New diaganosis

D47

Just got biospy result.  Andocarcinoma in
Right medial apex, and suspicious in left medial mid.  Gleason score, 3+3=6.  Age 65 good health, meeting with Oncologist in three days.  Any advice?

hopeful and optimistic

lots of advice here

 I am sorry for your diagnosis.

Hopefully we can help with information for direction, and share some of our experiences with you.

In order for us to give pertinent information, we need more information from you.

How many cores were taken in your biopsy? How many of these cores were positive? Of the cores that were positive, what was the Gleason, and the involvement (that is what percent of the core was cancerous)?

Was the digital rectal exam normal, or what did it indicate?

What is your PSA, and the history of your PSA tests?

Do you know the size of your prostate?

What led you to getting a biopsy?

………………………………………..

Most of this information is on the biopsy report which you need to have a copy of along with all medical information for your case.  This is important as you get second opinions at various medical specialties, and so you can communicate here and at any other group that you may visit.

D47

hopeful and optimistic said:

lots of advice here

 I am sorry for your diagnosis.

Hopefully we can help with information for direction, and share some of our experiences with you.

In order for us to give pertinent information, we need more information from you.

How many cores were taken in your biopsy? How many of these cores were positive? Of the cores that were positive, what was the Gleason, and the involvement (that is what percent of the core was cancerous)?

Was the digital rectal exam normal, or what did it indicate?

What is your PSA, and the history of your PSA tests?

Do you know the size of your prostate?

What led you to getting a biopsy?

………………………………………..

Most of this information is on the biopsy report which you need to have a copy of along with all medical information for your case.  This is important as you get second opinions at various medical specialties, and so you can communicate here and at any other group that you may visit.

They took 12 cores one

They took 12 cores one positive for Cancer 5%, Right medial apex.  One suspicious left medial mid.  PSA had doubled from 1.6 to 3.2 in year led to Biospy.  PSA done a week after Biospy was 11, Dr. attributed that elevation to recent irritation of the prostate.  Prostate slightly enlarged, the picture taken right before the biospy looked normal to the DR.

hopeful and optimistic

D47 said:

They took 12 cores one

They took 12 cores one positive for Cancer 5%, Right medial apex.  One suspicious left medial mid.  PSA had doubled from 1.6 to 3.2 in year led to Biospy.  PSA done a week after Biospy was 11, Dr. attributed that elevation to recent irritation of the prostate.  Prostate slightly enlarged, the picture taken right before the biospy looked normal to the DR.

Active Surveillance

You appear to have a low , low risk cancer, one that is indolent, not likely to spread. You are a candidate for "Active
Surveillance with delayed treatment if necessary".

The criteria for the active surveillance protocol varies slightly at various institutions. For example at Johns Hopkins, it is PSA less than 10, less than two cores with a 3+3=6 with less than 50 percent involvement in each, with psa/prostate ratio of less than 0.15(which yours is).

Active Surveilance for delayed treatment
is a very viable treatment decision for low risk prostate cancer, since 97 percent of men with LRPC are likely to die of something other than prostate cancer. The pathologic stage of patients who are closely monitored, is similar to initally treated patients with LRPC, so the treatment decisions will be very similar. I've been doing Active Surveilance for the past four years . I plan to continue with this treatment option for the rest of my life if I can. If not I feel that I will still be able to seek any necessary treatment.
 You mention, a picture before the biopsy(please be specific, what do you mean by that?) It is very important for you to have a second opinion on the results of your biopsy by a world class pathologist since determining a Gleason and the involvement is subjective. You do not want to be under or over treated. Simple have the results of your biopsy sent to one of these pathologists. There is a test called an MRI, a diagnostic test that will show suspicious lessions, and can indicate the polliblity that the cancer is outside the capsule. This chance is somewhat small in your case. The gold standard for MRI is an MRI with a tesla 3.0 magnet.      

D47

hopeful and optimistic said:

Active Surveillance

You appear to have a low , low risk cancer, one that is indolent, not likely to spread. You are a candidate for "Active
Surveillance with delayed treatment if necessary".

The criteria for the active surveillance protocol varies slightly at various institutions. For example at Johns Hopkins, it is PSA less than 10, less than two cores with a 3+3=6 with less than 50 percent involvement in each, with psa/prostate ratio of less than 0.15(which yours is).

Active Surveilance for delayed treatment
is a very viable treatment decision for low risk prostate cancer, since 97 percent of men with LRPC are likely to die of something other than prostate cancer. The pathologic stage of patients who are closely monitored, is similar to initally treated patients with LRPC, so the treatment decisions will be very similar. I've been doing Active Surveilance for the past four years . I plan to continue with this treatment option for the rest of my life if I can. If not I feel that I will still be able to seek any necessary treatment.
 You mention, a picture before the biopsy(please be specific, what do you mean by that?) It is very important for you to have a second opinion on the results of your biopsy by a world class pathologist since determining a Gleason and the involvement is subjective. You do not want to be under or over treated. Simple have the results of your biopsy sent to one of these pathologists. There is a test called an MRI, a diagnostic test that will show suspicious lessions, and can indicate the polliblity that the cancer is outside the capsule. This chance is somewhat small in your case. The gold standard for MRI is an MRI with a tesla 3.0 magnet.      

Pathology labs

Where can I find a list of quality Pathology labs?  Thanks for the information.