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Thread: Final Path Report in.

  1. #31
    Senior User
    Join Date
    Feb 2017
    Posts
    116
    Quote Originally Posted by ASAdvocate View Post
    When you get into nomograms and expected life spans, you can run into some jarring surprises. I recently tried a new PCa nomogram, and entered in my data.

    It said that I had less than a 1 percent chance of dying from PCa during the next 10 years.

    Yay! But, then I saw there was more.

    A 36 percent chance of being alive in 10 years. And, that assumes no current health issues.��
    I ran one of those nomograms and was pleased to discover that with my particular pathology report, even though G-9, I actually have a 95 percent chance of NOT dying of prostate cancer during the next 10 years. At 15 years, the number dips slightly but is still in the low-90's.

    Unfortunately, it also predicts that 50 years from now, I have a precisely zero chance of being alive. Bummer.

    It all brings to mind a famous line from Fight Club (a cult classic but totally sucks as a movie): On a long enough timeline, the survival rate for everyone drops to zero.
    YOB: 1954
    PSA 4.4 -- March 2016
    PSA 5.9 -- January 2017
    Cystoscopy to assess unexplained episode of severe overnight bleeding from urethra in December 2016; results normal; incident unexplained -- February 2017
    PSA 7.7 and PHI 59 -- March 2017
    3T MRI of prostate -- April 2017; prostate found to be enlarged (79cc) with two potentially cancerous lesions, one PIRADS-3 and one PIRADS-4 -- the latter in the anterior apex of organ
    Fusion biopsy -- August 2017; 14 cores taken, with two measured at Gleason 4+3, corresponding to the MRI PIRADS-4 target location
    PSA 7.0 -- November 2017
    RALP at Johns Hopkins, Dr. Allaf (highly recommend) -- February 2018
    Pathology report upgrades G4+3 tumor to 4+5. One additional cancerous nodule found, G3+4; organ-confined; margins clear, SV clear, LN clear
    Continence: One pad for two months, then dry
    ED: Resolved at one month with aid of Cialis
    PSA <0.1 -- May 2018
    PSA <0.1 -- Aug 2018
    PSA <0.1 -- Dec 2018
    PSA <0.1 -- Apr 2019

  2. #32
    Quote Originally Posted by Gerard View Post
    I ran one of those nomograms and was pleased to discover that with my particular pathology report, even though G-9, I actually have a 95 percent chance of NOT dying of prostate cancer during the next 10 years. At 15 years, the number dips slightly but is still in the low-90's.

    Unfortunately, it also predicts that 50 years from now, I have a precisely zero chance of being alive. Bummer.

    It all brings to mind a famous line from Fight Club (a cult classic but totally sucks as a movie): On a long enough timeline, the survival rate for everyone drops to zero.
    Hi Gerard. You and I are similarly lucky for G9 (4+5) guys (you upgraded from 4+3 and I downgraded from 5+5) in that we both had essentially clean path reports. Stats are hard to come by, but as far as I can tell, that happens in perhaps 25% of G9 men who undergo RP. Are you on a 4-month PSA schedule? My August visit will be my 2-yr mark, but I'm undecided about asking my uro if we can change from 3-month testing.

    Djin
    69 yr at Dx, BPH x 20 yr, 9 (!) neg. biopsies, PCA3 -
    2013 TURP (90→30 g) path neg, then 6-mo. checks
    6-06-17 Nodule on R + PSA rise on finasteride: 3.6→4.3
    6-28-17 Biopsy #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% 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 (4.5x5x4 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 wk) PSA <0.1
    LabCorp uPSA, Roche ECLIA:
    11-28-17 (3 m ) 0.010
    02-26-18 (6 m ) 0.009
    05-30-18 (9 m ) 0.007
    08-27-18 (1 yr.) 0.018
    09-26-18 (13 m) 0.013 checking rise
    11-26-18 (15 m) 0.012
    02-25-19 (18 m) 0.015
    05-22-19 (21 m) 0.015

  3. #33
    Quote Originally Posted by DjinTonic View Post
    Thanks, but no, not a doc. I do have a bio background and just before retiring worked in clinical-trials data (oncology, but not urology/prostate) for a few years. From perusing the articles I add to the Subforum, reading and participating in Forum posts, chatting with my uro/surgeon every 3 months, etc. I've learned a bit about a few areas of PCa. I know very little about many PCa topics, such as RT and HT. I guess my areas of interest track my own path from diagnosis through treatment and followup. I probably give the impression of knowing more than I actually do because of this new "hobby"--- searching journal articles and adding to the Subforum---I can sometimes point folks to info/papers of interest to them. There are many knowledgeable Forum Brothers here!

    Djin
    I don't think you give yourself enough credit, we appreciate all you do.

  4. #34
    Senior User
    Join Date
    Feb 2017
    Posts
    116
    Quote Originally Posted by DjinTonic View Post
    Hi Gerard. You and I are similarly lucky for G9 (4+5) guys (you upgraded from 4+3 and I downgraded from 5+5) in that we both had essentially clean path reports. Stats are hard to come by, but as far as I can tell, that happens in perhaps 25% of G9 men who undergo RP. Are you on a 4-month PSA schedule? My August visit will be my 2-yr mark, but I'm undecided about asking my uro if we can change from 3-month testing.

    Djin
    Hi, Djin. Lucky indeed! You got that right, Brother!

    I think that technically I'm still supposed to be on the 3-month regime, but without consulting a doc, I changed it to 4 months.

    Therefore, the next time I test will be in August, at the 4-month (or thereabouts) mark. Except we're supposed to be on vacation around that time, and I'm thinking I'll put the whole thing off until September.

    If I make it to 2 years without BCR, I'll be changing to six months. I don't care what the docs say.

    In any case, thanks for all you do here. I've profited a great deal by your opinions and the research you've posted.
    YOB: 1954
    PSA 4.4 -- March 2016
    PSA 5.9 -- January 2017
    Cystoscopy to assess unexplained episode of severe overnight bleeding from urethra in December 2016; results normal; incident unexplained -- February 2017
    PSA 7.7 and PHI 59 -- March 2017
    3T MRI of prostate -- April 2017; prostate found to be enlarged (79cc) with two potentially cancerous lesions, one PIRADS-3 and one PIRADS-4 -- the latter in the anterior apex of organ
    Fusion biopsy -- August 2017; 14 cores taken, with two measured at Gleason 4+3, corresponding to the MRI PIRADS-4 target location
    PSA 7.0 -- November 2017
    RALP at Johns Hopkins, Dr. Allaf (highly recommend) -- February 2018
    Pathology report upgrades G4+3 tumor to 4+5. One additional cancerous nodule found, G3+4; organ-confined; margins clear, SV clear, LN clear
    Continence: One pad for two months, then dry
    ED: Resolved at one month with aid of Cialis
    PSA <0.1 -- May 2018
    PSA <0.1 -- Aug 2018
    PSA <0.1 -- Dec 2018
    PSA <0.1 -- Apr 2019

 

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