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Thread: 3t MRI test results back tomorrow

  1. #61
    Welcome to "The Good Side" Wifeofgolfer & husband! Glad that you have arrived safely!

    Now is the time to do nothing other than Relax & Recover! Following RALP, one's abdominal wall is very sore from being over-inflated (like a balloon) with air during surgery. Thus, watching comedy movies is not advised! Applying counter pressure with a pillow is helpful in the event of coughing or laughter.

    Be sure to follow the URO MD's post operative instructions to the letter! Do lots of walking with increasing frequency, pace and duration, as able. Absolutely nothing strenuous until cleared by the MD. This includes swinging a golf club! A past FB felt good and went out and played golf way too soon and paid a price. Healing is a physiologic process that requires time. Healing can NOT be accelerated! So go easy and let healing occur at its own pace.

    Simply take it 1 Day at at time! Each day will be better than the previous. Once he is liberated from the catheter, he will feel like a completely new man! The return to continence is a bit of a journey for most. It too requires time, effort (Kegels) and patience.

    The biggest hurdle in your Journey to Cure has been crossed and is now behind you.

    Best wishes for a favorable Path Report and an uneventful complete recovery!

    MF
    PSA: Oct '09 = 1.91, Oct '11 = 2.79, Dec '11 = 2.98 (PSA, Free = 0.39ng/ml, % PSA Free = 13%)
    Referred to URO MD
    Jan '12: DRE = Positive: "Left induration"
    Jan '12: Biopsy = 6 of 12 Cores were Positive: 1 = Gleason 7 (3+4) and 5 = Gleason 6
    Referred to URO Surgeon
    March '12: Robotic RP: Left Positive Margins + EPEs. MD waited in surgery for preliminary Path Report then excised substantial left adjacent tissue(s) down to negative margins and placed 2 Ti clips for SR guidance, if needed in future.
    Pathology: Gleason (3+4) pT3a pNO pMX pRO / Prostate Size = 32 grams; Tumor = Bilateral; 20% / Perineural invasion: present
    3 month Post Op standard PSA = <0.1 ng/ml
    1st uPSA at 7 months Post Op = 0.018 ng/ml
    uPSA remains "stable" at 84 Months Post Op: Mean = 0.021 (20x uPSAs: Range 0.017 - 0.026) LabCorp: Ultrasensitive PSA: Roche ECLIA
    Continence = Very Good (≥ 99%)
    ED = present

  2. #62
    Top User garyi's Avatar
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    Quote Originally Posted by DjinTonic View Post
    According to some studies, MRI may miss 1 in 5 cases of clinically significant PCa rather than 1 in 10.

    I have no problem repeating that during my 20-year history of BPH and a slowly rising/fluctuating PSA,
    I was diagnosed with BPH; my yearly PSA rose from under 1 to about 2.5 over 15 years, and my 3+4 PCa was discovered only because of a TURP that I submitted to, hoping to ease my frequent urination. Cancer had never even been previously mentioned.

    After a 3T MRI and guided biopsy, four G3+3 cores and one G3+4 core were discovered, out of fourteen total cores taken. NONE of the G cores came from lesion areas specifically targeted. for what it's worth.

    Scientific precision with this maddening disease isn't often obtained. Keep trying researchers, and keep hoping brothers!
    72...LUTS for the past 7 years
    TURP 2/16,
    G3+4 discovered
    3T MRI 5/16
    MRI fusion guided biopsy 6/16
    14 cores; four G 3+3, one G3+4,
    CIPRO antibiotic = C. Diff infection 7/16
    Cured with Vanco for 14 days
    Second 3T MRI 1/17
    Worsened bulging of posterior capsule
    Oncotype DX GPS 3/17, LFP risk 63%, Likelihood of Low
    Grade Disease 81%, Likelihood of Organ Confined 80%
    RALP 7/13/17 Dr. Gonzaglo @ Univ of Miami
    G3+4 Confirmed, Organ confined
    pT2 pNO pMn/a Grade Group 2
    PSA 0.32 to .54 over 3 months
    DCFPyl PET & ercMRI Scans - 11/17
    A one inch tumor still in prostate bed = failed surgery
    All met scans clear
    SRT, 2ADT, IMGT 70.2 Gys @1.8 per, completed 5/18
    Radiation Procitis, and Ulcerative Colitis flaired after 20 years
    PSA <.006 9/18, .054 11/18, .070 12/18, .067 2/19, .078 5/19, .074 7/19
    We'll see....what is not known dwarfs what is thought to be fact

  3. #63
    Quote Originally Posted by DjinTonic View Post
    My BPH started when I was in my 40's. If you average my biopsies out, it looks like they were about every 2-2.5 years.

    As long as you don't have urinary symptoms from your BPH, it in itself is not too much to worry about. However, it can be difficult to determine how much of a rising PSA is due to BPH (i.e., ever increasing, but healthy, prostate tissue) vs. BPH + PCa. Regarding repeat biopsies, I take the advice of a uro with whom you are confident to let you know when it might be time for a repeat biopsy and/or imaging.
    Thanks for the info.

    Yeah thatís the hard part. With me we had the additional factor of testosterone replacement but I personally considered that a wash. I should have higher levels than what I was adjusted to with the testosterone replacement so if my body made its own testosterone it would have at least been the same levels.

    Iíll definitely depend on my urologist.

    Right now I tend to get up once a night, strong stream and not much in the way of dribbles. No sudden urges unless I really think about how much I donít want to be in a meeting and then I have a good reason to leave.

    My doc said that if/when it became a problem weíd just do a urolift procedure.

    The other problem Iím dealing with is some Ed issues. It started at the same time we stopped the testosterone and did the biopsy so Iím not sure which it is. The clomid brought my t levels back to what androgel did. So I donít know if itís BPH related, if all testosterone isnít the same and I need more of my natural stuff, or the biopsy hit a nerve. Cialis works to about 80% effectiveness but Iím not winning any awards.
    2006: 1.6 PSA age 36
    2007: 1.3 PSA age 37
    2012: 2.2 PSA age 42
    2013: 2.6 PSA age 43
    2014: 2.8 PSA age 44
    2015: 3.1 PSA age 45
    2016: 3.5 PSA age 46
    2017: ? N/A
    3/18Ė 4.1 PSA at 48 YO. u/s measured 46 ml prostate
    3/18Ėfree PSA 10%
    3/18Ė12 core all negative
    9/18Ė 4.5 PSA
    9/18Ė negative pca3
    12/18- 4K at 17%
    12/18- 3t MRI, 5mm pirads 3-4 and a pirads 1-2
    2/19- Fusion biopsy. G6 (3+3) 20% of a single core
    AS for now
    4/19-PSA at 7.21 (up from 4.5 in September 2018! Gulp

  4. #64
    Thank you Michael from both the golfer and his wife!
    We are so thankful for all the encouragement and knowledge given. As it is clear, this road is one with many twists and turns.
    I'm happy to have this step behind us. Even though we wanted the surgery ASAP, when the reality of it was here it was pretty frightening. I just kept reading posts and encouraging my husband with all I read.
    He is being a great patient and listening to the mean nurse who makes him get up and walk. It's getting better with each day. No wonder they call them "patient" because you need "patience" with healing.
    Yes, he is looking forward to getting catheter out on Thursday. A plan will be made after pathology report. We are in driving distance to Mayo so Golfer has agreed to participate in 2 studies. One is looking for cancer cells in SV fluid , and the other is a device for penile rehab. New adventures!

    We will be back with Pathology Report Thank you again Michael and all the FB and FS for sharing your journey and kind words.

    Stacie
    Wife of newly diagnosed husband...he is 62 years old
    Family history..dad passed away from PCa...brother has very aggressive PCa Gleason 8 , outside capsule..is winning for 15 years now
    March 2017 Self referral to Rochester for 2nd opinion due to slowly elevating PSA with negative DRE over a 5 year period
    1st MRI March of 2017 negative, Neg DRE
    3 mo PSA for 18 months...Nov 2018 jump in PSA from 4.2 to 6.8
    2nd MRI Nov 2018..Fused Targeted Biopsy Dec 2018 (Mayo Dr. Mynderse)outpatient
    DX 3+3 Gleason 6 (all 6 of 14 cores ), bilateral involvement, all cores under20% except one at 40% and another at 80%
    Jan 17th RALP done Dr. Igor Frank , Methodist Hospital Rochester
    Pathology: 3+3 Gleason 6, SV-, EPE-, SM abuted less than 3mm, no LN taken, catheter 7 days, urine retention, catheter 5 days, no incontinence ... ED improving . 20 mg Sildenafil as needed
    April 30 2019 PSA undetectable.

  5. #65
    Quote Originally Posted by Wifeofgolfer View Post
    Thank you Michael from both the golfer and his wife!
    We are so thankful for all the encouragement and knowledge given. As it is clear, this road is one with many twists and turns.
    I'm happy to have this step behind us. Even though we wanted the surgery ASAP, when the reality of it was here it was pretty frightening. I just kept reading posts and encouraging my husband with all I read.
    He is being a great patient and listening to the mean nurse who makes him get up and walk. It's getting better with each day. No wonder they call them "patient" because you need "patience" with healing.
    Yes, he is looking forward to getting catheter out on Thursday. A plan will be made after pathology report. We are in driving distance to Mayo so Golfer has agreed to participate in 2 studies. One is looking for cancer cells in SV fluid , and the other is a device for penile rehab. New adventures!

    We will be back with Pathology Report Thank you again Michael and all the FB and FS for sharing your journey and kind words.

    Stacie
    I shout out to all the spouses suffering through this. Stacie, you shine through as a great wife and caretaker, kudos to you.
    2006: 1.6 PSA age 36
    2007: 1.3 PSA age 37
    2012: 2.2 PSA age 42
    2013: 2.6 PSA age 43
    2014: 2.8 PSA age 44
    2015: 3.1 PSA age 45
    2016: 3.5 PSA age 46
    2017: ? N/A
    3/18Ė 4.1 PSA at 48 YO. u/s measured 46 ml prostate
    3/18Ėfree PSA 10%
    3/18Ė12 core all negative
    9/18Ė 4.5 PSA
    9/18Ė negative pca3
    12/18- 4K at 17%
    12/18- 3t MRI, 5mm pirads 3-4 and a pirads 1-2
    2/19- Fusion biopsy. G6 (3+3) 20% of a single core
    AS for now
    4/19-PSA at 7.21 (up from 4.5 in September 2018! Gulp

  6. #66
    Okay a question that woke me up this morning regarding my upcoming MRI fusion biopsy.

    The good doc indicated that they would be doing a focused biopsy with a single needle instead of the 12 core.

    Wouldnít it be better... since Iím going to be out and compliant.... wouldnít it be better to have them target the area which was identified during the MRI but then also request a 12 core to ensure the MRI didnít miss anything?

  7. #67
    Ice, you should update your signature with your MRI results and any others, otherwise we have to go through your previous posts to know what you findings are.

    I think by "one needle" you meant one core. Usually several cores are taken in a suspicious area(s) identified as PIRADS 3-5 on the MRI. I have never understood the logic of not taking the usual 12 cores around the prostate in the standard zones in addition to the MRI-identified areas. Both MRIs and biopsies miss existing lesions, and each repeat biopsy brings the chances of a false negative down. But perhaps you misunderstood you doc, or he/she wasn't clear when explaining
    69 yr at Dx, BPH x 20 yr, 9 (!) neg. biopsies, PCA3 -
    2013 TURP (90→30 g) path. neg. for cancer; then 6-mo. checkups
    6-06-17 DRE: nodule R and PSA rise, on finasteride: 3.6→4.3
    6-28-17 Biopsy #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 5% RLM
    Bone scan, CTs, X-rays: negative
    8-7-17 Open RP, neg. frozen sections, Duke Regional
    SM EPE BNI LVI SVI LNI(16): negative, PNI+, nerves spared
    pT2c pN0 bilat. acinar adenocarcinoma G9 (4+5) 5% of prostate (4.5 x 5 x 4 cm, 64 g)
    11-10-17 Decipher 0.37 Low Risk: 5-yr met risk 2.4%; 10-yr PCa-specific mortality 3.3%
    Dry; ED OK with sildenafil
    9-16-17 (5 weeks) PSA <0.1
    LabCorp uPSA (Roche ECLIA):
    11-28-17 (3 mo. ) 0.010
    02-26-18 (6 mo. ) 0.009
    05-30-18 (9 mo. ) 0.007
    08-27-18 (1 year) 0.018
    09-26-18 (13 mo) 0.013 (checking rise)
    11-26-18 (15 mo) 0.012
    02-25-19 (18 mo) 0.015
    05-22-19 (21 mo) 0.015

  8. #68
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    I agree. It is certainly worth asking. You are looking for something that may be small, but aggressive. Don't miss an opportunity to pull out all stops to find it.

  9. #69
    Quote Originally Posted by DjinTonic View Post
    Ice, you should update your signature with your MRI results and any others, otherwise we have to go through your previous posts to know what you findings are.

    I think by "one needle" you meant one core. Usually several cores are taken in a suspicious area(s) identified as PIRADS 3-5 on the MRI. I have never understood the logic of not taking the usual 12 cores around the prostate in the standard zones in addition to the MRI-identified areas. Both MRIs and biopsies miss existing lesions, and each repeat biopsy brings the chances of a false negative down. But perhaps you misunderstood you doc, or he/she wasn't clear when explaining
    Hey sorry Iíve been meaning to add the stat for my MRI to my signature but itís hard from the mobile version.

    I had a 12 core in March 2018 that was all clear. The MRI found two spots one 1-2 that they werenít worried with at all and a 3-4 pirads that was 5mm.

    My thought was ďIíll be in lala land instead of fighting the probe, so why not take the focused samples and another 12 core.

    Iím kind of concernedó given some misses by the MRI machines for members hereóthat they are underestimating the pirads 1-2. Or that there could be some cancer that wasnít found.

  10. #70
    Quote Originally Posted by IceStationZebra View Post
    Hey sorry I’ve been meaning to add the stat for my MRI to my signature but it’s hard from the mobile version.

    I had a 12 core in March 2018 that was all clear. The MRI found two spots one 1-2 that they weren’t worried with at all and a 3-4 pirads that was 5mm.

    My thought was “I’ll be in lala land instead of fighting the probe, so why not take the focused samples and another 12 core.

    I’m kind of concerned— given some misses by the MRI machines for members here—that they are underestimating the pirads 1-2. Or that there could be some cancer that wasn’t found.
    OK, your doc wants to investigate the PIRADS 3-4 lesion. Still, why sample the entire prostate? Also, good luck hitting it with a single core.

    Before my last biopsy, after a nodule was felt on DRE, I asked my doc to take extra cores. He did 14 instead of 12, with extra in the zone with the nodule. Two of the 14 were positive for high-grade PCa. The RP path report found my Pac was bilateral; however the cores on one side hit no cancer!
    69 yr at Dx, BPH x 20 yr, 9 (!) neg. biopsies, PCA3 -
    2013 TURP (90→30 g) path. neg. for cancer; then 6-mo. checkups
    6-06-17 DRE: nodule R and PSA rise, on finasteride: 3.6→4.3
    6-28-17 Biopsy #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 5% RLM
    Bone scan, CTs, X-rays: negative
    8-7-17 Open RP, neg. frozen sections, Duke Regional
    SM EPE BNI LVI SVI LNI(16): negative, PNI+, nerves spared
    pT2c pN0 bilat. acinar adenocarcinoma G9 (4+5) 5% of prostate (4.5 x 5 x 4 cm, 64 g)
    11-10-17 Decipher 0.37 Low Risk: 5-yr met risk 2.4%; 10-yr PCa-specific mortality 3.3%
    Dry; ED OK with sildenafil
    9-16-17 (5 weeks) PSA <0.1
    LabCorp uPSA (Roche ECLIA):
    11-28-17 (3 mo. ) 0.010
    02-26-18 (6 mo. ) 0.009
    05-30-18 (9 mo. ) 0.007
    08-27-18 (1 year) 0.018
    09-26-18 (13 mo) 0.013 (checking rise)
    11-26-18 (15 mo) 0.012
    02-25-19 (18 mo) 0.015
    05-22-19 (21 mo) 0.015

 

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