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Thread: Possible Prostate Cancer

  1. #1
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    Possible Prostate Cancer

    My husband is going to have a biopsy which will determine whether he has prostate cancer or not.

    The doctor said that in case he does he will have to go through a long 5 weeks radiation. With todays medicine I find that difficult that Radiation is the first mode of treatment What treatments are there in case there is prostate cancer. Any information will be welcomed.

  2. #2
    Quote Originally Posted by Katie H View Post
    My husband is going to have a biopsy which will determine whether he has prostate cancer or not.

    The doctor said that in case he does he will have to go through a long 5 weeks radiation. With todays medicine I find that difficult that Radiation is the first mode of treatment What treatments are there in case there is prostate cancer. Any information will be welcomed.
    Hi Katie,

    Iím sorry youíre going through this with your husband. What other evidence did the doctor based the radiation decision on? Iím far from an expert but it seems that itís kind of early to make that assessment without knowing what kind of cancer he has, grade, location, etc.

    The radiation might be that doctorís personal preference or there could be a reason why other options arenít available. But there are a lot of options from active surveillance to radioactive seeds to radiation to removal. Others may disagree but it sounds way toward early to decide that.

    Hang in there and prayers itís not serious whatever it is.

  3. #3
    Top User
    Join Date
    Aug 2016
    Posts
    1,346
    Welcome.

    Please start a signature for your husband; DOB, PSA history, family prostate history, urinary symptoms, DRE results. Check out other signatures to see what helps. Keep it updated.

    It helps us, but more importantly it helps you stay focused on what you know and what you don't know.

  4. #4
    You are putting the cart before the horse here, he hasn't been diagnosed yet.

    For treatable prostate cancers that need treated, radiation is often the first mode of treatment especially for older guys over 70. But there are different radiation protocols, including Cyberknife which require a lot few treatments than 5 weeks that are often available.

    Younger guys often get surgery, which has its own set of challenges.

    And there may be a chance that treatment can be deferred perhaps indefinitely, active surveillance.
    Nov 2013 PSA 4.2 Biopsy Jan 2014- 1 core positive, 20% Gleason 6, doctor highly reco'ed robotic RP - 2nd opinion at UPMC April 2014, put on active surveillance. 2nd biopsy Feb 2015, results negative. PSA test Feb 2016, 3.5. 3rd Biopsy Feb 2016. 3 positive cores less than 5%, Gleason 6. Octotype DX done April 2016, GPS Score of 24--rated "Low risk". PSA test 8/2016, 3.2. PSA test 1/2018 2.2 (after 7 months of proscar) PSA test 7/2018 2.3

  5. #5
    Welcome Katie H! We know what you are going through and can assure you that you will get through it!

    When convenient and if willing, please provide some additional and helpful background information on your husband. (eventually this can be incorporated into a "Signature" which will appear at the bottom of your posts.

    - Age
    - PSA History
    - Biopsy scheduled date
    - Has he had any imaging tests: MRI, CT, Ultrasound of his prostate gland?
    - Any Symptoms
    - Overall Health status
    - Any issues that would prevent him from having surgery?
    - Feel free to share your "approximate" location as there may be Forum Members who have been treated nearby

    Biopsy (Bx) is the only way to confirm the presence of Prostate Cancer (PCa). Unless his MD strongly suspects PCa, no assumptions can be made at this point.

    You have started "The Process" perfectly by seeking knowledge! Keep a list of questions and demand correct answers along the way.

    We are not medical experts and thus can not offer medical advice. However, collectively there is a whole lot of experience on The Forum which we will gladly share and offer suggestions.

    Try to remain calm, strong and optimistic. Even IF PCa is present, it is often 100% Curable when discovered early. Also keep in mind that most forms of PCa tend to progress slowly.

    Best wishes for a "clean" Biopsy report.

    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

  6. #6
    Moderator Top User HighlanderCFH's Avatar
    Join Date
    Nov 2011
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    7,075
    Hi Katie, welcome to the forum.

    Has the urologist given any hints on what type of case that s/he is suspecting? The others are right that, based on the info we have, there is no treatment option that would stand out in the event that cancer is found.

    Can you give us your husband's age and history of PSA readings?

    This will give us a few clues on what the situation might be.

    If the biopsy shows cancer, it will list the Gleason score for each (if more than one) positive sample. This will tell whether it is aggressive or very slow growing.

    If PC is found -- and is still confined to his prostate -- various treatment options will open up, all with the same rates of cure: prostatectomy (removal of the prostate) and the various forms of radiation.

    When is he having the biopsy?

    Please let us know what is going on -- and also please give us all the information you can when convenient.

    We'll all be here for both of ya!
    Chuck
    July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA 9/ 2011 = 5.7.
    Local uro DRE revealed significant BPH, no lumps.
    PCa Dx Aug. 2011 age of 61.
    Biopsy DXd adenocarcinoma in 3/20 cores (one 5%, two 20%). T2C.
    Gleason 3+3=6. CT abdomen, bone scan negative.
    DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
    Surgeon was Dr. Matthew Tollefson, who I highly recommend.
    Final pathology shows tumor confined to prostate.
    5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
    1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
    mid posterior prostate. Right posterior apex margin involved by tumor over 0.2 cm length,
    doctor says this is insignificant.
    Prostate 98 grams, tumor 2 grams.
    Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
    Seven annual post-op exams 2012 through 2018: PSA <0.1
    Semi-firm erections without "training wheels," usable erections with 100mg Sildenafil.
    NOTE: ED caused by BPH, not the surgery.

  7. #7
    Top User garyi's Avatar
    Join Date
    Apr 2017
    Posts
    1,107
    Quote Originally Posted by Katie H View Post
    My husband is going to have a biopsy which will determine whether he has prostate cancer or not.
    That's not entirely accurate. It MAY locate cancer, but maybe it won't.

    In any event, what kind of doctor a re you talking to. It seems he is giving you poor advise. Your husband has just started on the journey. Please heed the advise above, and don't stress out. Good luck!
    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
    pT2c pNO pMn/a Grade 2
    PSA 0.32 to .54 over 3 months
    DCFPyl PET & ercMRI Scans - 11/17
    A one inch tumor remains in prostate bed = failed surgery
    All met scans clear
    SRT, 2ADT, IMGT 70.2 Gys @1.8 per, completed 5/18
    PSA <.006 9/18, .054 11/18, .070 12/18, .067 2/19
    We'll see....what is not known dwarfs what is thought to be fact

  8. #8
    Quote Originally Posted by Katie H View Post
    My husband is going to have a biopsy which will determine whether he has prostate cancer or not.

    The doctor said that in case he does he will have to go through a long 5 weeks radiation. With todays medicine I find that difficult that Radiation is the first mode of treatment What treatments are there in case there is prostate cancer. Any information will be welcomed.
    I don't want to sound harsh BUT - Did the doctor really tell you "a biopsy which will determine whether he has prostate cancer or not" ?

    That is a very unlikely thing for an experienced urologist (was he a urologist?) to say because we know that initial biopsies do miss a LOT of prostate cancer. Most research indicates that about 1/3 of the time - When a biopsy finds NO cancer - in fact cancer is actually present.

    If the biopsy does find cancerous tissue - then you can be quite certain about the minimum amount and type of cancer. But, if NO cancer is found then all you know is that in that 1% of the entire prostate, which was sampled, there was no cancer.

    Detail and Precision are needed when discussing prostate cancer. As others have said - update your (husbands) signature with as precise and detailed information as possible.

    I think you would be very hard pressed to find any member of this forum who were told they needed "5 long weeks of radiation" prior to a biopsy and many other tests. Additionally 5-weeks (35-doses) is a bit of an odd number. Again, did the doctor actually say "5-weeks" ? Details, Details are critical.
    DOB: July 1947
    PSA: 2.0/2004 4.0/2010 5.8/2010 4.5/2012 5.6/2013 ALL Normal DRE
    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 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
    04/03/19 0.022

 

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