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JustJB
Regular
Joined: 15 Aug 2009
Posts: 39
Location: San Jose, CA
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 Posted: Fri Sep 04, 2009 7:12 pm Post subject: Recently Diagnosed, inviting feedback |
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(We try again!)
Hello;
I'm pleased to have found this forum and look forward to some good feedback on my situation.
I am 51 yrs, 10 mos. My PSA rose from 2.8 to 3.8 to the current 5.3 in about 39 months. I had a 12 point biopsy about a month ago. Prostate volume was 28; no irregularities felt in DRE. One of the biopsies came back positive with a Gleason of 3+3=6. I still don't have all the terminology down but the rating??? was T1C. I just checked the Partin and it shows about a 95% chance of the tumor being organ enclosed. Basically it seems if I have to have PC this is the way to have it.
I am just starting the process of deciding on treatment. I don't have any major underlying conditions so my life expectancy is over 30 years at this point, by standard actuarial tables. Personally I'm shooting for 40+ years; Life is way too interesting to check out early!
My urologist has earned my trust. He is at my local (2 miles) Kaiser and specializes in open surgery. I can elect robotic surgery but would have to go to the Kaiser facility in Walnut Creek, about 70 miles away.
At the moment I am leaning towards the surgery but will consult with specialists in both treatments.
I'd appreciate any feedback based on my specs and thanks in advance!
_________________
Age 52
Gleason 3+3 = 6
Stage T1C
1 out of 12 cores involved
Left side, median lobe |
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johnT
Senior User
Joined: 27 Apr 2009
Posts: 176
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| Posted: Fri Sep 04, 2009 8:41 pm Post subject: Re: Recently Diagnosed, inviting feedback |
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What was your % of core involvement in the 1 positive sample?
With your stats you have every option availabel to you with an excellent progonosis.
For your stats the Prostate Cancer research Institute recommends NO immediate treatment.
Your PSA doubling time is high, anything ove 3 years has an exellent result usng Active Survelience. You would be the poster boy for AS and you would have at least a 70% chance of no progression in 5 years and if progesssion is indicated by rising psa, treatment effectiveness is as good as if you had immediate treatment today.
I would recommend a 2nd opinion on your pathology as there is an excellent chance you have insignificant indolant PC. I would question your doctor and pathologist to look at this as a high psssibility. If your core % is less than 5% it is most likely indolant cancer clusters that will never hut you.
Surgery is also a good option especially for a younger patient. There is a high chance of permanent side affects such as ED and incontinence and a 100% chance of these for weeks or months.
Seeds are an excellent choice for a low grade PC. Convenience is great as it is a painless 45 min procedure and results are as good as surgery with much less side affects.
You have plenty of time to research all options and side affects as they will affect the rest of your life.
The Prostate Cancer Research Institute and YANA has excellent sections for the newly diagonosed.
Diet is also important and can significantly slow progression.
JohnT
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psa at diagnosis 40 in nov-08
gleason 6 and 7
Treatment choice seeds and IMRT |
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Hawk
Senior User
Joined: 22 Nov 2006
Posts: 406
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| Posted: Fri Sep 04, 2009 9:31 pm Post subject: Re: Recently Diagnosed, inviting feedback |
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I am happy for you and a bit envious  As john said you have every option from Seeds, External beam, open, or robotic surgery, Hifu, and watchful waiting.
A second opinion from one of the few expert pathologists in reading prostate biopsies is critical. In your case it may save you from ever having treatment. if it even saves your from treatment for 10 years there could be GREATLY improved treatments by then.
Relax and search the possibilities.
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History: PSA's 6.7 neg. biopsy - PSA 16.6 neg. biopsy - PSA's 8.2, 8.1, 8.7 - Biopsy. 4+4 Gleason 8. Lap RP Apr 2004, age 52 All neg margins, nodes, and structures. (T2a). Post RP PSA: every 6 mo. <.1 until Feb, 08 (46 mos) PSA .1 - I then got sensitive tests (all in 2008) showing:
Feb .06, May .09, Jun .10, Aug .10, Nov .15 -SRT |
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