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Thread: Interpretation of biopsy report

  1. #11
    Hi Littleman! Since your husband is not a candidate for surgery, he no longer needs to be in the care of his current URO Surgeon. If treatment is needed in the future, it won't be surgery.

    Since you will be looking into getting 2nd opinions, get to the nearest large academic teaching center that has a renowned URO Cancer Program. Start by making an appointment with a URO Radiologist who specializes in treating PCa.

    Definitely inquire about:

    - HDBRT = High Dose Brachytherapy. Reach out to Forum Brother subdenis who recently underwent this procedure. I also have a friend who had HDBRT. It required 2 procedures spaced apart by 2 weeks. Each took about 3 hours. My friend has had "0" unwanted effect and NO complaints.

    - Focal Therapies such as HIFU or Cryotherapy may be potential good options. These do not use radiation (ionizing) and there is no collateral damage to non targeted tissues with almost no unwanted effects.

    Where are you located? There may be Forum Brothers who can offer local suggestions.

    Most fortunately, AS is currently the best course of action. It is always best to have a Plan B established. Hoping that it never has to be put into action. If it does, your Plan B will be quick, painless with minimal lasting discomforts or inconveniences. Ideally, you want an RO who will take the time to figure out what the very best course of action to take considering all of your husband's specifics.

    You are doing a wonderful job. He is most fortunate to have you!

    MF
    Last edited by Michael F; 01-23-2019 at 04:36 PM.

  2. #12
    In the following You = You and your husband

    I was fortunate to start with a urologist/oncologist (MO) who is a RETIRED surgeon who now focuses on medical aspects of urogenital cancers. During my first two months of working with him as we developed a diagnosis he was willing to listen to anything I suggested and took the time to explain the reason I might want or not want to follow thru with my idea. Eventually it became clear I needed some aggressive treatment and he put me in touch with a superb surgeon and a very experienced radiation oncologist (RO). My MO sent ALL my test results, lab results, imaging to both the surgeon and the RO.

    The RO was amazing to talk with! He spent two-hours on the phone with me the first time we talked. He then wrote three long essays/dissertations specifically addressing my multiple questions. We then talked again for another hour on the phone. He was very honest (to the best of my limited knowledge) about radiation and my cancer. He then sent me even more material (I had asked for the original research to back up some of his claims and statements). We talked a third time for 30-minutes when I explained to him why I chose surgery. He was very supportive and did nothing to diminish my choice or surgical procedures.

    During this intense two week period, between my biopsy and my choosing surgery, my MO checked up on me several times to make sure I was getting all the information I needed and his recommended RO and surgeon were being helpful.

    You need to find medical professionals to talk to, professionals who will take the time to educate you and to understand your perspective, wishes, concerns, and attitudes. You face some difficult choices and challenges and your doctors need to support you and help you choose.
    Last edited by OldTiredSailor; 01-23-2019 at 04:55 PM. Reason: correct autospell correction confusion
    DOB: July 1947
    PSA: 2.0/2004 4.0/2010 5.8/2010 4.5/2012 5.6/2013 Normal DRE each year
    5/18 PSA: 9.2
    6/18 PSA: 10.2 & 8.4% Free
    DRE small soft prostate w/no abnormalities
    6/28 3T mpMRI PIRADS 3
    18 cc gland=PSD 0.57 ng/cc
    0.32 cc lesion in apical PZ with subtle T2 signal hypointensity
    mild restricted diffusion of contrast into lesion
    remainder of prostate unremarkable intact capsule
    7/18 4KScore 34% Probability Gleason =>7

    8/03/18 Bx: Adenocarcinoma 6 of 13 cores ONLY L lobe
    T1c / Grade II / unfavorable intermediate
    extent of G3-G4 tissue far greater than indicated by MRI
    G6 (3+3) 70% LL Base 50% L Lateral Mid 20% L Base
    G7 (3 +4) 100% LL Apex 20% L Mid 60% L Apex
    8/15/18 Clear CT scan and Bone Scan
    RALP 8/23/18 pT3a, G7 (3+4), 20% involvement, SM+ (Focal 2mm G6), EPE(Focal G6)+, PNI+, LNI-, SVI-, LVI-
    7g Tumor 20x size in MRI & biopsy report & in BOTH lobes not just L as biopsy reported

    PSA Post Surgery
    10/3/18 0.021
    01/4/19 0.018

 

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