A website to provide support for people who have or have had any type of cancer, for their caregivers and for their family members.
Page 1 of 6 123 ... LastLast
Results 1 to 10 of 54

Thread: Not great news...

  1. #1

    Not great news...

    but obviously not the worst either.

    Had an MRI done on June 28th, and I have to alter my signature now. The random biopsy that I had done several weeks ago found adenocarcinoma cells in 6 of the 12 samples taken. The assumption was that all of the cancer was confined for the moment to the left side of my prostate. The MRI found another small mass high up on the right side of my prostate. The good news is that the MRI confirmed that the cancer is still confined to my prostate, or at least there were no visible masses outside of it.

    The bad news is that I'm going to need another biopsy, so I asked for an MRI targeted biopsy this time. I'm expecting a call today or tomorrow to get that scheduled.

    Hopefully the mass is a Gleason 6 like the rest of the cancer. I find that I'm a lot more anxious about this biopsy than I was the first.
    Dx at age 56
    Maternal uncle with PCa
    Gleason Score of 6 (3+3) all cores
    Biopsy 6 of 12 cores positive 5%, 5%, 15%, 20%, 20%, 40%
    24 Needle Fusion Biopsy 8/6/19 - Awaiting hard copy of results, all positive cores are G6
    Oncytype DX score 29
    Perineural invasion: present in 2 cores
    PSA 2.4 Free PSA .4, PCA3 Positive 53H
    Prostate volume 32 mL
    Awaiting scheduling for PBT at UF PBTI

  2. #2
    Quote Originally Posted by Nonquixote View Post
    but obviously not the worst either.

    Had an MRI done on June 28th, and I have to alter my signature now. The random biopsy that I had done several weeks ago found adenocarcinoma cells in 6 of the 12 samples taken. The assumption was that all of the cancer was confined for the moment to the left side of my prostate. The MRI found another small mass high up on the right side of my prostate. The good news is that the MRI confirmed that the cancer is still confined to my prostate, or at least there were no visible masses outside of it.

    The bad news is that I'm going to need another biopsy, so I asked for an MRI targeted biopsy this time. I'm expecting a call today or tomorrow to get that scheduled.

    Hopefully the mass is a Gleason 6 like the rest of the cancer. I find that I'm a lot more anxious about this biopsy than I was the first.
    Have you put you values into any of the nonograms?

    According to the Cleveland Clinic Risk Calculator, you have a 47% risk your G6 would be upgraded post surgery..

    The MSK nonogram indicates you have a 56% risk of extra capsular extension.

    A mass up high near the base is not good either.

    Get treated.
    YOB 1957

    DX 12/18, GS 8, 4+4 6/12 cores, LL Apex 100%, LM Apex 60%, LL Mid 50%, LMM 40%, LL Base 5%, LM <5%, Right side negative.

    3/6/19. Pathology - Grade Group 4 with Intraductal Carcinoma
    T3aNO, GS8, 21 mm unifocal tumor 10%. -7 Nodes, - SV, - Margins, - PNI,
    - bladder neck neg., +LVI, + EPE non focal apex/mid lateral 1mm max extension, Cribriform pattern present. Decipher .86 High Risk.

    PSA 3/27/19 03 (29 days)
    4/25/19 <.03. (58 days)
    5/25/19 <.02. (88 days)
    9/10/2019. <.02. (198 days)

    3 Part Modality Treatment

    2/25/19 Robotic Laparoendoscopic Single Site Surgery outpatient Cleveland Clinic,

    ADT - started 6/19, end date 6/21.

    ART - Completed 9/26/19. (78 Gy, yes, I glow in the dark)

  3. #3
    I hate to burst your bad news bubble but that mass, which showed up on the MRI, might not even be cancer.

    My MRI scared me to death due to a pirads 3/4 and that turned out not to be cancer. The cancer was found in the random they did and didn't pop up on the MRI at all.

    Hang in there and best of luck. I have another biopsy in 78 days 2 hours and 8 minutes, but who is counting?

    With your load of positive cores and age, if it were me I would be opting for surgery and skipping the lost time and mess of another biopsy. Like me you're most likely not getting out of this life with the prostate onboard, so why waste even a day and take a chance it makes it outside the prostate?
    Last edited by IceStationZebra; 07-03-2019 at 07:07 PM.

  4. #4
    Quote Originally Posted by IceStationZebra View Post
    I hate to burst your bad news bubble but that mass, which showed up on the MRI, might not even be cancer.

    My MRI scared me to death due to a pirads 3/4 and that turned out not to be cancer. The cancer was found in the random they did and didn't pop up on the MRI at all.

    Hang in there and best of luck. I have another biopsy in 78 days 2 hours and 8 minutes, but who is counting?

    With your load of positive cores and age, if it were me I would be opting for surgery and skipping the lost time and mess of another biopsy. Like me you're most likely not getting out of this life with the prostate onboard, so why waste even a day and take a chance it makes it outside the prostate?
    I get what you're saying IceStationZebra (very cool movie btw), but I don't want to rush my decision. At this point really every modality is still open to me and I am carefully considering each and every one. I will be treated, and soonish but I don't want to look back and wish that I had considered X more carefully. I am consulting with a practioner (or practitioners) of each of the treatment options available to me. Reading books by men who have experienced prostate cancer, and books by treatment professionals and scholarly papers and journal articles.

    And I also agree that I'm most likely not getting out of life with a prostate. Unless I get hit by a truck or a train or fall off a very high cliff in the next few years. So surgery is still an option.
    Dx at age 56
    Maternal uncle with PCa
    Gleason Score of 6 (3+3) all cores
    Biopsy 6 of 12 cores positive 5%, 5%, 15%, 20%, 20%, 40%
    24 Needle Fusion Biopsy 8/6/19 - Awaiting hard copy of results, all positive cores are G6
    Oncytype DX score 29
    Perineural invasion: present in 2 cores
    PSA 2.4 Free PSA .4, PCA3 Positive 53H
    Prostate volume 32 mL
    Awaiting scheduling for PBT at UF PBTI

  5. #5
    Quote Originally Posted by Nonquixote View Post
    I get what you're saying IceStationZebra (very cool movie btw), but I don't want to rush my decision. At this point really every modality is still open to me and I am carefully considering each and every one. I will be treated, and soonish but I don't want to look back and wish that I had considered X more carefully. I am consulting with a practioner (or practitioners) of each of the treatment options available to me. Reading books by men who have experienced prostate cancer, and books by treatment professionals and scholarly papers and journal articles.

    And I also agree that I'm most likely not getting out of life with a prostate. Unless I get hit by a truck or a train or fall off a very high cliff in the next few years. So surgery is still an option.
    You might get out of life with a prostate, although it may be a radioactive prostate.
    YOB 1957

    DX 12/18, GS 8, 4+4 6/12 cores, LL Apex 100%, LM Apex 60%, LL Mid 50%, LMM 40%, LL Base 5%, LM <5%, Right side negative.

    3/6/19. Pathology - Grade Group 4 with Intraductal Carcinoma
    T3aNO, GS8, 21 mm unifocal tumor 10%. -7 Nodes, - SV, - Margins, - PNI,
    - bladder neck neg., +LVI, + EPE non focal apex/mid lateral 1mm max extension, Cribriform pattern present. Decipher .86 High Risk.

    PSA 3/27/19 03 (29 days)
    4/25/19 <.03. (58 days)
    5/25/19 <.02. (88 days)
    9/10/2019. <.02. (198 days)

    3 Part Modality Treatment

    2/25/19 Robotic Laparoendoscopic Single Site Surgery outpatient Cleveland Clinic,

    ADT - started 6/19, end date 6/21.

    ART - Completed 9/26/19. (78 Gy, yes, I glow in the dark)

  6. #6
    Quote Originally Posted by Nonquixote View Post
    I get what you're saying IceStationZebra (very cool movie btw), but I don't want to rush my decision. At this point really every modality is still open to me and I am carefully considering each and every one. I will be treated, and soonish but I don't want to look back and wish that I had considered X more carefully. I am consulting with a practioner (or practitioners) of each of the treatment options available to me. Reading books by men who have experienced prostate cancer, and books by treatment professionals and scholarly papers and journal articles.

    And I also agree that I'm most likely not getting out of life with a prostate. Unless I get hit by a truck or a train or fall off a very high cliff in the next few years. So surgery is still an option.
    Sounds like you're being smart.

    I would love to hear what your doctors are saying about the various radiationoptions. My doc said because of my age, I was not a candidate for radiation due to the high chance of secondary cancers right about the time I retire. And you're not that much older than me, so that's something to consider.

    I don't want surgery but if my next biopsy shows any additional cancer, time to RIP it out. My real risk is letting it get out of control. If surgery is unavoidable--which my doc believes--id rather just do it and remove the chance that I guess wrong as to when too late is.

    Good luck!

  7. #7
    Hi Nonq! Did a URO Radiologist assign a PIRADS value to the newly discovered lesion? Since AS was never a good option and treatment is on the horizon, why would you submit to an additional biopsy? IF surgery turns out to be your treatment of choice, a 2nd biopsy will prove to have been diagnostic overkill.

    Ask your MD in charge:

    - What is the approximate volume of PCa that I may be harboring?

    - What, if any, is the relationship between my volume of PCa and my PSA = 2.4?

    Take a look at my Signature. I was pT3a with a PSA < 3.0 This was not expected going into surgery and very unexpected coming out of surgery!

    Re "Currently researching treatment options:" Continue doing a good job. You want the treatment that both results in CURE and best fits your psyche.

    Keep asking questions and demand correct answers.

    MF
    Last edited by Michael F; 07-04-2019 at 01:07 AM.
    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 = G7 (3+4) and 5 = Gleason 6
    Referred to URO Surgeon
    March '12: Robotic RP: Left: PM + EPE. 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 c tertiary pattern 5 / Prostate Size = 32 grams / Tumor = Bilateral: 20% / PNI: 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 91 Months Post Op: Mean = 0.022 (22x uPSAs: Range 0.017 - 0.032) LabCorp: Ultrasensitive PSA: Roche ECLIA
    Continence = Very Good (≥ 99%)
    ED = present

  8. #8
    Quote Originally Posted by IceStationZebra View Post
    Sounds like you're being smart.

    I would love to hear what your doctors are saying about the various radiationoptions. My doc said because of my age, I was not a candidate for radiation due to the high chance of secondary cancers right about the time I retire. And you're not that much older than me, so that's something to consider.

    I don't want surgery but if my next biopsy shows any additional cancer, time to RIP it out. My real risk is letting it get out of control. If surgery is unavoidable--which my doc believes--id rather just do it and remove the chance that I guess wrong as to when too late is.

    Good luck!
    It sounds like your doctor is using 20+ year old studies about radiation and secondary cancers. It was a problem in the 1980's and 1990's, but is much less so now due to the advanced targeting of IMRT, SBRT, and PBT.

    Please consult with a radiation oncologist about their procedures.
    DOB: May 1944
    In Active Surveillance program at Johns Hopkins
    Strict protocol of tests, including PHI, DRE, MRI, and biopsy.
    Six biopsies from 2009 to 2019. Numbers 1, 2, and 5 were negative. Numbers 3,4, and 6 were positive with 5% Gleason(3+3) found. Last one was Precision Point transperineal.
    PSA has varied up and down from 3 to 10 over the years. Is 4.0 as of September 2019.
    Hopefully, I can remain untreated. So far, so good.

  9. #9
    Quote Originally Posted by ASAdvocate View Post
    It sounds like your doctor is using 20+ year old studies about radiation and secondary cancers. It was a problem in the 1980's and 1990's, but is much less so now due to the advanced targeting of IMRT, SBRT, and PBT.

    Please consult with a radiation oncologist about their procedures.
    I'll do that thanks, I'm not there yet just getting started in the walk.

  10. #10
    Top User
    Join Date
    Aug 2016
    Posts
    1,766
    I agree another biopsy is unnecessary. It is highly unlikely there is cancer only on one side. I wouldn't put much value in it being limited to G6 for your profile. If you are I'd suggest a second opinion on the Gleason grading. John Hopkins has a highly respected lab for this service.

    MRIs are unreliable for diagnosing cancer with certainty; such as being confined.

    You have three concerning aspects to your profile; your young age, your high volume, and your low PSA. These point to a higher risk cancer than not, imo.

 

Similar Threads

  1. PSA results are in, not great news, but totally expected
    By Pratoman in forum Prostate Cancer Forum
    Replies: 51
    Last Post: 06-30-2018, 10:54 AM
  2. Oncology visit, good news and not so good news and an apology
    By Geri in forum Colon Cancer and Rectal Cancer Forum
    Replies: 7
    Last Post: 05-27-2012, 09:06 PM
  3. baffling but great news
    By icedyaria in forum Pancreatic Cancer Forum
    Replies: 13
    Last Post: 06-04-2009, 02:29 AM
  4. Great News!
    By dagored11 in forum Lymphoma - Hodgkin's and Non-Hodgkin's Lymphoma Forum
    Replies: 2
    Last Post: 02-04-2009, 06:08 AM
  5. Some great news! (and humour!)
    By Pastor Rich in forum Breast Cancer Forum
    Replies: 1
    Last Post: 08-17-2005, 07:27 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •