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Re: How do they calculate % of cancer in gland based on biospy results
Tom From my experience and what I have learned I would definitely get second opinions. Right now you have minor involvement and not knowing your PSA history I don't think you need to rush into a decision. Talk to a radiation oncologist also. Make sure you are talking to doctors that are specialist in prostate cancer possibly at a teaching hospital. That being said keep on top of it, learn all you can and treat it early while there is a chance for a cure. Surgery if you are young, healthy and have a good surgeon is not really life changing. I wish I caught mine early (I had surgery). Rest easy, sounds like you are in a good position.
Re: How do they calculate % of cancer in gland based on biospy results
Thanks Bruce, yes I went out to the University of Washington to get a 2nd opinion & have been put in the Active Surveillance program, knowing that I need to take action if PSA increases or next biospy shows more cancer. My PSA had risen from .43 (March 2011) to 2.7 (November 2011) in 9 months, so the Dr. wanted to do a biospy as I was having some urgency symptoms etc.
Re: How do they calculate % of cancer in gland based on biospy results
There are about 7 chaps at my golf club that I know of who were biopsied for rising PSA in their late 50's over the past 7 years, tested positive and all chose surgery as there are a couple of excellent urological surgeons in my city. None have so far had a relapse ( to my knowledge ) and none had any ongoing negative side effects except for sexual ability. Most ( but not all )now need Viagara and most lament it's still not the same - and some get bad reactions to the drug. I've known 4 chaps from business who chose watchful waiting and all but one required surgery within 4 years or 5 years. So far all are o.k. Pretty small sample but it may be helpful.
Re: How do they calculate % of cancer in gland based on biospy results
Thanks for that bobbyboy,
My experience is that very few men are prepared to talk penly in venues such as the golf club about their sexual (and other) problems after surgery.
One of the values of the stories on this site is that the men are often anonymous and that gives them the power to talk quite candidly about their experiences.
The sample of men on the site is fairly large now - with more than 1,000 stories there. I think that may give a wider view.
Re: How do they calculate % of cancer in gland based on biospy results
Tom,
The thread has moved well away from your original question.
No one can make any accurate calculate of the entire volume of a tumour, so what they do is look at the estimated percentages of positive material (that labelled as adenocarcinoma) in each sample taken in the biopsy.
So in your case your report said
1 of 16 biopsy cores positive with 15% cancer (gleason 3+3=6)
That would be interpreted as a very low risk disease because
(a) There was very little positive material identified - most of the samples showed no signs of the disease
(b) your Gleson Score was "entry level" If the GS had been any lower the cells would not have been labelled as prostate cancer.
I am glad that you keep on asking questions because I have little doubt that there are others who are wondering about some of these issues themselves, so getting a discussion going might help them as well.
BUT.....I am not sure that you have yet graspd the fact that there is no certainty in the diganostic process. It has been said that diagnosis is more art than science and I would agree with that statement. Diagnosis is a series of educated guesses - regrettably many doctors do not have the education to understand the evidence produced or the wilingness to see further information. That is why it is important that we do some of the work ourselves.
Re: How do they calculate % of cancer in gland based on biospy results
Thanks for your patience in working with me on this issue, yes, I am disappointed that the medical community does not have a required standard way to more definitively give the patient an overall cancer assessment of the gland. More importantly, the Dr.s don't seem to care enough to give the patient this piece of mind for a potentially life altering decision with a full diagnostic test, rather than expect us to decide based on some blood marker readings & a tissue sampling. I wonder if that would be enough if it was their prostate on the table so to speak!
Re: How do they calculate % of cancer in gland based on biospy results
Tom, You say
I wonder if that would be enough if it was their prostate on the table so to speak!
The answer in most cases would probably be "YES". During my wanderings trying to get more information about my options I saw many doctors in South Africa, Australia and the US. Once I had learned the basics of the disease (and I knew I had a deal more to learn) i would ask the doctor, after he had clompleted the examination and we had discussed treatment options,
"What would YOU do, doctor, if you were in my position?" To the best of my recollection there was not one who would not have chosen the 'gold standard' of surgery, despite the odd variances in my blood and other tests, despite the fact that some of them were radiologists suggesting I might have radiation.
Re: How do they calculate % of cancer in gland based on biospy results
Well, I had fifteen DREs before I called it quits:-) plus of course a rectal MRI. so yes, I did all I could at that time to get as much input from as many people as I could.
