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02/04 I was diagnosed with PCa (7 out of 12 cores were positive via prostate biopsy). This Friday I will receive the test results from both a pelvic CT scan and a bone MRI to see if my PCa has spread. With a PSA pf 2.6 and a Gleason score of a 6 am i need need of rushing into surgery if the lastest results are negative?
My results will be coming this Friday 3/4/11.
I have not really researched PCa to a great extent and am only just getting around to reading a book my Urologist asked me to read.
100 Questions and Answers About Prostate Cancer
by Pamela Ellsworth, MD.
I will be 50 on April 30 and had to say really do not feel like having some surgery that good leave me laid up for a long time.
In general Pete the more research you do the better questions you will ask as you encounter various experts along the way, and the better prepared you will be to make a good decision for you and your circumstances. As a part of your research effort you may find my journal helpful; see http://protondon.blogspot.com/
Regards Don O.
As the two Don's have mentioned, it appears that you have time to do some reading/studying before making that decision.
It is not clear from your post, but I'm assuming that you were diagnosed on Feb 4, 2011. Is this correct?
You are young at 50, so have you had more than one PSA test? The one PSA 2.6 that you mentioned is low, what prompted the biopsy? Are there DRE indications or other flow problems that lead to the PSA test?
It does sound like you could have a less agressive PCa, but 7/12 cores is something to consider and watch closely. I suspect that your MRI & bone scan will not show anything as I had a high Gleason and 12/12 cores, but nothing detectable outside the prostate.
I know it is hard not to worry, try to step back and watch what happens. I would get second opinions on the biopsy results. There are labs listed on this site of where to do that. Different pathologists do get different results and a G6 is just at that point where mistakes are made.
Hang in there,
My Psa went up and entire point in a year so a biopsy was done with the result being PCa. My urologist at the meeting where he informed me of my diagnosis has already suggested that I have my prostate removed. He feel that because I am young and my PSa wnet up so fast that it would be in my best interest to just have it removed.
One the one hand I agreed yet it is my understanding that with prostate the recovery time can be a very prolonged one, not to mention permenant problem and a great deal of ongoing and fairly severe pain.
I really need to find a loca support group in addition to you guys. I have to say that I would be losing it if it wasn't for your help.
There are many other options other than surgery. Both Brachytherapy and IMRT have similar results as surgery with less long term side affects.
Research all treatment options and consult with a surgeon, brachytherapist and radiologist before making a final decision.
Sorry to read of your understandable concerns and welcome to the club you never wanted to join. You’ve had some good advice so far, and here’s my contribution.
1. There is a good deal of misunderstanding about PSA tests. You may have been aware of some of the issues from newspaper articles, although you were probably like the rest of us and didn’t really read those fully as it didn’t apply to you – until you were told you had a high reading. Well, time to start catching up now!! You talk about a rise of one point over 12 months – presumably from 1.6 ng/ml to 2.6 ng/ml – and the fact that you are told that this is indicative of an aggressive disease. That is not necessarily so. A study published only last week came to the conclusion that a rising PSA (at the level we are talking about here) had no relationship to aggressiveness, or even the presence of prostate cancer. You might like to read PSA 101 and 28 Day Experiment if you have not come across them already to give you some background to the issues you need to consider.
2. Although many people think of prostate cancer as one disease, there are in fact many varieties – one recent study suggested 24 or more The Prostate Cancer Quandry . The most reliable indicator we have of aggressiveness is the Gleason Grade/Gleason Score. The lowest Gleason Score at present is 3+3=6 – see Gleason Grades
3. More than half the men who eventually die of prostate cancer are over the age of 80. Ninety percent of the men who die from the disease are over 70. Younger men who sadly die before these ages usually have an aggressive form of the disease as indicated by Gleason Scores of 8 or higher and or a rocketing PSA in the hundreds or thousands. Some of those men do survive for many years – see Doug Adam for example - diagnosed 20 years ago with a Gleason 10 disease.
4. That’s the good news – no indication of an aggressive disease using current data, BUT….what is less good news is the number of positive needles in your biopsy. Seven positive needles out of twelve may indicate a large mass and a large mass may have more potential to spread - maybe slowly because of the low Gleason Score. So it is important to have an expert opinion on those biopsy results to ensure that they are all adenocarcinoma – there are at least four conditions that can be confused with adenocarcinoma which are not ‘cancer’ – and that they are Gleason Score 6. See Expert Pathologists There may be a cost to you in getting this second opinion, but it is really important to get good basic information to make the best decisions.
Hope this helps some. Prostate cancer is a disease where there is no certainty and should never be treated lightly, but men should also be aware that there have been many thousands of men who have had therapies that have damaged their quality of life severely with no proven benefit.
Good luck as you head into the marathon that is prostate cancer – and keep asking questions until you get answers you understand.