP and feeling great. The RP itself is the least of all the work you’ll have to do, to recover all function back to normal, so don’t sweat it. If you don’t absolutely love, and respect your Urologist, my advice is to keep looking until you do. Mine was so confident, and well appointed, that it overflowed to me. Good luck!! — Sinrod Stained Glass www.sinrodstudios.com Coney Island Memories www.sinrodstudios.com/coneymemories
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Leonard….. Did the doc remove your lymph nodes?? Were your numbers that different from mine?
My diagnosis was T1C, PSA 4.5, Gleason 7 = 3+4, 4 of 6 cores positive on one side, none of 6 cores positive on the other. My surgeon removed the nodes first, waited while a pathologist examined them, and finding they were negative, he continued with the surgery. Had they proved positive, he would probably have aborted the procedure. At least that is what he told me he would do, and I have no reason to doubt him. A friend was subsequently diagnosed with a Gleason 6 cancer. His surgeon removed the nodes for examination but he didn’t wait for results from the pathologist. The Partin tables suggest the likelihood of positive nodes is essentially zero in that case, and I guess he considered it so unlikely it would happen that there was no reason to wait for results during surgery. In my case, the Partin tables say the likelihood was only about 2 percent, but I guess my doctor considered that high enough to merit waiting. Since both these surgeons practice in the same area and use the same hospitals, I suspect they don’t differ substantially in matters like this. I can see why some surgeons might decide not even to remove the nodes for a Gleason 6 cancer. But the latest Partin tables only came out in 2001, and perhaps the standards are changing slowly. Some doctors may be more conservative than others about departing from past practice no matter what the numbers say. Others may want to be on the leading edge and consider it important to avoid any unnecessary interventions. Did you have any node involvement?
No. Thanks for always taking the time to reply…. and help…. Mike 
– Dept. of Mathematics, Northwestern Univ., Evanston, IL 60208
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Tom (&Leonard) I am presently home recuping form RP (removal). Had my surgery on the 16th. I was a 5.1 PSA and Tsb w/ Gleason 7. I am 53 years of age. I chose RP because of my age, as indications are that I can live long enough for it to come back if it does, so figured, get it out of there. I am in fairly good shape, and was walking 2 miles (36 laps around the 2nd floor) by thte third morning, on the advise of my Doc. Still walking 2.5 miles every day and feeling like a champ. Positive attitude. I knew nothing about PC prior, there is a wealth of info on the internet. Download a search engine and just start looking. Good luck. It sounds like you have caught it even earlier than I and you should come out like a champ. Go for it. Guy Howe
– Hide quoted text — Show quoted text – I was just diagnosed with Prostate Cancer yesterday, so I guess that makes me the newest member to "The Club". Well, PC is new to me, which means that I don’t know what I don’t know …… and don’t know what to ask my doctor. I’ve scanned though some of the past posts and found references to some reading material, some websites, and a ton of great discussion. I’ll be checking them out, and reading back in this NG as far as I can in the next few days. I suggest reading a book on the subject. I like Walsh’s book "Guide to Surviving Prostate Cancer", but there is another well like book by a urologist name Marks. The advantage of doing that over using the internet is that you will get a consistent point of view. Prostate cancer is a complex disease, and it is easy to get confused. After you have got one point of view, including the commonly agreed upon basics, straight, you can look at other points of view and see them in context. Using the internet is more confusing because you will see a variety of conflicting statements, and it will be hard to tell which of them you should pay attention to. You will also get a lot of advice of the form, "I did …., and it worked (didn’t work) for me". Such information can put a human face on things, but prostate cancer is not the same in all men. You need an overall perspective first. I’ll be seeing my family Dr. this Friday (was diagnosed by my Urologist yesterday), and would appreciate any suggestions regarding what info I should ask about. I’m getting my CAT & Bone scans next week, so if all goes OK I guess I have about 10 days to learn about, and decide, on the various treatment methods. Your family doctor may or may not be specially knowledgeable about prostate cancer. You need to talk to your urologist or perhaps some other prostate cancer specialist that your doctors can refer you to. It is unlikely that you must decide in 10 days. You can probably take a bit longer than that to be sure you understand everything and have made the right decision. But once you make the decision, there is no point in dawdling further. Here’s what info I DO have: 49 yrs. old – Philadelphia PA PSA 1.6 I believe the Dr. said 1 of 10 nodes(?) tested positive at something like 2% (but I wasn’t taking notes – guess I should have). Gleason? – No idea The Gleason would be very important in deciding upon treatment. Also, given your relatively low PSA, it seems possible that you were referred to a urologist because your doctor felt something on digital rectal examination. Just what he felt would also be important. One thing to keep in mind is that at your age, aggressive treatment of early prostate cancer by a skilled practitioner is unlikely to have serious side effects. But you want to be sure you do have a very skilled practitioner, particularly if you choose surgery. Thanks in advance for you advice and comments. Tom — Dept. of Mathematics, Northwestern Univ., Evanston, IL 60208
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I was just diagnosed with Prostate Cancer yesterday, so I guess that makes me the newest member to "The Club". Well, PC is new to me, which means that I don’t know what I don’t know …… and don’t know what to ask my doctor. I’ve scanned though some of the past posts and found references to some reading material, some websites, and a ton of great discussion. I’ll be checking them out, and reading back in this NG as far as I can in the next few days.
I suggest reading a book on the subject. I like Walsh’s book "Guide to Surviving Prostate Cancer", but there is another well like book by a urologist name Marks. The advantage of doing that over using the internet is that you will get a consistent point of view. Prostate cancer is a complex disease, and it is easy to get confused. After you have got one point of view, including the commonly agreed upon basics, straight, you can look at other points of view and see them in context. Using the internet is more confusing because you will see a variety of conflicting statements, and it will be hard to tell which of them you should pay attention to. You will also get a lot of advice of the form, "I did …., and it worked (didn’t work) for me". Such information can put a human face on things, but prostate cancer is not the same in all men. You need an overall perspective first. I’ll be seeing my family Dr. this Friday (was diagnosed by my Urologist yesterday), and would appreciate any suggestions regarding what info I should ask about. I’m getting my CAT & Bone scans next week, so if all goes OK I guess I have about 10 days to learn about, and decide, on the various treatment methods.
Your family doctor may or may not be specially knowledgeable about prostate cancer. You need to talk to your urologist or perhaps some other prostate cancer specialist that your doctors can refer you to. It is unlikely that you must decide in 10 days. You can probably take a bit longer than that to be sure you understand everything and have made the right decision. But once you make the decision, there is no point in dawdling further. Here’s what info I DO have: 49 yrs. old – Philadelphia PA PSA 1.6 I believe the Dr. said 1 of 10 nodes(?) tested positive at something like 2% (but I wasn’t taking notes – guess I should have). Gleason? – No idea
The Gleason would be very important in deciding upon treatment. Also, given your relatively low PSA, it seems possible that you were referred to a urologist because your doctor felt something on digital rectal examination. Just what he felt would also be important. One thing to keep in mind is that at your age, aggressive treatment of early prostate cancer by a skilled practitioner is unlikely to have serious side effects. But you want to be sure you do have a very skilled practitioner, particularly if you choose surgery. Thanks in advance for you advice and comments. Tom
– Dept. of Mathematics, Northwestern Univ., Evanston, IL 60208
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Sorry about the Dx, Tom…… I was diagnosed September 20….. and have scheduled surgery for Nov. 21. I’m scared to death….. Now…. a question to others……. my PSA is 8.8…. Gleaseon 3 + 3 = 6, Grade T1c, one of 12 cores positive, less than 5% tissue involvement….. But…… my doc is not doing bone or CAT scans? Again, why the difference? My doc even says he will not take out the nodes……. All the different opinions among docs surely does make this confusing…..
It used to be standard to do CAT scans and bone scans. But with prostate cancer being discovered earlier and earlier, and with more information—such as the latest Partin tables—about the likelihood of finding anything with these tests, many doctors don’t bother. I had a Gleason 7=3+4, and my urologist also didn’t bother with either of those tests. The purpose of a CAT scan is to see if there is any evidence of cancer beyond the gland, but they are notoriously difficult to interpret. Similarly for MRIs, but there are some newer MRI technique that show promise of doing better. Many doctors don’t think these measures add any information not obtainable from the Partin tables. Bone scans might show indication of metastasis, but for early prostate cancer discovered by PSA testing with Gleason scores in the range 5-7, it is very unlikely that a bone scan will show anything. Moreover, it may be difficult to distinguish other bone lesions from cancer and lead to unnecessary anxiety and uncertainty. But some doctors are more conservative and prefer the methods they have been using for years. Also, some doctors want a bone scan to provide a baseline to compare with if at some time in the future there is evidence of metastasis. I think that the doctors don’t really differ that much about the usefulness of any of these tests, but some still think it wise to use them. It may be the "belt and suspenders" mentality. As to removing lymph nodes, according to the Partin tables, with your diagnois, the chances of the lymph nodes being positive are essentially zero. Some doctors believe arithmetic more than others, and maybe some don’t completely trust the research behind the Partin tables. — Dept. of Mathematics, Northwestern Univ., Evanston, IL 60208
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Leonard….. Did the doc remove your lymph nodes?? Were your numbers that different from mine? Did you have any node involvement? Thanks for always taking the time to reply…. and help…. Mike
– Hide quoted text — Show quoted text – Sorry about the Dx, Tom…… I was diagnosed September 20….. and have scheduled surgery for Nov. 21. I’m scared to death….. Now…. a question to others……. my PSA is 8.8…. Gleaseon 3 + 3 = 6, Grade T1c, one of 12 cores positive, less than 5% tissue involvement….. But…… my doc is not doing bone or CAT scans? Again, why the difference? My doc even says he will not take out the nodes……. All the different opinions among docs surely does make this confusing….. It used to be standard to do CAT scans and bone scans. But with prostate cancer being discovered earlier and earlier, and with more information—such as the latest Partin tables—about the likelihood of finding anything with these tests, many doctors don’t bother. I had a Gleason 7=3+4, and my urologist also didn’t bother with either of those tests. The purpose of a CAT scan is to see if there is any evidence of cancer beyond the gland, but they are notoriously difficult to interpret. Similarly for MRIs, but there are some newer MRI technique that show promise of doing better. Many doctors don’t think these measures add any information not obtainable from the Partin tables. Bone scans might show indication of metastasis, but for early prostate cancer discovered by PSA testing with Gleason scores in the range 5-7, it is very unlikely that a bone scan will show anything. Moreover, it may be difficult to distinguish other bone lesions from cancer and lead to unnecessary anxiety and uncertainty. But some doctors are more conservative and prefer the methods they have been using for years. Also, some doctors want a bone scan to provide a baseline to compare with if at some time in the future there is evidence of metastasis. I think that the doctors don’t really differ that much about the usefulness of any of these tests, but some still think it wise to use them. It may be the "belt and suspenders" mentality. As to removing lymph nodes, according to the Partin tables, with your diagnois, the chances of the lymph nodes being positive are essentially zero. Some doctors believe arithmetic more than others, and maybe some don’t completely trust the research behind the Partin tables. — Dept. of Mathematics, Northwestern Univ., Evanston, IL 60208
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Sorry about the Dx, Tom…… I was diagnosed September 20….. and have scheduled surgery for Nov. 21. I’m scared to death….. Now…. a question to others……. my PSA is 8.8…. Gleaseon 3 + 3 = 6, Grade T1c, one of 12 cores positive, less than 5% tissue involvement….. But…… my doc is not doing bone or CAT scans? Again, why the difference? My doc even says he will not take out the nodes……. All the different opinions among docs surely does make this confusing….. Take care, Tom…. I wish you well…..what part of the country are you from? Read, read, read……. and study up on this as much as you can. Mike
– Hide quoted text — Show quoted text – I was just diagnosed with Prostate Cancer yesterday, so I guess that makes me the newest member to "The Club". Well, PC is new to me, which means that I don’t know what I don’t know …… and don’t know what to ask my doctor. I’ve scanned though some of the past posts and found references to some reading material, some websites, and a ton of great discussion. I’ll be checking them out, and reading back in this NG as far as I can in the next few days. I’ll be seeing my family Dr. this Friday (was diagnosed by my Urologist yesterday), and would appreciate any suggestions regarding what info I should ask about. I’m getting my CAT & Bone scans next week, so if all goes OK I guess I have about 10 days to learn about, and decide, on the various treatment methods. Here’s what info I DO have: 49 yrs. old – Philadelphia PA PSA 1.6 I believe the Dr. said 1 of 10 nodes(?) tested positive at something like 2% (but I wasn’t taking notes – guess I should have). Gleason? – No idea Thanks in advance for you advice and comments. Tom
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- Hide quoted text — Show quoted text – Tom, Sorry to hear about your recent Dx. Welcome to the club anyway, all the members here will provide whatever assistance and advice requested. You are on the right track with your reading. Read as much information as you can get your hands on especially with the various treatments available and the side effects. Your details look a little bit screwy however I am sure you will obtain greater understanding as you read and gain more information. Good luck and keep us posted….oh, BTW you have age on your side. AW Sydney, Australia I was just diagnosed with Prostate Cancer yesterday, so I guess that makes me the newest member to "The Club". Well, PC is new to me, which means that I don’t know what I don’t know …… and don’t know what to ask my doctor. I’ve scanned though some of the past posts and found references to some reading material, some websites, and a ton of great discussion. I’ll be checking them out, and reading back in this NG as far as I can in the next few days. I’ll be seeing my family Dr. this Friday (was diagnosed by my Urologist yesterday), and would appreciate any suggestions regarding what info I should ask about. I’m getting my CAT & Bone scans next week, so if all goes OK I guess I have about 10 days to learn about, and decide, on the various treatment methods. Here’s what info I DO have: 49 yrs. old – Philadelphia PA PSA 1.6 I believe the Dr. said 1 of 10 nodes(?) tested positive at something like 2% (but I wasn’t taking notes – guess I should have). Gleason? – No idea Thanks in advance for you advice and comments. Tom
Not a bad idea to have a different pathologist, from a different hospital, check the readings on your biopsy slides. Your treatment will be greatly dependent on the reading of the Gleason score plus pther items, of course. (And keep records, PSA, any treatments, etc.) — "Labrias contrectant tobacus, nunquam contrectabunt meus" Paul F
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Tom, Sorry to hear about your recent Dx. Welcome to the club anyway, all the members here will provide whatever assistance and advice requested. You are on the right track with your reading. Read as much information as you can get your hands on especially with the various treatments available and the side effects. Your details look a little bit screwy however I am sure you will obtain greater understanding as you read and gain more information. Good luck and keep us posted….oh, BTW you have age on your side. AW Sydney, Australia
– Hide quoted text — Show quoted text – I was just diagnosed with Prostate Cancer yesterday, so I guess that makes me the newest member to "The Club". Well, PC is new to me, which means that I don’t know what I don’t know …… and don’t know what to ask my doctor. I’ve scanned though some of the past posts and found references to some reading material, some websites, and a ton of great discussion. I’ll be checking them out, and reading back in this NG as far as I can in the next few days. I’ll be seeing my family Dr. this Friday (was diagnosed by my Urologist yesterday), and would appreciate any suggestions regarding what info I should ask about. I’m getting my CAT & Bone scans next week, so if all goes OK I guess I have about 10 days to learn about, and decide, on the various treatment methods. Here’s what info I DO have: 49 yrs. old – Philadelphia PA PSA 1.6 I believe the Dr. said 1 of 10 nodes(?) tested positive at something like 2% (but I wasn’t taking notes – guess I should have). Gleason? – No idea Thanks in advance for you advice and comments. Tom
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I was just diagnosed with Prostate Cancer yesterday, so I guess that makes me the newest member to "The Club". Well, PC is new to me, which means that I don’t know what I don’t know …… and don’t know what to ask my doctor. I’ve scanned though some of the past posts and found references to some reading material, some websites, and a ton of great discussion. I’ll be checking them out, and reading back in this NG as far as I can in the next few days. I’ll be seeing my family Dr. this Friday (was diagnosed by my Urologist yesterday), and would appreciate any suggestions regarding what info I should ask about. I’m getting my CAT & Bone scans next week, so if all goes OK I guess I have about 10 days to learn about, and decide, on the various treatment methods. Here’s what info I DO have: 49 yrs. old – Philadelphia PA PSA 1.6 I believe the Dr. said 1 of 10 nodes(?) tested positive at something like 2% (but I wasn’t taking notes – guess I should have). Gleason? – No idea Thanks in advance for you advice and comments. Tom
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Hi, Michael. Did the report mention your Stage (T1a, T2b,…) or your overall Gleason score (3+3=6, 3+4=7, …)? The "last sentences" merely means that the biopsy did not identify any escape from the capsule. You won’t know for sure until and unless your prostate is removed and biopsied on a lab table. — Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05 PSA .07 .05 .06 .05 non Illegitimi carborundum
– Hide quoted text — Show quoted text – I think I just received my membership card in this group today. From the posts I’ve seen, you seem to be a caring and well informed, well, family.(?) While I can hardly say it is a pleasure to join, I look forward to our give and take — and your guidance. I have "adenocarcinoma" in one core with a gleason score of 6. My Uro said that was cancer in 5% to 10% of the prostate. I have high-grade PIN in "part C, as well as in several other cores," according to the biopsy report. One core has "chronic and focal acute inflammation with atrophy of the prostate." Two cores have "Intraepithelial neoplasia, high grade, focal, of prostate." Four cores have "benign hyperplasia of prostate." In a descriptive section, the report says, "Present in two of three core fragments in part C are foci of moderately differentiated invasive adenocarcinoma of intermediate nuclear grade having architectural features of Gleason’s pattern 3. On the slides, the larger focus measures about 0.1 cm, and the smaller is about 0.6 mm. Together, they occupy between 5 – 10% of the total area in part C. No perineurel invasion is identified." Does this last sentence mean I have no cancer outside the prostate? I forgot to ask that question. I’m 60 and in otherwise excellent health. I run around 20 miles a week on a track behind our house. (That’s about two pairs of running shoes a year! I see there are some runners among you.) What did I leave out? I would appreciate any feedback you feel is appropriate. Michael K
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The "last sentences" merely means that the biopsy did not identify any escape from the capsule.
No, it doesn’t mean that. See my posting above above, and: http://prostatepointers.org/prostate/oppenheimer/oppenheimer3.html (in the 5th paragraph up from the end). — Peter Headland
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Welcome from a less-than-a year member. You have come to the right place, with knowledgeable, intelligent, and, above all, very caring and sincere people. Being here has made an enormous difference to me as I have dealt with PCa–I only wish I had known of it earlier. But true support is here and, as I have gratefully learned, some very real and important helpful suggestions. By the way, as I read your information, I believe that you have every reason to be very optimistic. But, of course, you must make a treatment decision and take care of your PCa. The very best of luck to you.
– Hide quoted text — Show quoted text -I think I just received my membership card in this group today. From the posts I’ve seen, you seem to be a caring and well informed, well, family.(?) While I can hardly say it is a pleasure to join, I look forward to our give and take — and your guidance. I have "adenocarcinoma" in one core with a gleason score of 6. My Uro said that was cancer in 5% to 10% of the prostate. I have high-grade PIN in "part C, as well as in several other cores," according to the biopsy report. One core has "chronic and focal acute inflammation with atrophy of the prostate." Two cores have "Intraepithelial neoplasia, high grade, focal, of prostate." Four cores have "benign hyperplasia of prostate." In a descriptive section, the report says, "Present in two of three core fragments in part C are foci of moderately differentiated invasive adenocarcinoma of intermediate nuclear grade having architectural features of Gleason’s pattern 3. On the slides, the larger focus measures about 0.1 cm, and the smaller is about 0.6 mm. Together, they occupy between 5 – 10% of the total area in part C. No perineurel invasion is identified." Does this last sentence mean I have no cancer outside the prostate? I forgot to ask that question. I’m 60 and in otherwise excellent health. I run around 20 miles a week on a track behind our house. (That’s about two pairs of running shoes a year! I see there are some runners among you.) What did I leave out? I would appreciate any feedback you feel is appropriate. Michael K
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Given the fad for women to fry and eat their placentas after birth, maybe I should be demanding to be allowed to eat my prostate? — Peter Headland
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Oops! Yes, you’re right of course, it was the wrong word, not what I intended.
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Hello Michael, welcome to the "family". This is without a doubt the best ng that I have ever seen. You will find a wide range of topics here. Do not be put off by the humor when it presents itself. There is also frank discussion that some find offensive, and we have unfortunately lost members over some of it. Do not be afraid to ask any questions here. We are all here for information and support. You will no doubt run into a lot of practical problems as you progress through this experience. There are a lot of resources available to help you educate yourself, e.g., the phoenix5 web site. Take a look at Joe’s recent post, "1300 Page Prostate Cancer Website". There is a wealth of information there. On your numbers, you appear to be in good shape. I was PSA 5.0, PSA Free 6%, Gleason 6 (post surgery path report reported Gleason 5), 6% in two of ten biopsy specimens, prostate 30 grams. They told me that there was almost no chance that the cancer had spread when I was diagnosed, and after the RRP the path report showed organ contained disease, clear surgical margins, and lymph nodes clear. I wish you the same! Good luck. Thank you. David S.
– Hide quoted text — Show quoted text – I think I just received my membership card in this group today. From the posts I’ve seen, you seem to be a caring and well informed, well, family.(?) While I can hardly say it is a pleasure to join, I look forward to our give and take — and your guidance. I have "adenocarcinoma" in one core with a gleason score of 6. My Uro said that was cancer in 5% to 10% of the prostate. I have high-grade PIN in "part C, as well as in several other cores," according to the biopsy report. One core has "chronic and focal acute inflammation with atrophy of the prostate." Two cores have "Intraepithelial neoplasia, high grade, focal, of prostate." Four cores have "benign hyperplasia of prostate." In a descriptive section, the report says, "Present in two of three core fragments in part C are foci of moderately differentiated invasive adenocarcinoma of intermediate nuclear grade having architectural features of Gleason’s pattern 3. On the slides, the larger focus measures about 0.1 cm, and the smaller is about 0.6 mm. Together, they occupy between 5 – 10% of the total area in part C. No perineurel invasion is identified." Does this last sentence mean I have no cancer outside the prostate? I forgot to ask that question. I’m 60 and in otherwise excellent health. I run around 20 miles a week on a track behind our house. (That’s about two pairs of running shoes a year! I see there are some runners among you.) What did I leave out? I would appreciate any feedback you feel is appropriate. Michael K
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On June 13, responding to Mike, Wayne wrote in pertinent part: My own case was very similar, age 66, PSA 4.3, one of 12 cores with Gleaon 6. Pathology reported two palatable tumors after they got it out. Nothing palatable via DRE.
I know that criticizing a poster’s errors in language is considered to be flaming, but I got such jolt out of the above, that, meaning no offense, I just have to comment. About tumors, Wayne, of course, meant to write "palpable," meaning "obvious." What he wrote was "palatable," meaning "delicious." This brought to my sick mind visions of eating — and enjoying — tumors. Ech. To wax didactic, this would be a "malapropism," which is defined as, "(t)he usually unintentionally humorous misuse of a word, especially by confusion with one of similar sound." (Dictionary.com) OK, got that out of my system and school is dismissed ;-) Except for Mike’s hard school of learning about the nature of his disease and what best to do about it. I very strongly recommend reference to the website of the Prostate Cancer Research Institute at http://prostate-cancer.org/index.html There, Mike will find objective information and references that should help him immensely in the coming struggle. All the best, and do keep us informed. Regards, Steve J "Never give in–never, never, never, never, in nothing great or small, large or petty, never give in except to convictions of honour and good sense. Never yield to force; never yield to the apparently overwhelming might of the enemy.” –Sir Winston L. S. Churchill
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Hello JK. Sinrod, Nice post and right to the point. I was back east for a week. It was extremely fun, and hot. 94o and hello…..very high humidity… Good info to Michael Kiely. John Loomis
– Hide quoted text — Show quoted text – I think I just received my membership card in this group today. From the posts I’ve seen, you seem to be a caring and well informed, well, family.(?) While I can hardly say it is a pleasure to join, I look forward to our give and take — and your guidance. Consider yourself a lucky guy! How’s that for a positive spin on things? You got yourself diagnosed early, and there’s a very good chance you’ll die of getting hit by a truck before you croak of PCa. Read and absorb all your options. My personal and slanted advice is to find the best experienced surgeon and hospital in your area and have an RP. I’m 55 and 3 years post surgery. I’m very pleased with where I am in life now. Good luck! — JK Sinrod Sinrod Stained Glass Studios www.sinrodstudios.com Coney Island Memories www.sinrodstudios.com/coneymemories
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I think I just received my membership card in this group today. From the posts I’ve seen, you seem to be a caring and well informed, well, family.(?) While I can hardly say it is a pleasure to join, I look forward to our give and take — and your guidance.
Consider yourself a lucky guy! How’s that for a positive spin on things? You got yourself diagnosed early, and there’s a very good chance you’ll die of getting hit by a truck before you croak of PCa. Read and absorb all your options. My personal and slanted advice is to find the best experienced surgeon and hospital in your area and have an RP. I’m 55 and 3 years post surgery. I’m very pleased with where I am in life now. Good luck! — JK Sinrod Sinrod Stained Glass Studios www.sinrodstudios.com Coney Island Memories www.sinrodstudios.com/coneymemories
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"Perineural invasion" means the cancer is spreading along nerves within the prostate; it doesn’t tell you anything about whether it has extended beyond the prostate capsule. Recent studies by some of the best in the field suggest that this very common finding is meaningless. Biopsies can never tell you that there is definitely no cancer outside your prostate. They usually cannot tell you even if there is. Only surgery could give you any reasonable indication about that (and even then, the cancer might have metastasized to a different site, though that seems very unlikely in your case). The inflammation and atrophy are very common and don’t mean anything at all in respect of cancer. For future reference, "prostatic intraepithelial neoplasia" = PIN. Generally considered to be precancerous, but might not become so for many decades. All-in-all, that is pretty good pathology, given that it is positive at all. But get a move on and choose a treatment plan – you can’t ignore this. As others have said, a second opinion on the pathology from a top-rated centre might be illuminating. — Peter Headland
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– Hide quoted text — Show quoted text -I think I just received my membership card in this group today. From the posts I’ve seen, you seem to be a caring and well informed, well, family.(?) While I can hardly say it is a pleasure to join, I look forward to our give and take — and your guidance. I have "adenocarcinoma" in one core with a gleason score of 6. My Uro said that was cancer in 5% to 10% of the prostate. I have high-grade PIN in "part C, as well as in several other cores," according to the biopsy report. One core has "chronic and focal acute inflammation with atrophy of the prostate." Two cores have "Intraepithelial neoplasia, high grade, focal, of prostate." Four cores have "benign hyperplasia of prostate." In a descriptive section, the report says, "Present in two of three core fragments in part C are foci of moderately differentiated invasive adenocarcinoma of intermediate nuclear grade having architectural features of Gleason’s pattern 3. On the slides, the larger focus measures about 0.1 cm, and the smaller is about 0.6 mm. Together, they occupy between 5 – 10% of the total area in part C. No perineurel invasion is identified." Does this last sentence mean I have no cancer outside the prostate? I forgot to ask that question. I’m 60 and in otherwise excellent health. I run around 20 miles a week on a track behind our house. (That’s about two pairs of running shoes a year! I see there are some runners among you.)
That is a serious problem, but you can increase the milage on your shoes by applying some glue over the heel worn spots with a hot glue gun. You must repeat this every few days, as it wears away, but it adds very many miles. Kidding a little of course. No joy, but a warm welcome to the club anyway. No, the biopsy is not sufficient to declare no cancer outside the prostate. "No perineurel invasion is identified" just means the bioposy samples did not identify any at the limited locations of the cores. However your case of one core with Gleason 6 is relatively low grade, which probably does means about 99% chance of none outside yet, according to the Partin tables (books below, and online too). That is the good news, you have time to cure this thing. First thing to do is to make sure your doctor got a second opinion on the biopsy lab work. I’d assume that is pretty standard, to be sure it is accurate before planning action based on it. Second thing is to read at least a couple of Prostate Cancer books, Walsh or Dummies for example are excellent. Only after you acquire some understanding do you decide a plan. I didnt understand most of the words in your report, but the pathololgy report after RRP surgery will be greatly more accurate. The report wont get any better after they get it out to look at it (all they can do is find more). But they can actually see and test all of the margins then, which will be meaningful. And you will know then it is gone. My own case was very similar, age 66, PSA 4.3, one of 12 cores with Gleaon 6. Pathology reported two palatable tumors after they got it out. Nothing palatable via DRE. The side effects of RRP are far from trivial, but I’m glad the cancer is gone now. Wayne
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I think I just received my membership card in this group today. From the posts I’ve seen, you seem to be a caring and well informed, well, family.(?) While I can hardly say it is a pleasure to join, I look forward to our give and take — and your guidance. I have "adenocarcinoma" in one core with a gleason score of 6. My Uro said that was cancer in 5% to 10% of the prostate. I have high-grade PIN in "part C, as well as in several other cores," according to the biopsy report. One core has "chronic and focal acute inflammation with atrophy of the prostate." Two cores have "Intraepithelial neoplasia, high grade, focal, of prostate." Four cores have "benign hyperplasia of prostate." In a descriptive section, the report says, "Present in two of three core fragments in part C are foci of moderately differentiated invasive adenocarcinoma of intermediate nuclear grade having architectural features of Gleason’s pattern 3. On the slides, the larger focus measures about 0.1 cm, and the smaller is about 0.6 mm. Together, they occupy between 5 – 10% of the total area in part C. No perineurel invasion is identified." Does this last sentence mean I have no cancer outside the prostate? I forgot to ask that question. I’m 60 and in otherwise excellent health. I run around 20 miles a week on a track behind our house. (That’s about two pairs of running shoes a year! I see there are some runners among you.) What did I leave out? I would appreciate any feedback you feel is appropriate. Michael K