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Excellent News Today

hopeful and opt...
Posts: 1293
Joined: Apr 2009

As part of the Active Surveillance protocol that I am under, today I received the results from my third biopsy. There were six samples that were targeted using an MRI machine, and eleven that were random for a total of seventeen...............all were benign......I will be having another biopsy in two years, and at least a DRE and PSA in six months, an office visit. Last year there were 3 that three that were targeted and eleven that was random...all clean.....two yars ago in 3/09 when I was diagnosed, 2 of 12 were postive, 3+3=6 with less than 5 percent involvement...except for this PSA, all others were about the same at about 2.5.

Additionally this time, my PSA results were elevated. It was 3.9 versus my average of 2.5.....I did ride a bike the day before which may account fot the PSA rise....my doc focused 100 percent on biopsy ...and zero on the PSA.

Beau2
Posts: 232
Joined: Sep 2010

Ira,

Congratulations on the good news. No PCa detected ... fantastic!

You rode a bike before a PSA !?!? Sounds like a rookie mistake...., or something I would do.

Here's hoping for more good biopsies.

Beau2
Posts: 232
Joined: Sep 2010

Ira,

Congratulations on the good news. No PCa detected ... fantastic!

You rode a bike before a PSA !?!? Sounds like a rookie mistake...., or something I would do.

Here's hoping for more good biopsies.

hopeful and opt...
Posts: 1293
Joined: Apr 2009

Your right, it was a rookie mistake........I was thinking that I was only going for a biopsy....which wasn't true at all.......in fact, in addition to a PSA, I had a PCA3(no fun at all), a blood test, a questionnaire to fill out......I also had an enigma before, and had to drive home in stop and go traffic on the freeway for about two hours, feeling where the needles went into my prostate during the ride............what a day of fun

VascodaGama's picture
VascodaGama
Posts: 1531
Joined: Nov 2010

Hopeful
Should we celebrate with a glass of red-wine?
Good news indeed. Hope for more similar excellent news in two years time.
I would appreciate if you explain about the PCA3 (no fun at all) test. There exist very few reports on this important “tool” for the diagnosis of PCa which is reported as better than PSA.

Congrats
VGama

hopeful and opt...
Posts: 1293
Joined: Apr 2009

This test is a new investigational ( only an indicator) urine gene test that is available. The test is a molecular biologic assay. This test has a specificity of 75% and a sensitivity of 57%. (What that means is that among 100 bad tumors, for example, they only can identify 75 of them. And among 100 good tumors, they identify them as bad in 57). The test is done by a doctor who does a DRE and vigorously massages(the fun part...my doc is very experienced, has muscles on his finger, and can make a grown man cry) the prostate; the patient gives urine and the results are sent to Bostwick Laboratories(the only laboratory that does this) for analysis. It is a pretty expensive test, at I think about $500.

So the way the results work, 35 is the magic number, so the less one score is below 35 the better. Mine was 8.3 "Prostatic cells are present but do not over express the PCA3 gene", "value of 35 or greater suggests a high likelihood of prostate cancer"

It is also stated that only a prostate biopsy can diagnose prostate cancer. The test's preformance has been established by Bostwick Laboratories. It has not been approved by the United States Food and Drug administration and should not b4e used as the sole evidence for or against the diagosis of prtostate cancer. Clinicco-patholological correlation iws indicated.

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Also here is something that I had found on the internet

. I am about to have a prostate biopsy
Can the PCA3 test replace a prostate biopsy?
How does the PCA3 test help in making a decision about a biopsy?
The Progensa™ PCA3 test is not a replacement for a prostate biopsy
But the PCA3 test result can be a significant criterion in discussing the need for a biopsy. This is
particularly true for males with an elevated PSA value in which an earlier biopsy was unsuspicious (“negative”).
The result of a PCA3 test, given additional clinical and laboratory findings as well
as the patient’s history, may lead to the joint decision between the patient and the doctor not to carry out a repeat biopsy.
You can read a summary of the scientific basis for this conclusion here
Latest research results demonstrate that the PCA3 test results make it possible to estimate the malignancy
of an existing prostate cancer. This may result in sparing patients invasive therapy, should the test result
indicate that the patient suffers from a carcinoma with a low malignant potential.
You can read the opinions of practical urologists on the PCA3-test here
Yes, I would like a PCA3 test
How should I proceed? What is the next step?
5. Opinions of practical urologists on the PCA3 test
Prof. Dr. med. Bernd Schmitz-Draeger (Fürth, Germany) states:
“… with a PCA3 score below 35 the risk for prostate cancer is decreased, above it is
elevated.” Moreover he states “Let’s take a patient with a very low PCA3 value of – say
- 5: this patient has a three-time lower risk as other patients with a similar PSA
value. If we assume the risk for prostate cancer at 25% in patients with a PSA value
between 4,0 and 10,0 ng/ml, then the patient with a low PCA3 score has a risk of 8%.
This does not provide final certainty, but causes relief for the patient and the
doctor.”

4. I am about to have a prostate biopsy
Can the PCA3 test replace a prostate biopsy?
How does the PCA3 test help in making a decision about a biopsy?
The Progensa™ PCA3 test is not a replacement for a prostate biopsy
But the PCA3 test result can be a significant criterion in discussing the need for a biopsy. This is
particularly true for males with an elevated PSA value in which an earlier biopsy was unsuspicious (“negative”).
The result of a PCA3 test, given additional clinical and laboratory findings as well
as the patient’s history, may lead to the joint decision between the patient and the doctor not to carry out a repeat biopsy.
You can read a summary of the scientific basis for this conclusion here
Latest research results demonstrate that the PCA3 test results make it possible to estimate the malignancy
of an existing prostate cancer. This may result in sparing patients invasive therapy, should the test result
indicate that the patient suffers from a carcinoma with a low malignant potential.
You can read the opinions of practical urologists on the PCA3-test here
Yes, I would like a PCA3 test
How should I proceed? What is the next step?
5. Opinions of practical urologists on the PCA3 test
Prof. Dr. med. Bernd Schmitz-Draeger (Fürth, Germany) states:
“… with a PCA3 score below 35 the risk for prostate cancer is decreased, above it is
elevated.” Moreover he states “Let’s take a patient with a very low PCA3 value of – say
- 5: this patient has a three-time lower risk as other patients with a similar PSA
value. If we assume the risk for prostate cancer at 25% in patients with a PSA value
between 4,0 and 10,0 ng/ml, then the patient with a low PCA3 score has a risk of 8%.
This does not provide final certainty, but causes relief for the patient and the
doctor.”
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Yes Celebrate, with Red wine, white wine, ginger ale, a walk in the sunshine, party or whatever you enjoy........celebrate every day

mrspjd
Posts: 688
Joined: Apr 2010

Congrats and wishes for continued success. This is very good news indeed! It almost seems as if there has been a “reversal” of the PCa! If I understood correctly, and not to second guess or question a good thing, wondering...did the doctor suggest any reasons why he thought the first biopsy pathology might have determined low risk, low % core positive PCa, but subsequent path reports for targeted biopsies came back clean/negative?

hopeful and opt...
Posts: 1293
Joined: Apr 2009

The doctor did not discuss why the first patholoogy determined low risk cancer while the newer biopsies were clean, however, my guess is that only a small sample of the prostate has been sampled, and that cancer within the prostate is small, not large enough to be identified by the MRI machine, or that there is human error in taking a biopsy in the exact place identified by the MRI. In any case, I strongly believe that there is stil cancer within the prostate; however, I am an excellent candidate for Active Surveillance with Delayed Treatment.

When I first choose AS as a treatment, I was uncomfortable with the decision, since the possible consequences are scary, however, as I am better educated about this treatment option, and the benefits of a closely monitored surveillance program, I am more and more comfortable with the decision I made to follow an active surveillance program, however I have concerns, that the technology to identify cancer within the prostate and the aggressveness of these cancers by type on a molecular level still need to improve in order to more effectively identify patients that need treatment versus those who do not. Additionally I think that developing a program of various markers that are current and new ones is another way to help in monitoring this disease among patients.

BRONX52
Posts: 156
Joined: Apr 2010

Great news Ira----hopefully all of your follow up tests will render the same results and you you won't have to worry about this beast any more---take care- Dan

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