This forum is for the discussion of anything to do with Prostate Cancer. There are only four rules:
No fundraisers, no commercials (although it is OK to recommend choices of treatment or medical people based on your personal research; invitations to participate in third-party surveys are also acceptable, provided there is no compensation to YANA);
No harvesting e-mail addresses for Spam;
No insults or flaming - be polite and respectful at all times and understand that there may be a variety of points of view, all of which may have some validity;
Opinions are OK, but please provide as much factual evidence as possible for any assertions that you are making
Failure to abide by these simple rules will result in the immediate and permanent suspension of your posting privileges.
Since this is an International Forum, please specify your location in your post.
One thing I'm a little confused over. Is the pathology report how they determine what is the best treatment option. I would expect some type of mri or color doppler or other tests to determine exact location and if the cancer is contained or not, before moving forward. Like you mentioned and what I could find, the location and extent of both sides with apex involvement, favors radiation.
One of the first things we all have to learn in trying to get to grips with our diagnosis and decision making process is to gain a clear understanding that diagnosis is far from an exact science. All tests, scans etc are subject to both technical and human error and interpretation. Some tests produce marginally more accurate results than others, but all have false negative (failing to identify a tumour) and false positive (identifying as a tumour material that is benign) outcomes. Skilled and careful experts are more likely to interpret these findings more accurately than those who do not have the expertise or the time to examine them all.
This is why there can be a wide range of outcomes from the diagnostic process - again if I can refer briefly to my case. The 'worst case' diagnosis was Stage 4; Gleason Score 7a: PSA 7.2. The 'best case' was Stage T1c: Gleason Score 5: PSA 3.3.Now that's a pretty wide range!!
The pathology report is the main 'driver' of decision making because it is the best pointer to the likelihood of the identified tumour as being more or less aggressive. The higher the Gleason Score, the more positive needles, the more investigation should be undertaken to try to ascertain the likelihood of the disease having escaped the gland. That is where scans like MRI and Color-Doppler and ploidy analysis/PAP tests come in. None of them will give a definitive answer to the question "Where is the tumour? Has there been spread?" but when all available information is interpreted by a skilled expert, the probabilities can be calculated more accurately. And then an appropriate decision can be made.
Peet,
Here's another source I found invaluable on my journey. I located a local chapter of UsToo the prostate cancer support group. Chapters usually
have monthly meetings and love to talk to newly diagnosed guys and share their experiences with them. These are guys who have "been there and done that". There is nothing better than learning about "quality of life" issues from guys who live with them every day.
I understand there is another group associated with the ACS called "Man to Man". They don't have a group near me so I don't have firsthand knowledge like I do UsToo. You can find UsToo on the web and they put out excellent monthy newsletters you can read online.
The predictive value of PNI for extracapsular extension has decreased over time because of a downward stage migration driven largely by early detection efforts for prostate cancer. As patients have presented for definitive therapy with earlier, smaller tumors, the significance of PNI on prostate needle biopsy specimens has decreased. The presence of PNI on biopsy specimens does not preclude cure after definitive therapy or mandate wide excision of the ipsilateral neurovascular bundle at the time of surgery, and it should not deter the performance of radical prostatectomy in a patient who is otherwise a good surgical candidate.
Do a google search for prostate cancer perineural invasion and you can learn a deal more.
2nd Pathology report. any comments appreciated as first consult with a radiology oncologist next week. I paid $150 for this 2nd report from a site recommended on this forum. Thanks for that Terry
For an additional $350 they offer a more detailed assessment but I passed on that
2ND OPINION RECEIVED 11/15/2012 MICROSCOPIC DESCRIPTION
A) Left Base: Benign prostatic glands and stroma.
B) Left Mid: Prostatic adenocarcinoma, Gleason score
3+3=6, measuring 2mm (10% of the tissue).
C) Left Apex: Prostatic adenocarcinoma, Gleason score
3+3=6, measuring 7mm (40% of the tissue).
D) Left Base Lat: Benign prostatic glands and stroma.
E) Left Lat Mid: Prostatic adenocarcinoma, Gleason score
3+3=6, measuring 2.5mm (20% of the tissue).
F) Left Lat Apex: Prostatic adenocarcinoma, Gleason score
3+3=6, measuring 1mm (7% of the tissue).
G) Right Base: Prostatic adenocarcinoma, Gleason score
3+4=7, measuring 4mm (30% of the tissue).
H) Right Mid: Small focus of atypical glands.
I) Right Apex: Prostatic adenocarcinoma, Gleason score
3+4=7, measuring 5mm (40% of the tissue).
J) Right Lat Base: Prostatic adencarcinoma, Gleason score
3+3=6, measuring 3mm (30% of the tissue).
K) Right Lat Mid: Small focus of atypical glands.
L) Right Lat Apex: Prostatic adenocarcinoma, Gleason
score 3+3=6, measuring 1mm (5% of the tissue).
Comments: Perineural invasion is seen in these biopsies.
Eight of twelve tissue cores are involved with
adenocarcinoma.
PHOTOMICROGRAPH
Malignant
Report Date: 11/16/2012
All malignant
