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denistd's picture
denistd
Posts: 490
Joined: Apr 2009

Today I learned that I have a very low grade prostate cancer, I have, in the past, had both larynx and early lung cancer, had chemo and radiation on the larynx in 2009 and all there is really doing well. Had a small nodule removed from my lung in 2012 that turned out to be cancerous. They found it on a one year scan for the larynx, iy was only a one and a half centimeter nodule. I had the biopsy because my dad, brother and Uncle all had prostate cancer, all survived that. My PSA, which has been elevated for years due to BPH, last PSA was 5.6, up from 5.0 last year. Anyway doc said we could do nothing and watch, I am 70, or radiation, I chose the rads only because treatment has worked on larynx, stage 2, and surgery on the lung ? stage no one ever told me if the lung thing was staged. Did I do the right thing going for the surgery? the doc said I would not get any symptoms for at least 5 to 8 years and it was not going to kill me.

 

hopeful and opt...
Posts: 1290
Joined: Apr 2009

As I understand you have been diagnosed with prostate cancer today, and need to make a decision about treatment.

In order to provide direction specific to you, more information is needed about the specifics of your diagnosis.

How many cores were taken in your biopsy,

How many cores were positive?

For each core that was positive, what was the Gleason score and the amount of involvement (percent cancer) of each core that was positive?

Any other pertinent information from the biopsy, perinial invasion, etc.

What did the DRE examine(finger wave) show, abnormalities? Normal?

It is important to have a second opinion of your biopsy slides by a world class pathologist that specializes in prostate cancer. Determining Gleason score is subjective and you do not want to be under or over treated. 

denistd's picture
denistd
Posts: 490
Joined: Apr 2009

There were 12 cores taken, 2 were positive. The doctor was showing me the results on his paperwork, gleason for both was 2, I saw this but did not know what it meant. DRE showed nothing abnormal. Don't know about the percentage of involvement only that he said there were a few cancer cells in the two cores. I am seeing a radiation doc in a couple of weeks. The urologist I saw is a professor of Urology at Penn State Hershey Medical Center. I have had two runins with cancer before and both were treated at Hershey, they did a fantastic job. I will ask about a second opinion when I see the rad guy.

 

hopeful and opt...
Posts: 1290
Joined: Apr 2009

Dear Denistd,

It is important that you have a copy of all your medical records, and be informed. Specifically you need to have a copy of your pathology report so you can refer to same.

 

The Gleason score generally ranges from a 3+3=6 to a 5+5=10. This Gleason score indicates the aggressiveness of the  the cancer that is found. A Geason of 3=3=6 is a less agressive cancer while a 5+5=10 is very aggressive. Also there are scores such as 3+4=7 and 4+3=7, the first number that is mentioned is more predominent.

As far is involvement, the percent of cancer in the core that was found...this is important to know since it is an indication of the extensiveness of the cancer found in the prostate, and somewhat of an indication if the cancer has gone outside the prostate or not.

The critieria for "Active Surveillance with delayed treatment if necessary" varies just a little at various institutions.

I beleive that at JohnHopkins, for example the criterial is for a low low aggressive cancer is

less than two cores out of twelve with a 3+3+6

less than 50 percent involvement or less in each of the cores

PSA/Prostate size ratio 0.15 or less

PSA 10 or less

I was diagnosed in March 09 with a low low aggressive cancer. I have been on Active Surveillance for the last 51 months. Like you I am currently 70. I plan to continue with this program for the rest of my life if I can.

Please click my name. You can see what I have been doing, and some sources of information that is good for you to read.

PS. I suggest that you see a doctor that specializes in Active Surveillance, hopefully at a major academic center of excellence.

PPS. A hobby of mine is to play the Ukulele, but unfortunately I am a poor singer.

PPPS. Get back to us with the details of your situation after you receive the written biopsy report from your doc.

 

 

 

denistd's picture
denistd
Posts: 490
Joined: Apr 2009

 In my original post i asked if I had done the right thing opting for surgery, I meant opting for no surgery.

denistd's picture
denistd
Posts: 490
Joined: Apr 2009

gleason was 2=3=5 in bith cores. Will do all of the other stuff you said, thanks for help, really appreciated. Denis

denistd's picture
denistd
Posts: 490
Joined: Apr 2009

Had my 3 to 4 month psa taken. the psa I had back in May was 6.00. WE have done nothing. The Latest psa was 5.5. Seeing the urologist tomorrow to see what all this means. I was surprised that it went down. Denis

hopeful and opt...
Posts: 1290
Joined: Apr 2009

The PSA basically shows a trend over time. There are various factors that affect the PSA on a short term basis, sex before the blood test, exercise, hard stool, etc. Do not pay too much attention to each PSA finding. The critical information are the results of the biospy.

In my case my PSA recently went down from 4.3 to 3.8, after rising from a 2.5 . Click my name to see the results of my psa's and other pertinent information about Acive Surveillance.

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