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Thread: Prostate Biopsy Tomorrow- PLEASE READ

  1. #1
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    Question Prostate Biopsy Tomorrow- PLEASE READ

    I am a 47 year old who 2 years ago had a normal PSA level. Just recently my PSA came back at 9.8. My medical doctor was very concerned that it had elevated so fast. I was sent to a urologist who performed a rectal exam. He said I was swollen on the right side and he was concerned because he felt something hard. My grandfather died of prostate cancer in his 50's. I have had no symptoms whatsoever of a sore prostate, trouble urinating or ejaculating, with the exception of urinating a little more than normal at night. i have had stomach pain from acid reflux (I think). More recently I have had bone pain....but I think it is probably arthritis (not sure). My question is this: When a hard nodule, mass or whatever you want to call it is felt by the doctor....is it most often prostate cancer or could it be benign? I am worried because of the family history of prostate cancer. Also, how long does it take to get biopsy results back?

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    While an elevated PSA, "something hard" on the DRE are certainly not encouraging, it doesn't necessarily mean you have PCa. PSA could be eleveated due to inflammation and what the doc felt could be calcification. The biopsy is the typical, next step. (Wish the color doppler were more readily available.)

    My husband's case (see recent thread "MRI/MRSI..") is somewhat different because his PSA has always been normal, but as you read more on the LINK DELETED PER FORUM POSTING POLICIES. PLEASE REVIEW AND COMPLY. THANK YOU. you'll surely find men with cases similar to yours. And you'll probably learn that you have many options, and that rarely is there a need to rush in making a decision.

    My DH is wimpy when it comes to medical procedures, and for him the biopsies were nothing. Of course, there are some risks but they are minimal with experienced urologists and generally healthy patients. I went along for his first one, but not for the next two after which, both times, he went to work in the afternoon.

    Hope you get good news after your biopsy, but if you don't, you'll find plenty of cyberbuddies here.
    Last edited by pbj11; 02-21-2011 at 12:47 AM.
    Husband's (Bob's) DRE in late 2008 at age 60: Elongated nodule, L side
    PSA: 1998, 2003, 2008, 2009, 2010, 4/11, 10/11 --- 0.4 0.4 0.5 0.6 0.4 0.5 0.6
    2009: 1/12, R lat apex, G6, 5%
    2010: no Gleason, R mid, HGPIN; R lat mid, atypical
    2011: 2/12, R lat apex, G6, 2% and R mid, G6 2%
    Prostate size: normal @ 25 g
    After Dr. Fred Lee's opinion in 11/2011, decided to stop annual biopsies unless there's a jump in PSA level. Will continue semiannual PSAs.

  3. #3
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    My last biopsy was collected on 12/13 and the pathologist dated his report on 12/15.
    Prepare for the worst and hope for the best. PCa is very treatable.

  4. #4
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    Hi bobbyo, - One of 4 Biopsies performed ONLY because of an elevated PSA reading, produce a Prostate Cancer (PCa) diagnosis. Adding a positive (abnormal) DRE (Digital Rectal Exam) increases that figure to about 50%. Depending on where it is done Biopsy results should be available in 2 to 7 days.

    Don't be surprised if you find blood in your urine and/or semen for some time following the Biopsy. IF it occurs, it can last from hours to weeks depending on the individual. Do not have another PSA for at least 6 weeks, to ensure that the Prostate has had time to heal, allowing for reliable results. Good luck with your procedure and its results. - John@newPCa.org (aka) az4peaks

    Quote Originally Posted by bobbyo View Post
    I am a 47 year old who 2 years ago had a normal PSA level. Just recently my PSA came back at 9.8. My medical doctor was very concerned that it had elevated so fast. I was sent to a urologist who performed a rectal exam. He said I was swollen on the right side and he was concerned because he felt something hard. My grandfather died of prostate cancer in his 50's. I have had no symptoms whatsoever of a sore prostate, trouble urinating or ejaculating, with the exception of urinating a little more than normal at night. i have had stomach pain from acid reflux (I think). More recently I have had bone pain....but I think it is probably arthritis (not sure). My question is this: When a hard nodule, mass or whatever you want to call it is felt by the doctor....is it most often prostate cancer or could it be benign? I am worried because of the family history of prostate cancer. Also, how long does it take to get biopsy results back?

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    While you are waiting for your biopsy results, (most big cities, 2 days) pick up a copy of Patrick Walsh's book, "Guide to surviving prostate Cancer", any bookstore or library..Hopefully, you will not need the information it contains, but with the information you posted, it won't won't hurt to get ahead of the learning curve..Good luck tomorrow...
    PSA at age 55: 3.5, DRE negative.
    65: 8.5, DRE " normal", biopsy, 12 core, negative...
    66 9.0 DRE "normal", BPH, (Proscar)
    67 4.5 DRE "normal" second biopsy, negative.
    67.5 5.6, DRE "normal" U-doc worried..
    age 68, 7.0, third biopsy (June 2010) positive for cancer in 4 cores, 2 cores Gleason 6, one core Gleason 7. one core Gleason 9. RALP on Sept. 3, 2010, Positive margin, post-op PSA. 0.9, SRT , HT. Feb.2011 PSA <0.1 Oct 2011 <0.1 Feb 2012 <0.01 Sept 2012 0.8 June 2013 1.1, Casodex added, PSA 0.04 10/2013. PSA 0.32 1/14. On 6/14 PSA 0.4, "T"-5. 10/14 PSA 0.6, T-11

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    Tell your doc you want an actual copy of the detailed report (in your hands). Has alot of information that you can learn from and others can maybe answer questions for you, when the information is known up front. This information is also useful plugging in numbers into nomograms and PCa models to compare on generalizations made about prognosis for successful surgery or other treatments.

    Cyber PCa Universities (lol): www.yananow.net www.prostate-help.org www.prostate-pointers.org
    "Youth is wasted on the Young"-W.C. Fields

  7. #7
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    I Bobbyo,
    I didn't have any warning signs either. When my urologist checked my prostate he said the dreaded uh-oh. I was booked for a biopsy and my lab results came back within a week.
    The proceedure itself isn't all that bad, just remember to check your modesty at the door. When I had my biopsy I had a colonoscopy in the morning and the prostate biopsy early in the afternoon. This did lead to a rather embarrasing moment during the biopsy as I was still full of air from the earlier procedure.
    If the results do come back positive there are a variety of effective treatments. If you have a family history of PC ( I do as well) then you may want to act fairly quickly as opposed to watchful waiting. We're all with you.

  8. #8
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    Welcome to the place no one wants to be.
    You are on the correct track with family history Just take it easy and look at all your options.
    Age 55
    PSA
    11/08-3
    12/09-3.5
    7/10-4.75
    8/1-4.6
    Gleason score 6
    lt lobe 2 of 5 C
    rt lobe 4 of 5 C
    tc2

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    good luck with your results. in my country, it takes 2-3 weeks to get a biopsy result back. its quite important that youll get it earlier. prostate cancer is a treatable cancer and you'll need to remain calm and fight it; as its what cancer hates. PSA 9.8 is not THAT high. My dad's PSA is 10 and the biopsy didnt show any cancer signs (yet..the docs told us its probable to early to find the cancer so he will need to go thru another biopsy in 3 months). But even if its cancer its usually only a surgery be positive

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    I got my biopsy results back on Friday. Not good news. I was diagnosed with Prostate cancer.....T2C. The pathology report was 4+3 in left lobe, 3+3 on right....which he says is a Gleason score of 7. 12 samples submitted. I went for a second opinion today to another urologist. He did another DRE, and read the pathology report and told me that it would probably end up being a Gleason score of 8 on the left side and 7 on the right. He said that they usually find out after surgery that the gleason scores are higher. I am being sent for bone scans, MRI. cat scans and to an oncologist. Does anyone know the chances that this has spread outside the prostate? He suggest the Divinci Robotic prostatectomy if this has not spread. Any advice welcome.

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    Now you really need to read the book I mentioned in my first post to your thread.. Your PC is still in the early stages and with a PSA of 10 they are not likely to find any spread with the bone scan and MRI..Any spread outside the "capsule" can not be detected at this point...So your two choices are surgery or some form of radiation treatment..Don't be rushed or pushed into anything before you are comfortable with YOUR decision. In your biopsy results, how many of the 12 cores tested positive for PC and what percentage of those cores were positive? These numbers point to how far the cancer has spread and they have a considerable impact on your choice of treatment..One of the people you should talk to is a radiation oncologist who performs Brachytherapy, seeds..The combined treatment of both seeds and IMRT performs just as well as surgery with less side-effect risk..With surgery, the end results are VERY dependent on the skills of the surgeon..The book I recommended was written by a surgeon (one of the best) and so it is somewhat biased towards surgery..Another more even-handed and up to date book "Winning the Battle against Prostate Cancer" by Gerald Chodak is worth reading too...Best of luck to you..
    PSA at age 55: 3.5, DRE negative.
    65: 8.5, DRE " normal", biopsy, 12 core, negative...
    66 9.0 DRE "normal", BPH, (Proscar)
    67 4.5 DRE "normal" second biopsy, negative.
    67.5 5.6, DRE "normal" U-doc worried..
    age 68, 7.0, third biopsy (June 2010) positive for cancer in 4 cores, 2 cores Gleason 6, one core Gleason 7. one core Gleason 9. RALP on Sept. 3, 2010, Positive margin, post-op PSA. 0.9, SRT , HT. Feb.2011 PSA <0.1 Oct 2011 <0.1 Feb 2012 <0.01 Sept 2012 0.8 June 2013 1.1, Casodex added, PSA 0.04 10/2013. PSA 0.32 1/14. On 6/14 PSA 0.4, "T"-5. 10/14 PSA 0.6, T-11

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    12 cores tested

    4+3 on left
    3+3 on right

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    Those are your Gleason scores.. You are a 4+3=7, a moderately aggressive cancer. Also included in the biopsy report (you should have your own hard copy) will be the percentage of cancer found in each core and, out of the 12 cores, how many of them detected cancer..one out of the 12, three out of the 12, six out of the 12 or even 12 out of 12...These two readings can be used to judge how much cancer is in your prostate and to guess whether it is contained or not....For instance, say one of the cores tests 100% positive for cancer...That indicates there is cancer right at the edge of the gland and the chances the cancer is outside the capsule (the prostate boundary) are fairly high..

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    Number of cores positive

    it was 4 out of 6 cores positive and 2 out of 6

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    Sorry to hear of your biopsy results. Do request a copy of the pathologist's report and note the % of cancerous cells in each positive core.

    I'd recommend reading "Invasion of the Prostate Snatchers" before deciding on a treatment. The book also discusses lifestyle changes you can make to improve your prognosis. I think those are as important as the medical treatment plan.
    Husband's (Bob's) DRE in late 2008 at age 60: Elongated nodule, L side
    PSA: 1998, 2003, 2008, 2009, 2010, 4/11, 10/11 --- 0.4 0.4 0.5 0.6 0.4 0.5 0.6
    2009: 1/12, R lat apex, G6, 5%
    2010: no Gleason, R mid, HGPIN; R lat mid, atypical
    2011: 2/12, R lat apex, G6, 2% and R mid, G6 2%
    Prostate size: normal @ 25 g
    After Dr. Fred Lee's opinion in 11/2011, decided to stop annual biopsies unless there's a jump in PSA level. Will continue semiannual PSAs.

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    percentage of biopsy cores

    I failed to mention the number of cores. It was 20% on one side and 30% on the other.

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    Read the books, (forget "Snatchers", it doesn't apply to you) listen to your doctors and decide on a treatment plan.. Your cancer is treatable and curable with either surgery or some type of radiation treatment..They will all try and sell you the service they provide. This is BIG business..Take your time and learn all you can..

  18. #18
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    On the diagnosis front, there are stats out there from both Hopkins and the Germans saying that initial Gleasons are too low about a third of the time and too high about 5%. Action point - your doc was probably too glib, but your treatment options don't change, e.g., if a reasonable lab said you had a 4 (as in 4+3), then you need treatment and Active Surveillance is off the table.
    The docs will insist on the bone scan and CT scan, but with your % cancer, I would not lose sleep on these tests.

    Some will tell you that at your age you should stay away from radiation - because the radiation in 15-25 years can cause a different cancer. They have gotten much better with radiation, although horror stories are still out there.
    If I could have gotten over the fear factor, I might have done that.

    You want to take a hard, skeptical look at the side effect stats. Unfortunately, surgery options will get you to 40-50% chance of either incontinence or impotence, and if you are hearing lower stats, you are likely hearing very rosy (meaning inaccurate) stories.

    Good luck
    age 60
    PSA 7.5
    Gleason 3+4
    HIFU June 10 Bermuda Dr Scionti
    Salvage HIFU April 11 Bermuda

  19. #19
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    Quote Originally Posted by bobbyo View Post
    it was 4 out of 6 cores positive and 2 out of 6
    20% and 30%

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    What are considered normal PSA levels for men under 50?

    Come to find out from my Primary care doctor, there was a PSA a little over a year ago with a score of 3.6. He NEVER told me, never did a DRE, NEVER mentioned me seeing a urologist, NOTHING. Now over a year later he decides to send me to a urologist when my levels were at 10 and I'm diagnosed with advanced prostate cancer. What are the normal PSA levels for a 47 year old? The more I think about it...the more ticked off I'm getting.

 
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