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Thread: prostate cancer?

  1. #51
    Quote Originally Posted by Sushi2911 View Post
    I think that you are almost rude.
    Probably my husband has pca and we will deal with it, no matter what.
    Fyi he paid for the doctors and medicine and the mri, not the insurance.
    Nothing more to say
    Another is direct and that can be hard to accept sometimes. However, he is right.

    Your husband needs a biopsy and while I hate to be the bearer of bad news, it may take multiple biopsies to find cancer if it is there. I've had every test known to man, some pointed towards cancer others away from it.

    I did biopsy1-MRI-fusion biopsy2-random biopsy3. The MRI showed potential cancer that tested negative.

    My concern reading some of what you wrote is that your husband so badly wants this not to be cancer that he is willing to find a doctor to tell him what he wants to hear. My other fear is the MRI shows nothing and your husband uses that as rationale for not doing the biopsy.

    I have cancer that never showed up on an MRI that took two biopsies to find and a third to confirm. It is sometimes is hard to find.

    It sounds a lot like your husband is looking for a reason not to have a biopsy. Just my thoughts reading between the lines. Maybe I'm mistaken in my impression.

  2. #52
    Experienced User
    Join Date
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    Quote Originally Posted by Sushi2911 View Post
    I think that you are almost rude.
    Probably my husband has pca and we will deal with it, no matter what.
    Fyi he paid for the doctors and medicine and the mri, not the insurance.
    Nothing more to say
    Oh I dont think he was trying to be rude at all. I think his comment was meant to be encouraging.
    Wife posting
    Age 51
    PSA 9/2019 - 4.8
    fPSA - 9%
    4K score 12%
    Bx 9/2019
    Final Diagnosis - prostate carcinoma
    Highest Gleason Score - 3+3=6
    Number of cores positive - 4
    Percent of cores positive - 28.6% (4 of 14 cores - 12 samples taken. 2 broke in half)
    Maximum % of tumor in positive cores - 60%
    Overall prostatic tissue involvement - 5.8%
    Perineural invasion - present
    Lymph-vascular invasion - not identified
    Periprostatic fat invasion/extrsprostatic extension - not identified

    Left base - G3+3=6. 4% involved. Perineural invasion present.
    Right apex - G3+3=6. 40% involved.
    Right lateral mid - G3+3=6. 5% involved.
    Left lateral apex - G3+3=6. 40% involved.

    OncoDX score 23. Low Risk.
    High Grade Disease 14%
    Non Organ Confined Disease 16%

  3. #53
    Quote Originally Posted by Sushi2911 View Post
    I think that you are almost rude.
    Probably my husband has pca and we will deal with it, no matter what.
    Fyi he paid for the doctors and medicine and the mri, not the insurance.
    Nothing more to say
    A cultural misunderstanding has occurred. In US culture, no one has been rude to you here.

    In your culture, people are more reserved in their opinions.
    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 Intraductal Carcinoma
    T3aNO, 1 mm EPE, GS8, 21 mm uni-focal tumor involved 10% of prostate.

    7 Nodes, SV, SM, PNI, and BNI were negative.

    LVI and Cribriform pattern present.

    Decipher .86 High Risk.

    Post Surgery PSA
    3/25/19 .03. (<1 month)
    4/25/19 <.03. (2 months)
    5/25/19 <.02. (3 months)
    9/10/2019. <.02. (6 months)
    11/27/2019. <.02. T<3. (9 months)

    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)

  4. #54
    Regular User
    Join Date
    Sep 2019
    Posts
    16
    In my country mpMRI 3T, as i found out, is the first step in diagnosing cancer. It does not replace the biopsy, but it is recommended so as to avoid false negative biopsies.
    We visited a third doctor because, the second one asked for another psa in 3 months and we did not feel ok with that.
    We rejected the first one not because of the biopsy he recommended but because of the private hospital he is in, they have bad reputation.
    Mri is a tool before biopsy here.
    Also, in my country it is very common to visit surgeons when a big problem occurs.

    Thank you very much for your help in here.

  5. #55
    Quote Originally Posted by Sushi2911 View Post
    In my country mpMRI 3T, as i found out, is the first step in diagnosing cancer. It does not replace the biopsy, but it is recommended so as to avoid false negative biopsies.
    We visited a third doctor because, the second one asked for another psa in 3 months and we did not feel ok with that.
    We rejected the first one not because of the biopsy he recommended but because of the private hospital he is in, they have bad reputation.
    Mri is a tool before biopsy here.
    Also, in my country it is very common to visit surgeons when a big problem occurs.

    Thank you very much for your help in here.
    Hi,

    Thanks for the update.

    I don't think anyone here disagrees with the 3t MRI. Here in America you usually have to have a random biopsy first in order to justify the 3t MRI.

    Me personally, I see little value in the MRI diagnostically because my cancer showed up in multiple areas that never lit up on an MRI. So what use was the MRI? The fusion biopsy done on the area that did light up on the MRI they did didn't find cancer. I asked them to do a random biopsy when they completed the fusion and that is where the cancer was found. So...I'm a bit skeptical. I think that if you have a significant cancer, the MRI can help make it known.

    So my advice to you is that no matter what comes of the MRI, push and fight, scratch and claw for the biopsy. If you can find a doctor that sedates for the biopsy, your husband will very much appreciate not being awake for it. It's bearable if you have to be awake but sedation is 1000x better.

    Good luck to you guy. Keep getting educated and you'll find like me that it significantly calms you down. Also the farther you go in the process you get over the shock of the diagnosis and it becomes a to do item on your list of life.

  6. #56
    Sushi, as the odd German-Canadian in this predominantly US forum I'm now wondering where you're from?

    In Germany fusion biopsies, also transperineal ones, are the best diagnostic option. If sedation is offered at no significant surcharge, go for it. The procedure is neither too terrible nor too pleasant.

    You are doing everything optimally so don't worry. Fingers crossed for a negative biopsy / best results.

  7. #57
    Moderator Top User HighlanderCFH's Avatar
    Join Date
    Nov 2011
    Posts
    7,297
    Quote Originally Posted by Sushi2911 View Post
    I think that you are almost rude.
    Probably my husband has pca and we will deal with it, no matter what.
    Fyi he paid for the doctors and medicine and the mri, not the insurance.
    Nothing more to say

    Hang in there, Sushi. Another has his best interests in his heart and simply prefers the "tough love" type of approach. He is a very good contributor here and you will always get very direct -- and honest -- comments from him.

    He might take some "getting used to," but believe me when I assure you he means the very best for you AND your husband.

    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.
    Eight annual post-op exams 2012 through 2019: PSA <0.1
    Semi-firm erections without "training wheels," usable erections with 100mg Sildenafil.
    NOTE: ED caused by BPH, not the surgery.

  8. #58
    Top User garyi's Avatar
    Join Date
    Apr 2017
    Posts
    1,473
    Quote Originally Posted by HighlanderCFH View Post
    Hang in there, Sushi......I assure you he means the very best for you AND your husband.
    As do we ALL, Sushi, and don't give up as you get used to us.

    You would do your husband, and us, a big favor by completing a signature block, with his medical history and your location. Instructions are at the top of the menu. Also consider including your profile, so we better understand each other, and the many experienced people on this forum can better assist you.
    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, .081 9/19, .116 11/19
    We'll see....what is not known dwarfs what is thought to be fact

  9. #59
    Regular User
    Join Date
    Sep 2019
    Posts
    16
    Hello!
    Update....

    PSA 4.4-free PSA 30%

    DRE-slightly induration

    I apologize for my english (translated)

    - enlarged 4.8cm * 3.8cm*4.9cm

    -suspicious area at the left side 8mm*3mm (on the periphery) PIRADS4

    -no other suspicious areas in the gland/on the periphery

    -spermatic vesicles: normal

    -bladder:normal

    -prostate gland:integral

    Biopsy is scheduled
    Last edited by Sushi2911; 11-18-2019 at 09:09 PM. Reason: More info

  10. #60
    Quote Originally Posted by Sushi2911 View Post
    Hello!
    Update....

    PSA 4.4-free PSA 30%

    DRE-slightly induration

    I apologize for my english (translated)

    - enlarged 4.8cm * 3.8cm*4.9cm

    -suspicious area at the left side 8mm*3mm (on the periphery) PIRADS4

    -no other suspicious areas in the gland/on the periphery

    -spermatic vesicles: normal

    -bladder:normal

    -prostate gland:integral

    Biopsy is scheduled
    Hi Sushi,

    You'll see from the chart on this page that PIRADS 4 are classified as "probably malignant," but only a biopsy can tell for certain. The biopsy will take cores from around the prostate and probably an extra couple in the suspicious area. The good take-away news is that if there is cancer found, the imaging suggests that it is prostate-confined and, if so, that means that there is a good chance that primary treatment, RT or surgery, will be successful if needed.

    Best of luck!

    Djin

 

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