I'm a newbie to PC

dreamer574
dreamer574 Member Posts: 4
edited March 2014 in Prostate Cancer #1
This whole thing is pretty overwhelming and sort of knocked me back on my heels.I've kind of been on an emotional roller coaster between denial and devistation. Anybody else in their early 50's who's dealing with their PC care to talk and help me gain some perspective?
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Comments

  • lewvino
    lewvino Member Posts: 1,010
    I was diagnosed at age 54
    I was diagnosed at age 54 and am 7 months post surgery. Would be more then willing to chat with you. Shoot me an email at lewvino@yahoo.com and we can see when will work for both of us. Can relate to that knocked back feeling!

    Larry (Chattanooga, Tn area)
  • randy_in_indy
    randy_in_indy Member Posts: 496 Member
    Dreamer
    swingshift gives some good advice as well as others here, Larry, trew, hopeful, bd, the list is extensive. Settle in and read, read, and read more. My path is well documented here...I choose robotic surgery...here's my path in a nutshell.

    52 years old
    PSA 9/09 7.25
    PSA 10/09 6.125
    Diagnosis confirmed Oct 27, 2009
    8 Needle Biopsy = 5 clear , 3 postive
    <20%, 10%, 10%
    Gleason Score (3+3)=6 in all positive cores
    11/09 Second Opinion on Biopsy slides from Dr. Koch
    (4+3) = 7 5%
    (3+4) = 7 10%
    (3+4) = 7 10%
    Endorectol MRI with Coil - Indicated the Palpal tumor was Organ confined
    da Vinci 12/29/09 - Dr. Hollensbee & Scott
    Post Surgery Pathology:
    Prostate size 5 x 4 x 3.5 cm Weight: 27 g
    Gleason: Changed to (3+4) = 7
    Primary Pattern 3, 80%
    Secondary Pattern 4, 18%
    Tertiary Pattern 5, 2%
    Tumor Quantitation:
    Greatest Dimension, Largest tumor focus: 19 mm
    Additional Dimension 18 x 15 mm
    Location, largest tumor focus: Right posterior quadrant
    Multifocality: Yes
    Greatest dimension second largest focus 10 mm
    Location: second largest focus: Left Posterior quadrant
    Extraprostatic extension: Yes
    If yes, focal or non-focal: Nonfocal
    If yes: location(s) right and left antero-lateral
    Seminal vesicle invasion: No
    Cancer at surgical margin: No
    If no, closest distance with location: less than 1 mm, right posterior quadrant
    Apex involvement: No
    Bladder involvement: NO
    Lymph-vascular invasion: No
    Perineural invasion: Yes
    Lymph nodes: 9 from right pelvic 0/9 positive
    Stage: pT3a, pNo, pMX
    All nerves sparred - found two additional pudendal arteries

    FIRST PSA TEST 2-11-10 <0.1 NONDETECTABLE

    A reading list for you:

    Recommend-Guide to Surviving Prostate Cancer-Second Edition
    Dr Patrick Walsh
    Recommend-The First Year Prostate Cancer-An Essential Guide for the Newly Diagnosed
    Chris Lukas
    Recommend-Saving Your Sex Life-A guide for Men with Prostate Cancer
    Dr. John Mulhall
    Prostate Cancer Meet The Proton Beam-Apatient's Experience
    Fuller Jones
    Recommend-You Can Beat Protate Cancer and you do nto need surgery to do it
    Robert J. Marckini
    Recommend-Surviving Protate Cancer without Surgery-The New Gold Standard that save your life and life style
    Dr Michael J. Dattoli
    Conquer Prostate Cancer
    Rabbi Ed Weinsberg
    Recommend-Eat to Beat Prostate Cancer Cookbook
    Ricketts


    Comprehensive Book list on Prostate Cancer - http://www.wellnessbooks.com/bookstore/

    http://www.havasupaitribe.com/waterfalls.html
  • Swingshiftworker
    Swingshiftworker Member Posts: 1,017 Member
    Don't Let It Stress You Out!
    I'm 59 and was diagnosed 2 months ago. I have an early stage PCa, which I assume you have too.

    There's a overwhelming amount of information about treatment alternatives out there and, as an early stage PCa patient, all of the treatments are available to you. However, the choices change and become more limited as your cancer advances, but "fortunately" our cancer is one of those that progresses slowly and that can be regularly monitored w/PSA tests and biopsies, which is what makes "active surveillance" before treatment a reasonable approach.

    Read all you can and talk to all of the people w/PCa or who know about PCa that you can directly or via the Net. Try to sort through the inherent biases of the various sources of information -- eg., surgeons recommend surgery, radiologists recommend radiation and satisfied patients (regardless of the treatment) recommend the treatment they received (whatever it was). Regarding patient reports, don't rely JUST on reported SUCCESSES -- all of them will be glowing -- but look also at reports of similar treatments that went BADLY. You can find such comparisons right here on this forum.

    Just remember that only YOU can make the RIGHT treatment choice for YOU. Quality of life issues (side effects) are the main things that distinguish the various treatment options and REMEMBER that you don't have to elect ANY treatment until it is medically necessary to take action. Don't opt for treatment prematurely out of FEAR, which many men do because they just want to "get rid" of the disease ASAP. Elect a treatment only if it is really medically necessary for you and make sure that you've given your INFORMED CONSENT to the treatment based on COMPLETE disclosure of ALL of the risks of treatment.

    That said, you don't need to obsess about the cancer and can go on w/your daily life without it affecting you very much until you elect to receive treatment. In the case of PCa, the cure can "seem" much worse than the disease, especially if you become impotent and incontinent as a result of treatment, which is why taking your time to select the right treatment for you is SO important.

    Just do your research, monitor the course of the disease and take steps necessary to receive the treatment you've selected (eg., by changing medical carriers if possible to get the treatment you want, by choosing the "right" physician or treatment center -- which is CRITICAL, BTW, by raising money if you don't have medical insurance, etc.) before the time comes to actually undergo the treatment.

    In the meantime, don't let it stress you out!

    Relax, enjoy life (kiss your wife and pet your dog) and take the time to appreciate all of the things in life that you've previously taken for granted too long -- sunrises, sunsets, a walk in the forest, etc. -- which will take your mind off of your disease.

    Good luck and best wishes!
  • zakpaga
    zakpaga Member Posts: 69
    Dreamer,
    You already got

    Dreamer,

    You already got excellent advice from those who posted before me. I just want to tell you that I am 52 years old and was diagnosed with PCa in January 2010. Please don't stress yourself too much about your new situation. I know it is easier said than done. Educate your self; try to live life at the fullest and do not take any thing for granted. Get closer to your wife. She will be of good support during your new journey.


    I wish you all the best.


    Victor
  • jminnj
    jminnj Member Posts: 129 Member
    zakpaga said:

    Dreamer,
    You already got

    Dreamer,

    You already got excellent advice from those who posted before me. I just want to tell you that I am 52 years old and was diagnosed with PCa in January 2010. Please don't stress yourself too much about your new situation. I know it is easier said than done. Educate your self; try to live life at the fullest and do not take any thing for granted. Get closer to your wife. She will be of good support during your new journey.


    I wish you all the best.


    Victor

    A Little Younger Acutually
    Dreamer, I am 47 and was diagnosed in November. I am 2 months post surgery and so far things are going well. You have already been given a lot of great advice from Larry, Randy and the others. These guys really helped me a great deal as I started my own journey.

    As Victor said educate yourself, reach out to us if you have specific questions. There are a lot of treatment options out there, don't let anyone sway you into picking a treatment you are not 100% comfortable with; being comfortable with the decision is a huge part of the healing process. Make sure to include your wife in all the discussions as she needs to understand everything you are going through. My e-mail is ghostrdr2112@yahoo.com. If you want to ask me specific questions about my experience with the robotic surgery, let me know.

    Take care,
    Joe
  • dreamer574
    dreamer574 Member Posts: 4
    jminnj said:

    A Little Younger Acutually
    Dreamer, I am 47 and was diagnosed in November. I am 2 months post surgery and so far things are going well. You have already been given a lot of great advice from Larry, Randy and the others. These guys really helped me a great deal as I started my own journey.

    As Victor said educate yourself, reach out to us if you have specific questions. There are a lot of treatment options out there, don't let anyone sway you into picking a treatment you are not 100% comfortable with; being comfortable with the decision is a huge part of the healing process. Make sure to include your wife in all the discussions as she needs to understand everything you are going through. My e-mail is ghostrdr2112@yahoo.com. If you want to ask me specific questions about my experience with the robotic surgery, let me know.

    Take care,
    Joe

    Thanks
    I must be in my denial stage today. Had to work to make myself come in here and see what posts I might find. I'm glad I did. It's good to know there are those out there who are willing to help me process all this even if in this moment the best I can do is to take some of the advice I got to get out and enjoy some of the things we don't normally take the time for.

    Thanks for being there. Hopefully soon I'll muster the strength and courage needed to absorb all the information out there in order to make the best choices.

    Hope to talk to you guys again soon
    Dave
  • chitown
    chitown Member Posts: 90 Member
    Newbie too-need advise on waitime from biopsy to davinci surgery
    Got positive biopsy about a month ago. Am 48, fit and healthy. PSA of 2.1 but a papable nodule motivated the biopsy. Gleason at 3:3. Have decided on da vinci. The question is if I can wait 2-3 months to surgery. Or is there a inherent risk to waiting. Doctors are split on this. Also, looking of surgery and post surgery advise and inspiration..Thanks in advance.
  • lewvino
    lewvino Member Posts: 1,010
    chitown said:

    Newbie too-need advise on waitime from biopsy to davinci surgery
    Got positive biopsy about a month ago. Am 48, fit and healthy. PSA of 2.1 but a papable nodule motivated the biopsy. Gleason at 3:3. Have decided on da vinci. The question is if I can wait 2-3 months to surgery. Or is there a inherent risk to waiting. Doctors are split on this. Also, looking of surgery and post surgery advise and inspiration..Thanks in advance.

    You should have no problem
    You should have no problem waiting the 3 months. I had Gleason 7 and Doc told me I could wait a little (Ended up being about 5 months) But not to go over 1 year.

    Inspiration post surgery....Did great. 99.9% Dry when the cath came out and still doing great.
    Sex...Had success with Levitra at about day 45 post surgery. Doing well know with Levitra.

    Biggest factor is getting a doctor with LOTS of experience.

    Larry
  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,339 Member
    chitown said:

    Newbie too-need advise on waitime from biopsy to davinci surgery
    Got positive biopsy about a month ago. Am 48, fit and healthy. PSA of 2.1 but a papable nodule motivated the biopsy. Gleason at 3:3. Have decided on da vinci. The question is if I can wait 2-3 months to surgery. Or is there a inherent risk to waiting. Doctors are split on this. Also, looking of surgery and post surgery advise and inspiration..Thanks in advance.

    how many cores taken.......how many positive,,
    and what is the involvement of each.

    Ira
  • chitown
    chitown Member Posts: 90 Member
    lewvino said:

    You should have no problem
    You should have no problem waiting the 3 months. I had Gleason 7 and Doc told me I could wait a little (Ended up being about 5 months) But not to go over 1 year.

    Inspiration post surgery....Did great. 99.9% Dry when the cath came out and still doing great.
    Sex...Had success with Levitra at about day 45 post surgery. Doing well know with Levitra.

    Biggest factor is getting a doctor with LOTS of experience.

    Larry

    thanks larry
    the surgeon i have scheduled in july had done 2600 da vinci and 400 open surgery. are there any do and dont before and after surgery...i like to visualize as much so any details of what went thru your mind and body few days before surgery and then first 1 and 2 week after..and then road to recovery. that will be very helpful. right now i am mental mess :-)
  • chitown
    chitown Member Posts: 90 Member
    jminnj said:

    A Little Younger Acutually
    Dreamer, I am 47 and was diagnosed in November. I am 2 months post surgery and so far things are going well. You have already been given a lot of great advice from Larry, Randy and the others. These guys really helped me a great deal as I started my own journey.

    As Victor said educate yourself, reach out to us if you have specific questions. There are a lot of treatment options out there, don't let anyone sway you into picking a treatment you are not 100% comfortable with; being comfortable with the decision is a huge part of the healing process. Make sure to include your wife in all the discussions as she needs to understand everything you are going through. My e-mail is ghostrdr2112@yahoo.com. If you want to ask me specific questions about my experience with the robotic surgery, let me know.

    Take care,
    Joe

    Set for surgery in July
    Thanks for your sharing here. I am 48 and set for da vinci in july. larry is already sharing your experience and will greatly appreciate learning from your current journey. i want to specicifically know day by day for the first week..not just for my learning but fo my wife and kids. then the 2nd week onwards regarding back to normal life..recovery, pain, activities, emotion, side effects, any gotcha and do and dont..thanks in advance.

    i am 48, very fit and healthy otherwise, PSA 2.1 Gleason 3:3, 6 of the 16 cores in biopsy were cancerous...no symptons of any kind before the biopsy..

    am waiting 3 more months for surgery so can get my body and mind in top shape.
  • Kongo
    Kongo Member Posts: 1,166 Member
    chitown said:

    thanks larry
    the surgeon i have scheduled in july had done 2600 da vinci and 400 open surgery. are there any do and dont before and after surgery...i like to visualize as much so any details of what went thru your mind and body few days before surgery and then first 1 and 2 week after..and then road to recovery. that will be very helpful. right now i am mental mess :-)

    2600?
    2600 DaVinci surgeries for one surgeon seems almost like a production line. DaVinci was approved by the FDA in 2000. There are roughly 250 days a year (M-F not counting holidays) that are considered "work days." Even if the good doctor is a saint and never takes a vacation, 2600 robotic surgeries would be more than one a day every day for the past ten years, not counting the 400-odd open surgeries Larry indicates he has done. Taking into account office visits and non-surgery work this doctor must do, I just can't imagine how he was able to do that many surgeries. The number seems highly inflated to me.
  • chitown
    chitown Member Posts: 90 Member
    Kongo said:

    2600?
    2600 DaVinci surgeries for one surgeon seems almost like a production line. DaVinci was approved by the FDA in 2000. There are roughly 250 days a year (M-F not counting holidays) that are considered "work days." Even if the good doctor is a saint and never takes a vacation, 2600 robotic surgeries would be more than one a day every day for the past ten years, not counting the 400-odd open surgeries Larry indicates he has done. Taking into account office visits and non-surgery work this doctor must do, I just can't imagine how he was able to do that many surgeries. The number seems highly inflated to me.

    Right Kongo!
    I believe he is also counting the surgery he has participated in - in his traning and and he trains dozens of doctors now. Also, he began his own training at Henry Ford about 10 years ago. So yes, it sounds inflated but am trying to give him benefit of doubt. Samadi and Vipul Patel claim a similar number.

    Where my head is that he had done lots...is that a fair thinking?
  • Kongo
    Kongo Member Posts: 1,166 Member
    chitown said:

    Right Kongo!
    I believe he is also counting the surgery he has participated in - in his traning and and he trains dozens of doctors now. Also, he began his own training at Henry Ford about 10 years ago. So yes, it sounds inflated but am trying to give him benefit of doubt. Samadi and Vipul Patel claim a similar number.

    Where my head is that he had done lots...is that a fair thinking?

    Lots of Confusion
    There are so many studies, statistics, claims, and whatnot about this disease. I would rather have too much information than not enough but it takes awhile to get your head around it all.

    My approach is to get as much information as possible, complie a "rack and stack" matrix where I compare pros, cons, and impact on the quality of life factors that are important to me, and then make the best informed decision I can at the time with input from my wife, family, and doctors I trust.

    Haven't finished my research yet but am getting closer.

    Good luck as you sort through all this.
  • lewvino
    lewvino Member Posts: 1,010
    Kongo said:

    2600?
    2600 DaVinci surgeries for one surgeon seems almost like a production line. DaVinci was approved by the FDA in 2000. There are roughly 250 days a year (M-F not counting holidays) that are considered "work days." Even if the good doctor is a saint and never takes a vacation, 2600 robotic surgeries would be more than one a day every day for the past ten years, not counting the 400-odd open surgeries Larry indicates he has done. Taking into account office visits and non-surgery work this doctor must do, I just can't imagine how he was able to do that many surgeries. The number seems highly inflated to me.

    Kongo,
    Starting in 2000 we

    Kongo,
    Starting in 2000 we can go with 9 years not counting 2010. Lets take an easy estimate of 100 work days a year. That is 150 days less then your estimate. 100 * 9 = 900 days. Doing just 3 surgeries a day gives you 2700. Many surgeons book and perform 4 per day. The day I had my surgery I was the second one scheduled at 10 am. Dr. Smith is chair of the Urology dept at Vanderbilt and could be counting training he took and training that he gives. I even asked Dr. Smith Since Vanderbilt is a teaching hospital if he did the entire surgery. He responded No that students in their last year of medical internship would open and close me but that he is always called in at the critical part of the surgery and takes over controls. Of course you can always call his office and ask for a rough estimate. They are located in Nashville Tn at Vanderbilt University hospital.

    Larry
  • randy_in_indy
    randy_in_indy Member Posts: 496 Member
    chitown said:

    Newbie too-need advise on waitime from biopsy to davinci surgery
    Got positive biopsy about a month ago. Am 48, fit and healthy. PSA of 2.1 but a papable nodule motivated the biopsy. Gleason at 3:3. Have decided on da vinci. The question is if I can wait 2-3 months to surgery. Or is there a inherent risk to waiting. Doctors are split on this. Also, looking of surgery and post surgery advise and inspiration..Thanks in advance.

    Chitown
    Ok, I do not in any way want to scare anyone...but I do have to say something to you that needs to be said. Based on my personal experience with da vinci surgery the wait time after the biopsy is a minimum of 6 weeks according to my surgeon so that complete healing of the prostate from the punctures can take place for several reasons:
    1. nothing open on the prostate when they are in there trying to take it out - nothing to ooze or otherwise escape during the removal and be left behind as a positive margin.
    2. the swelling from the prostate being punctured in the biopsey so the surgical field will be normal and not stressed in anyway for the removal.

    Now, my word of caution when thinking about waiting and again this is coming from my personal case....I waited 70 days from my biopsy or 10 weeks of which was not for any other reason but scheduling and knowing I needed to complete in 2009 to avoid having to come up with a $950 deductable that had already been meet for 2009 and had I choose a date in January I would have had to repay immediately from the surgery.

    But the important part here is really none of this but rather the fact...my biopsy was 3+3=6 in all three samples of 8 samples (smaller prostate gland - only 8 samples) with a nodgle on the right side felt in DRE. Post Op pathology put the nodgle less than 1mm....find a metric ruler and 1mm is one tenth of a centimeter which is on rulers....VERY VERY tiny....well that nodgle was less than 1mm from breaking through the prostate gland. Additionally, my gleason changed to 3+4=7 not the biopsy 3+3=6.


    So my advice...find someone who is good at reading MRI with Coil or spectroscopy-preferred but more rare...and have that test done to try and determine first if you have a tumor/nodgle and second see if it's broken through the prostate. Then based on that information you may be better equiped with making a decision on the date to plan whatever treatment choice you are going with. In retrospect for myself I feel if I had waited much longer I might be dealing with positive margins and further treatment.

    Now in your case you have all samples with cancerous cells from the biopsy...IF you were me....I would look for more testing to determine a. if you had a nodgle/tumor...if it looked close to escaping the prostate outer capsle. Now that is if you were me...I would be doing that...now you are not me...but that is what I would do.....everyone has to make up their own minds about what treatment, tests, healthcare choices you seek or do.

    Hope I helped. Here is my stats and path

    52 years old
    PSA 9/09 7.25
    PSA 10/09 6.125
    Diagnosis confirmed Oct 27, 2009
    8 Needle Biopsy = 5 clear , 3 postive
    <20%, 10%, 10%
    Gleason Score (3+3) 6 in all positive cores
    11/09 Second Opinion on Biopsy slides from Dr. Koch
    (4+3) = 7 5%
    (3+4) = 7 10%
    (3+4) = 7 10%
    Endorectol MRI with Coil - Indicated the Palpal tumor was Organ confined
    da Vinci 12/29/09 - Dr. Hollensbee & Scott
    Post Surgery Pathology:
    Prostate size 5 x 4 x 3.5 cm Weight: 27 g
    Gleason: Changed to (3+4) = 7
    Primary Pattern 3, 80%
    Secondary Pattern 4, 18%
    Tertiary Pattern 5, 2%
    Tumor Quantitation:
    Greatest Dimension, Largest tumor focus: 19 mm
    Additional Dimension 18 x 15 mm
    Location, largest tumor focus: Right posterior quadrant
    Multifocality: Yes
    Greatest dimension second largest focus 10 mm
    Location: second largest focus: Left Posterior quadrant
    Extraprostatic extension: Yes
    If yes, focal or non-focal: Nonfocal
    If yes: location(s) right and left antero-lateral
    Seminal vesicle invasion: No
    Cancer at surgical margin: No
    If no, closest distance with location: less than 1 mm, right posterior quadrant
    Apex involvement: No
    Bladder involvement: NO
    Lymph-vascular invasion: No
    Perineural invasion: Yes
    Lymph nodes: 9 from right pelvic 0/9 positive
    Stage: pT3a, pNo, pMX
    All nerves sparred - found two additional pudendal arteries

    FIRST PSA TEST 2-11-10 <0.1 NONDETECTABLE


    Randy in indy
  • randy_in_indy
    randy_in_indy Member Posts: 496 Member
    Kongo said:

    Lots of Confusion
    There are so many studies, statistics, claims, and whatnot about this disease. I would rather have too much information than not enough but it takes awhile to get your head around it all.

    My approach is to get as much information as possible, complie a "rack and stack" matrix where I compare pros, cons, and impact on the quality of life factors that are important to me, and then make the best informed decision I can at the time with input from my wife, family, and doctors I trust.

    Haven't finished my research yet but am getting closer.

    Good luck as you sort through all this.

    Kongo
    You are using a very methodical approach to determining the treatment choice for your situation and should be an example of what everyone should be doing with their situation...I can tell you many people do not delve into this that way and only take their doctor's advice and just schedule and go blindly into the treatment that they really didn't even choose....I am a very analytical person myself and it's beyond me seeing people blindly going through this process and generally life in that cavalier manner...obviously most people on here are certainly are not that way or they wouldn't have taken the step to even find this forum.

    One comment I have while you are painstakenly going through this process with your "rack and stack" matrix is that this BEAST seems to have a mind of its own that treats people differently and who's outcomes may be totally different using the same treatment choices....

    It's a befuddling experience to say the least.

    Randy in Indy
  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,339 Member

    Chitown
    Ok, I do not in any way want to scare anyone...but I do have to say something to you that needs to be said. Based on my personal experience with da vinci surgery the wait time after the biopsy is a minimum of 6 weeks according to my surgeon so that complete healing of the prostate from the punctures can take place for several reasons:
    1. nothing open on the prostate when they are in there trying to take it out - nothing to ooze or otherwise escape during the removal and be left behind as a positive margin.
    2. the swelling from the prostate being punctured in the biopsey so the surgical field will be normal and not stressed in anyway for the removal.

    Now, my word of caution when thinking about waiting and again this is coming from my personal case....I waited 70 days from my biopsy or 10 weeks of which was not for any other reason but scheduling and knowing I needed to complete in 2009 to avoid having to come up with a $950 deductable that had already been meet for 2009 and had I choose a date in January I would have had to repay immediately from the surgery.

    But the important part here is really none of this but rather the fact...my biopsy was 3+3=6 in all three samples of 8 samples (smaller prostate gland - only 8 samples) with a nodgle on the right side felt in DRE. Post Op pathology put the nodgle less than 1mm....find a metric ruler and 1mm is one tenth of a centimeter which is on rulers....VERY VERY tiny....well that nodgle was less than 1mm from breaking through the prostate gland. Additionally, my gleason changed to 3+4=7 not the biopsy 3+3=6.


    So my advice...find someone who is good at reading MRI with Coil or spectroscopy-preferred but more rare...and have that test done to try and determine first if you have a tumor/nodgle and second see if it's broken through the prostate. Then based on that information you may be better equiped with making a decision on the date to plan whatever treatment choice you are going with. In retrospect for myself I feel if I had waited much longer I might be dealing with positive margins and further treatment.

    Now in your case you have all samples with cancerous cells from the biopsy...IF you were me....I would look for more testing to determine a. if you had a nodgle/tumor...if it looked close to escaping the prostate outer capsle. Now that is if you were me...I would be doing that...now you are not me...but that is what I would do.....everyone has to make up their own minds about what treatment, tests, healthcare choices you seek or do.

    Hope I helped. Here is my stats and path

    52 years old
    PSA 9/09 7.25
    PSA 10/09 6.125
    Diagnosis confirmed Oct 27, 2009
    8 Needle Biopsy = 5 clear , 3 postive
    <20%, 10%, 10%
    Gleason Score (3+3) 6 in all positive cores
    11/09 Second Opinion on Biopsy slides from Dr. Koch
    (4+3) = 7 5%
    (3+4) = 7 10%
    (3+4) = 7 10%
    Endorectol MRI with Coil - Indicated the Palpal tumor was Organ confined
    da Vinci 12/29/09 - Dr. Hollensbee & Scott
    Post Surgery Pathology:
    Prostate size 5 x 4 x 3.5 cm Weight: 27 g
    Gleason: Changed to (3+4) = 7
    Primary Pattern 3, 80%
    Secondary Pattern 4, 18%
    Tertiary Pattern 5, 2%
    Tumor Quantitation:
    Greatest Dimension, Largest tumor focus: 19 mm
    Additional Dimension 18 x 15 mm
    Location, largest tumor focus: Right posterior quadrant
    Multifocality: Yes
    Greatest dimension second largest focus 10 mm
    Location: second largest focus: Left Posterior quadrant
    Extraprostatic extension: Yes
    If yes, focal or non-focal: Nonfocal
    If yes: location(s) right and left antero-lateral
    Seminal vesicle invasion: No
    Cancer at surgical margin: No
    If no, closest distance with location: less than 1 mm, right posterior quadrant
    Apex involvement: No
    Bladder involvement: NO
    Lymph-vascular invasion: No
    Perineural invasion: Yes
    Lymph nodes: 9 from right pelvic 0/9 positive
    Stage: pT3a, pNo, pMX
    All nerves sparred - found two additional pudendal arteries

    FIRST PSA TEST 2-11-10 <0.1 NONDETECTABLE


    Randy in indy</p>

    Randy I agree with you
    however, I notice a very few men, have in fact reported that they had the MRI coil, and none have reported that they have had the spectroscopy along with it.

    You are one of the very few who have had an MRI----you listened, but you are an exception....

    You would think that men would want to know where they stand, and so would their doctors.

    I also notice that there are useless test prescibed for men with low volume prostate cancer, such as the bone scan. The American Urological Association does not recommend for gleasons under 8. There is also a book put out by steven strum md that discusses this along with other things........it is a very detailed book, and needs to be read many times.

    Ira
  • chitown
    chitown Member Posts: 90 Member

    Chitown
    Ok, I do not in any way want to scare anyone...but I do have to say something to you that needs to be said. Based on my personal experience with da vinci surgery the wait time after the biopsy is a minimum of 6 weeks according to my surgeon so that complete healing of the prostate from the punctures can take place for several reasons:
    1. nothing open on the prostate when they are in there trying to take it out - nothing to ooze or otherwise escape during the removal and be left behind as a positive margin.
    2. the swelling from the prostate being punctured in the biopsey so the surgical field will be normal and not stressed in anyway for the removal.

    Now, my word of caution when thinking about waiting and again this is coming from my personal case....I waited 70 days from my biopsy or 10 weeks of which was not for any other reason but scheduling and knowing I needed to complete in 2009 to avoid having to come up with a $950 deductable that had already been meet for 2009 and had I choose a date in January I would have had to repay immediately from the surgery.

    But the important part here is really none of this but rather the fact...my biopsy was 3+3=6 in all three samples of 8 samples (smaller prostate gland - only 8 samples) with a nodgle on the right side felt in DRE. Post Op pathology put the nodgle less than 1mm....find a metric ruler and 1mm is one tenth of a centimeter which is on rulers....VERY VERY tiny....well that nodgle was less than 1mm from breaking through the prostate gland. Additionally, my gleason changed to 3+4=7 not the biopsy 3+3=6.


    So my advice...find someone who is good at reading MRI with Coil or spectroscopy-preferred but more rare...and have that test done to try and determine first if you have a tumor/nodgle and second see if it's broken through the prostate. Then based on that information you may be better equiped with making a decision on the date to plan whatever treatment choice you are going with. In retrospect for myself I feel if I had waited much longer I might be dealing with positive margins and further treatment.

    Now in your case you have all samples with cancerous cells from the biopsy...IF you were me....I would look for more testing to determine a. if you had a nodgle/tumor...if it looked close to escaping the prostate outer capsle. Now that is if you were me...I would be doing that...now you are not me...but that is what I would do.....everyone has to make up their own minds about what treatment, tests, healthcare choices you seek or do.

    Hope I helped. Here is my stats and path

    52 years old
    PSA 9/09 7.25
    PSA 10/09 6.125
    Diagnosis confirmed Oct 27, 2009
    8 Needle Biopsy = 5 clear , 3 postive
    <20%, 10%, 10%
    Gleason Score (3+3) 6 in all positive cores
    11/09 Second Opinion on Biopsy slides from Dr. Koch
    (4+3) = 7 5%
    (3+4) = 7 10%
    (3+4) = 7 10%
    Endorectol MRI with Coil - Indicated the Palpal tumor was Organ confined
    da Vinci 12/29/09 - Dr. Hollensbee & Scott
    Post Surgery Pathology:
    Prostate size 5 x 4 x 3.5 cm Weight: 27 g
    Gleason: Changed to (3+4) = 7
    Primary Pattern 3, 80%
    Secondary Pattern 4, 18%
    Tertiary Pattern 5, 2%
    Tumor Quantitation:
    Greatest Dimension, Largest tumor focus: 19 mm
    Additional Dimension 18 x 15 mm
    Location, largest tumor focus: Right posterior quadrant
    Multifocality: Yes
    Greatest dimension second largest focus 10 mm
    Location: second largest focus: Left Posterior quadrant
    Extraprostatic extension: Yes
    If yes, focal or non-focal: Nonfocal
    If yes: location(s) right and left antero-lateral
    Seminal vesicle invasion: No
    Cancer at surgical margin: No
    If no, closest distance with location: less than 1 mm, right posterior quadrant
    Apex involvement: No
    Bladder involvement: NO
    Lymph-vascular invasion: No
    Perineural invasion: Yes
    Lymph nodes: 9 from right pelvic 0/9 positive
    Stage: pT3a, pNo, pMX
    All nerves sparred - found two additional pudendal arteries

    FIRST PSA TEST 2-11-10 <0.1 NONDETECTABLE


    Randy in indy</p>

    Thanks Randy - few more thoughts
    Randy - I went for my full body bone scan and abdomen/pelvic CT stan on Friday and made the mistake of asking the big tattooed bone scan technician 'how does it look'. He said there is a light shadow in the front ribs..does looks like some trauma and not cancer'. Have been on pins and needles all weekend waiting for Monday to talk to the doc.

    On the original topic the waiting part is created also is because the biopsy gave be sepis with e-coli in the blood which put me on life support in ICU for a week and on my last day there I was told that I had cancer. What a double whammy! So the goal is also for body to recover for surgery.

    Hope I dont get a third whammy next week!

    Please keep me advised..value every word you say
  • Kongo
    Kongo Member Posts: 1,166 Member
    lewvino said:

    Kongo,
    Starting in 2000 we

    Kongo,
    Starting in 2000 we can go with 9 years not counting 2010. Lets take an easy estimate of 100 work days a year. That is 150 days less then your estimate. 100 * 9 = 900 days. Doing just 3 surgeries a day gives you 2700. Many surgeons book and perform 4 per day. The day I had my surgery I was the second one scheduled at 10 am. Dr. Smith is chair of the Urology dept at Vanderbilt and could be counting training he took and training that he gives. I even asked Dr. Smith Since Vanderbilt is a teaching hospital if he did the entire surgery. He responded No that students in their last year of medical internship would open and close me but that he is always called in at the critical part of the surgery and takes over controls. Of course you can always call his office and ask for a rough estimate. They are located in Nashville Tn at Vanderbilt University hospital.

    Larry

    Thanks, Larry
    Thanks for that perspective on the numbers. I hadn't imagined that surgeons were doing multiple procedures a day. My urologist indicated to me that even when everything goes smoothly, it takes 3-4 hours.