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Cleveland Clinic’s UPSA will be approved soon.
DOB 5/1957
PSA - 11/2010=1.9, 6/12=2.3, 12/13=2.19, 12/14=2.64, 3/17=5.29, 3/17=3.91, 6/17=3.47, 12/17=4.50, 12/17=3.80, free PSA low risk (local (Uro, “My opinion you don’t have cancer), 8/18=5.13, 10/18=5.1, 10/19 ISO PSA 56% risk cancer. All DREs negative.
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, (Uro opinion “This has been going on for a year”.... ah, more like 2 years ). Bone scan/CT negative
2/25/19 R-LESS (Robotic Laparoendoscopic Single Site Surgery) outpatient Cleveland Clinic,
3/6/19. Pathology - Grade Group 4 with Intraductal Carinoma
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)
ADT - 6/3/19
ART - 8/5/19
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A welcome advancement BUT.......One more abbreviation to learn and it might knock some of the others I have learned right out of my leaky brain. Time to update the abbreviation list. 
History: age 53 It took 3 biopsies (34 cores) to find 2 cores 4+4 Gleason 8
Lap RP at MSKCC Apr 2004, age 54 All neg margins, nodes & structures. (T2a).
Post RP PSA: <.1 until Feb, 08 (46 mos) PSA 0.1 - I then got sensitive tests -> 2008: Feb 0.06,
May-08 0.09 - Jun-08 0.10, - Aug-08 0.10, - Nov-08 0.15
SRT Dec-2008 ---Post SRT PSA 2009, Feb-09 0.10, May-09 0.09, Aug-09 0.06, Dec-09 .04, - 2010 Mar-09 0.04, 2011 .02, 2012 .02,
STARTED UP Feb 2014-0.06, Jul-2015 0.10, Oct-2015 0.10, Feb-2016 0.15, Jun-2016 0.17, Dec-2016 0.25, Jan-2019 0.74, Jun -2019 0.72
Aug 2018 Auximin scan - nothing
Had an inflatable penile implant 2018 for ED. Best decision ever https://www.peyroniesforum.net/index...oard,56.0.html
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Top User
 Originally Posted by Hawk
A welcome advancement BUT.......One more abbreviation to learn and it might knock some of the others I have learned right out of my leaky brain. Time to update the abbreviation list.
Y in the WRLD do U COMPLN about ABBRVS ???
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The big question is, will Uros actually use it?
I asked repeatedly over a year for one of the available advanced tests (PHI, PCA3, MiPS, or 4kScore) and was denied at every appointment.
Wife Posting, Husband D.O.B. 1975
2/2018 - routine physical PSA 15
3/2018 - PSA 13
4/2018 - PSA down to 11.6, free PSA done, 18%
6/2018 - PSA 10, free PSA 20%
7/2018 - mp- MRI done, prostate volume =22cc, "inflammation consistent with prostititis"
11/2018 - PSA 14, free PSA 11%,
3/2019 - PSA 12, free PSA 17%, 2nd opinion on MRI = PI RADs 3 lesion
4/2019 - Cognitive Fusion Biopsy
5/12 cores positive
4 Gleason 3+3
1 Gleason 3+4 (Where PIRADs 3 lesion IDd)
Decipher Biopsy score: .07 very low risk
Bone scan negative
MRI 6/19 said PIRADS 4 lesion, no definite EPE
RRP 7/19 Final Path: pT3a
G6 - 75-90%
G7 - 11-25%
24mm tumor, 30% of prostate
EPE+, BNI+, SM + (at bladder neck), LVI-, SVI -, PNI-, Nodes -
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Top User
Originally Posted by AceVA
The big question is, will Uros actually use it?
I asked repeatedly over a year for one of the available advanced tests (PHI, PCA3, MiPS, or 4kScore) and was denied at every appointment.
While current tests (including imaging) can be helpful, they often are not -- especially because they involve stats and likelihoods. So if one comes back iffy (the scientific term for uncertain) and you want anything approaching certainty, you still wind up with a biopsy (not that it can't miss lesions too, as we know). The hope is that "liquid biopsies," e.g., on blood, can determine the actual presence or absence of malignant prostate cells or their components.
Things we want to know for a given test are: What percentage of (high-grade) cancers put what the test measures (cells or cell components) into the liquid (blood, urine, sperm)? How good is the test at reliably detecting small amounts of the target substance in men? Can the test distinguish G6 from higher grades?
Last edited by DjinTonic; 07-22-2019 at 04:50 PM.
69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx, 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 Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM
Bone scan, CTs, X-rays: neg.
8-7-17 Open RP, neg. frozen sections, Duke Regional
SM EPE BNI LVI SVI LNI(16): negative, PNI+, nerves spared
pT2c pN0 pMX 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 (30-day check)
11-26-18 (15 m) 0.012
02-25-19 (18 m) 0.015
05-22-19 (21 m) 0.015 |
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Top User
Originally Posted by AceVA
The big question is, will Uros actually use it?
I asked repeatedly over a year for one of the available advanced tests (PHI, PCA3, MiPS, or 4kScore) and was denied at every appointment.
Maybe the Uro's aren't very current. we run into that often. Maybe the value of an advanced test is questionable, given your good pathology your very low Decipher score.
Do you want an advanced test enough to pay for it out-of-pocket
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 
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Originally Posted by garyi
Maybe the Uro's aren't very current. we run into that often. Maybe the value of an advanced test is questionable, given your good pathology your very low Decipher score.
Do you want an advanced test enough to pay for it out-of-pocket
To clarify, I was asking for those tests over a year ago when the first ever PSA test came back at 15.5, and the Uro was giving him week after week of antibiotics (I think 20 weeks in total) because it must be prostatitis in a 42 year old.  At the time, yes, I was happy to pay out of pocket and said so.
While I'm hopeful that the decipher biopsy got it right, his MSKCC nomogram, as well as PSA density point towards adverse pathology. We'll find out later this week!
Wife Posting, Husband D.O.B. 1975
2/2018 - routine physical PSA 15
3/2018 - PSA 13
4/2018 - PSA down to 11.6, free PSA done, 18%
6/2018 - PSA 10, free PSA 20%
7/2018 - mp- MRI done, prostate volume =22cc, "inflammation consistent with prostititis"
11/2018 - PSA 14, free PSA 11%,
3/2019 - PSA 12, free PSA 17%, 2nd opinion on MRI = PI RADs 3 lesion
4/2019 - Cognitive Fusion Biopsy
5/12 cores positive
4 Gleason 3+3
1 Gleason 3+4 (Where PIRADs 3 lesion IDd)
Decipher Biopsy score: .07 very low risk
Bone scan negative
MRI 6/19 said PIRADS 4 lesion, no definite EPE
RRP 7/19 Final Path: pT3a
G6 - 75-90%
G7 - 11-25%
24mm tumor, 30% of prostate
EPE+, BNI+, SM + (at bladder neck), LVI-, SVI -, PNI-, Nodes -
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