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Positive Biopsy

MichaelF1002
Posts: 54
Joined: Mar 2013

Well, my biopsy results came back positive. Just found out 15 minutes ago.  I don't remember much of what the doctor told me on the phone except that the right side was positive and the Gleason score is 3+3.  He says it is very low grade, I think he also said low volume but I don't remember.  Still in shock.  I have an appointment with him tomorrow to discussion my options.  Can anybody offer some advice about what I should ask? I read on someplace online where 3+3 has a "favorable prognosis."  True?  Thanks.

Michael

hopeful and opt...
Posts: 1305
Joined: Apr 2009

I am sorry for your diagnosis. All of , like you are shocked when we hear the news, This usually last two or three months.

Since determining a Gleason score is subjective, it is very important for you to ask your doctor at the meeting tomorrow to send the slides to a world class pathologist, one who specializes in Prostate Cancer for a second opinion. Two such Pathologists are Francisco Civantos305-325-5587 and Dianon Laboratories 800-328-2666. This is especially important to do in low aggressive disease such as a Gleason 3+3=6.

Please make sure that you get a copy of the biopsy report, and all other pertenient medical information , so it will be available at different consults with specicalists  using different treatment methods, and to share with us if you wish.

I personally am on "Active Surveillance with Delayed treatment, if necessary" for the past four years. PLease click my name to read what I have done, and various studies that support this.

 

Kongo's picture
Kongo
Posts: 1167
Joined: Mar 2010

Michael,

Sorry to read of your diagnosis.  If your recollection is correct, however, it seems that you will have many options to deal with this prostate cancer.  A 3+3=6 Gleason score is low risk and likely confined to the prostate.  In many cases these types of cancers are indolent and will never pose a long term threat to your health.

When you meet with your doctor tomorrow please take along your wife or someone close to you who can help keep notes.  The amount of information that first comes your way can be overwhelming and it is easy to lose sight of key details in all the discussion.  Take notes and ask if you can record the conversation as well.  You should also ask for paper copies of all of your records and begin to build a file which you will need should you seek other opinions from different experts.

You should ascertain from the doctor what the stage of your cancer is, how many cores were positive and what percent involvement is present.  You should also ask about whether or not perineural invasion is present (PNI) and have your doctor expaln what this could mean to you.  I would also ask your doctor to look at your PSA velocity and doubling time as a measure of how serious your cancer might be.

As Hopeful and Optimistic suggests, you should get information on how to ship your biopsy slides to another pathologist to get a second opinion.

Keep in mind that urologists are surgeons.  Urologists frequently advise newly diagnosed patients that surgery is necessary to remove the prostate and the sooner the better.  Regardless of how much you may like and trust your urologist, you need to seek second opinions on treatment, particularly with a low risk diagnosis.  Prostate cancer is very slow growing and you have a lot of time to research and study your options.

Typically, low risk prostaste cancer is treated with either surgery or radiation.  An increasing number of doctors are recommending watchful waiting to monitor the progress and not take any corrective actions.  The advantages here are that if your cancer does not progress you don't have to worry about suffering any of the side effects possible from surgery or radiation.  If your cancer does progress, as evidenced by increasing PSA or another biopsy, you will likely have plenty of time to make treatment decisions without harm.

Besides your urologist, I also recommend you seek consultations with a radiation oncologist and there are a number of types of new radiation techniques that offer excellent curative percentages (>90%) with minimal side effects.

Good luck to you.

 

K

 

MichaelF1002
Posts: 54
Joined: Mar 2013

Thanks so much for your responses and advice. I have printed out the posts and will bring them with me to tomorrow's appointment.  I have already survived the loss of a kidney to cancer; I probably can handle whatever comes my way regarding this.  Wish me luck.

Regards,

Michael

VascodaGama's picture
VascodaGama
Posts: 1544
Joined: Nov 2010

Michael

I am sorry for the positive results.

I recall back in 2000 when I also received the bad news. I visited the doctor alone because I never thought I had cancer. The news put me in a trance state so intense that caused me temporary loss of consciousness and I do not remember the time since I left the hospital till I met my wife. It was shocking

I hope you recuperate from the situation the soonest and start looking forward to deal positively with the problem. You will find this forum very helpful. The guys here will share their thoughts and you will need the comfort of your family when discussing about the next steps.

As I commented in your other thread, you will have the time needed for an earlier therapy. Do things timely and coordinately. Now you need to confirm the diagnosis and get several other tests to check for a clinical stage. Proper diagnosis will lead to the best way in treating cancer and to better outcomes.

http://csn.cancer.org/node/256212

You are an experienced cancer patient. You have knocked down the bandit one time and you will do it again successfully.

Best wishes and luck in your journey

VGama  Wink

Rakendra's picture
Rakendra
Posts: 74
Joined: Apr 2013

Sorry to hear, but any cancer is a tough one.  However, maybe a 3+3 is not such bad news, if bad  news has to come at all!  3+3 has a very favorable prognosis with good chance for many years to come.  Many here (including me) would celebrate for a 3+3.  And, it is important to reiterate the opinion that Gleason score is in the eye of the beholder.  This score may change with a second opinion.  

And, remember that PCa is not a case where one opinion or set of statistics fits all.  This cancer may be unique to each, and yet similar to all.  Never assume any statistics about your regression or life expecatancy chances.  The less stress you can put yourself and your immune system thru, the better your chances.  I have found that there are certainly very good opinions and facts that are important to know and consider, but also, each individual's atitude and methods of dealing with this can have a huge effect on the progress of the disease.  Some patients will take control with very aggressive actions to combat.  Others will do less.  

A positive note is this.  You already have had one cancer experience that you have dealt with successfully, and it would seem that nothing positive could have come from that experience.  On the other hand, that experience will greatly help you in dealing with your 3+3.  I like to believe that every experience in my life is for my benefit, even those experiences I do not expect or welcome.  An example is that your previous cancer will be an asset in your present situation.  You cannot change the situation, but you can change the way you think about it. love, swami

MichaelF1002
Posts: 54
Joined: Mar 2013

Thanks again to everyone for their kind words of encouragement.  My kidney cancer was caught early and because of that I have only a 5% chance of it spreading.  It seems this prostate cancer has been caught early also.  So I am grateful for that and I emphathize with those who are not so fortunate.  I am going to get a second opinion on the slides, as recommended, but my concern is that they will come back with a higher Gleason score, which could or could not be the more accurate one.  Then I have to make a choice between the treatment options offered me with 3+3 (which I will hear about today), or because of the higher score, perhaps a more stringent treatment, which might be unnecessary if the lower one is the correct one. How does one make such decisions?  The kidney cancer was easy.  Take out the kidney, cure the cancer.  There wasn't any other choice because of the location of the mass in the kidney.  The kidney had to come out.  Since then my most difficult decision has been what to eat for breakfast every morning.

Thanks again

Michael

hopeful and opt...
Posts: 1305
Joined: Apr 2009

Also the second opinion pathologist may come back with no cancer.

I recommended that you seek a world class experts who you can bank on.

I don't know whether or not Kaiser will pay for this...they may...but if not it is a couple of hundred dollars, well worth it;

I know some men with Kaiser who had a second opinion from another Kaiser doctor(no charge)........in my opinion this is not an independent pathologist...or a world class as I recommended to you.

PS Also if there is a difference, which happens from time to time, you can always get a third p opinion on the slides.

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