BIOPSY REPORT TODAY

kimber45

My doc just called me. I had one in 12 come back with a gleason score of 6. Another sample was questionable. I need to have the usual tests. Did anyone else need a cystoscopy as one of the tests?

Kongo

Cystoscopy
Kimber, unless you have some difficulty urinating, are experiencing pain, or some other issue like a kidney stone or something, I can't imagine why they would want to do a cystoscopy. It's not part of the "usual tests" following a positive biopsy report that I have ever heard of. Sometimes doctors order up all kinds of tests after a positive biopsy such as a bone scan, chest x-ray, complete blood panel, etc., but most urological associations would not recommend even these given your relatively low risk diagnosis of 1 of 12 cores positive and a Gleason 6.

kimber45

Kongo said:

Cystoscopy
Kimber, unless you have some difficulty urinating, are experiencing pain, or some other issue like a kidney stone or something, I can't imagine why they would want to do a cystoscopy. It's not part of the "usual tests" following a positive biopsy report that I have ever heard of. Sometimes doctors order up all kinds of tests after a positive biopsy such as a bone scan, chest x-ray, complete blood panel, etc., but most urological associations would not recommend even these given your relatively low risk diagnosis of 1 of 12 cores positive and a Gleason 6.

I do have an enlarged
I do have an enlarged prostate. When the biopsy was done- I peed and there was still some urine in my bladder. I'm wondering if that may be the reason ?

trfouts

Kongo said:

Cystoscopy
Kimber, unless you have some difficulty urinating, are experiencing pain, or some other issue like a kidney stone or something, I can't imagine why they would want to do a cystoscopy. It's not part of the "usual tests" following a positive biopsy report that I have ever heard of. Sometimes doctors order up all kinds of tests after a positive biopsy such as a bone scan, chest x-ray, complete blood panel, etc., but most urological associations would not recommend even these given your relatively low risk diagnosis of 1 of 12 cores positive and a Gleason 6.

Kongo i have read many of
Kongo i have read many of your post and understand where you are coming from, But as a recent survivor of a R P gleason of 3+3=6 and stage T2c not wanting to go through Radiation and then wondering if they got it or not. The choice is a personal one whether you want the cancer out of your body or take the Radiation and not know and then find out it did not work, and then not be able to have nerve sparing surgery because of the scare tissue from the radiation. Sometimes peace of mind is better than worrying about functioning sexually.I am 56 and will recover from this.I respect your opinion and just hope we support what ever Others decide.

Kongo

trfouts said:

Kongo i have read many of
Kongo i have read many of your post and understand where you are coming from, But as a recent survivor of a R P gleason of 3+3=6 and stage T2c not wanting to go through Radiation and then wondering if they got it or not. The choice is a personal one whether you want the cancer out of your body or take the Radiation and not know and then find out it did not work, and then not be able to have nerve sparing surgery because of the scare tissue from the radiation. Sometimes peace of mind is better than worrying about functioning sexually.I am 56 and will recover from this.I respect your opinion and just hope we support what ever Others decide.

Agree I Think
trfouts,

I'm a little confused by your post on this thread as my comments above were in reference to whether or not a cystoscopy was a usual test after a positive diagnosis of prostate cancer from a biopsy, and in my experience I had never heard of that before.

In any event, I suspect you may be referring to other recent posts of mine regarding opinions on RP as an option to treat various stages of prostate cancer.

I certainly agree with you that whatever choice you make should lead you to peace of mind following treatment.

Men who choose RP to treat low risk PCa statistically have excellent chances of not only beating the cancer but in recovering their urinary and sexual function. The same can be said for radiation.

In older men (approaching 70 or beyond) or obese men or with a high BMI, or men with very enlarged prostates, I believe the statistics show that RP is more difficult to perform and incurs a higher risk of adverse side effects in a variety of areas.

For later stage cancers where there is high probability that the cancer has spread beyond the prostate I question why surgery would be performed as removing the prostate will not curb the growth of cancer in other areas which would need to be treated with HT, radiation, or some other technique better suited for metastatic prostate cancer. Since every case is unique, there may well be situations where it makes sense to do an RP in conjunction with other treatment; I just haven’t seen any of those examples discussed in this forum.

After a man has chosen whatever treatment he believes is best, I agree that we should all support his decision in every way we can. During the time a man is between diagnosis and treatment and considering potential options and asks advice, I think it is appropriate to share experiences and research that might be helpful. And I believe it is particularly important to encourage men to seek second opinions to validate what they learn through their own research.

I don’t believe I have ever suggested that a man seek the same treatment method I chose over another. I have strongly suggested that men seek multiple opinions about different treatment so that they are as fully informed as possible when they make their decision. If given an informed choice and a man chooses to go another route than I did, I sincerely wish the best for them and rejoice in their successes. What bothers me is when men suggest that a particular treatment is superior to another without having done the requisite research, or deliberately slants the available information, or when they state that a particular treatment is the “best” or “gold standard.” These types of statements, in my view, should be clearly put forth as personal, lay opinions and hopefully based on some experience or research that supports it.

As you point out, we each have different priorities. In your case, peace of mind in knowing that a cancerous prostate was no longer in your body was a determinant factor in your decision. In my own case, keeping the prostate (even if the radiation didn’t get it all although I suspect it did) didn’t bother me in the least. I WANTED to keep my prostate, even an irradiated one. I just didn’t want to risk the potential side effects and chose a method that I felt minimized the risk of adverse effects. So, based on our individual and differing priorities, we each made a decision that was best for us.

But once a man makes a decision and has his treatment, I agree completely, that we should all support his choice and look forward to his recovery.

lewvino

trfouts said:

Kongo i have read many of
Kongo i have read many of your post and understand where you are coming from, But as a recent survivor of a R P gleason of 3+3=6 and stage T2c not wanting to go through Radiation and then wondering if they got it or not. The choice is a personal one whether you want the cancer out of your body or take the Radiation and not know and then find out it did not work, and then not be able to have nerve sparing surgery because of the scare tissue from the radiation. Sometimes peace of mind is better than worrying about functioning sexually.I am 56 and will recover from this.I respect your opinion and just hope we support what ever Others decide.

Surgery in all cases Does
Surgery in all cases Does not mean the end of a functioning sex life. I had the robotic surgery and have been very pleased with the results. Yes you will have problems but hopefully they can be overcome. I firmly believe a lot of the functionality return is based on the surgeons skill level and of course how much of the nerve bundle can be saved.

Doc spared 100% of the nerve bundle on one side and about 60 - 70% Spared on the side that the cancer was found the most.

An excellent book to read is "Saving your sex life" by Dr. John Mulhall.

Larry age 56
Gleason 7
13.5 months post surgery

trfouts

Kongo said:

Agree I Think
trfouts,

I'm a little confused by your post on this thread as my comments above were in reference to whether or not a cystoscopy was a usual test after a positive diagnosis of prostate cancer from a biopsy, and in my experience I had never heard of that before.

In any event, I suspect you may be referring to other recent posts of mine regarding opinions on RP as an option to treat various stages of prostate cancer.

I certainly agree with you that whatever choice you make should lead you to peace of mind following treatment.

Men who choose RP to treat low risk PCa statistically have excellent chances of not only beating the cancer but in recovering their urinary and sexual function. The same can be said for radiation.

In older men (approaching 70 or beyond) or obese men or with a high BMI, or men with very enlarged prostates, I believe the statistics show that RP is more difficult to perform and incurs a higher risk of adverse side effects in a variety of areas.

For later stage cancers where there is high probability that the cancer has spread beyond the prostate I question why surgery would be performed as removing the prostate will not curb the growth of cancer in other areas which would need to be treated with HT, radiation, or some other technique better suited for metastatic prostate cancer. Since every case is unique, there may well be situations where it makes sense to do an RP in conjunction with other treatment; I just haven’t seen any of those examples discussed in this forum.

After a man has chosen whatever treatment he believes is best, I agree that we should all support his decision in every way we can. During the time a man is between diagnosis and treatment and considering potential options and asks advice, I think it is appropriate to share experiences and research that might be helpful. And I believe it is particularly important to encourage men to seek second opinions to validate what they learn through their own research.

I don’t believe I have ever suggested that a man seek the same treatment method I chose over another. I have strongly suggested that men seek multiple opinions about different treatment so that they are as fully informed as possible when they make their decision. If given an informed choice and a man chooses to go another route than I did, I sincerely wish the best for them and rejoice in their successes. What bothers me is when men suggest that a particular treatment is superior to another without having done the requisite research, or deliberately slants the available information, or when they state that a particular treatment is the “best” or “gold standard.” These types of statements, in my view, should be clearly put forth as personal, lay opinions and hopefully based on some experience or research that supports it.

As you point out, we each have different priorities. In your case, peace of mind in knowing that a cancerous prostate was no longer in your body was a determinant factor in your decision. In my own case, keeping the prostate (even if the radiation didn’t get it all although I suspect it did) didn’t bother me in the least. I WANTED to keep my prostate, even an irradiated one. I just didn’t want to risk the potential side effects and chose a method that I felt minimized the risk of adverse effects. So, based on our individual and differing priorities, we each made a decision that was best for us.

But once a man makes a decision and has his treatment, I agree completely, that we should all support his choice and look forward to his recovery.

Yes we agree about whatever
Yes we agree about whatever decision you make needs to be what is the best for you.About the cystoscopy i do not know why but they did one on me and i developed a terrible infection from it,and was in the emergency room 2 days later.I changed Uro's the next day .I value your opinion as i do everyone who has posted on this site,it took me a year to come up with my decision to have a Radical Prosectomy to ease my mind, so i also took the wait and see approach but a rising PSA doubling in 8 months made my choice for Rp an easy one. I am 21 days after surgery and things are going great,About not choosing Radiation my Job would not allow me to work because of Haz-mat so for the same time i would have to be off for radiation i could have RP and a clear mind.

Kongo

kimber45 said:

I do have an enlarged
I do have an enlarged prostate. When the biopsy was done- I peed and there was still some urine in my bladder. I'm wondering if that may be the reason ?

Cystoscopy
Kimber,

I'm really scratching my head on this one. trfouts post on this thread indicates he had one too but isn't sure why and he developed an infection.

I'm sure your doctors are great, but sometimes you read about a lot of unnecessary tests because they're all basically "reasonable and customary" or because Medicare of your insurance will pay for them even if they really aren't warranted. I would really question the doctor on this one and make him explain why he's doing it.

If it's "just to me sure" or "an abundance of caution" then I think they may be viewing you as a business development opportunity.

Good luck in sorting that one out.