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prostrate cancer

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  • Clevelandguy
    Clevelandguy CSN Member Posts: 1,361 Member
    #22

    Hi,

    What are you confused about? Sound like the latest biopsy showed cancer 3+3,3+4 I assume on the right side. Sounds to me the cancer is gone on the left side but still remains on the right side. AS,Hifu, radiation, or surgery for the right side?

    Dave 3+4

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  • 12tugod
    12tugod CSN Member Posts: 23 Member
    #23

    MRI didn't reveal any legions, all clear.

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  • 12tugod
    12tugod CSN Member Posts: 23 Member
    #24


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  • 12tugod
    12tugod CSN Member Posts: 23 Member
    #25

    something is wrong with that picture.

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  • Old Salt
    Old Salt CSN Member Posts: 1,693 Member
    #26

    An MRI only suggests whether cancerous loci are present. The positive biopsy results are definitive.

    Clearly you have cancerous foci in what's left of your prostate. If you give us the complete biopsy report we can try to give you an idea (!) whether treatment will be needed.

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  • 12tugod
    12tugod CSN Member Posts: 23 Member
    #27

    ===========================================================

    Collected: 2/13/2023  Received: 2/13/2023 Reported: 2/14/2023


    A. PROSTATE, LEFT BASE, BIOPSY:  Benign prostate tissue with HIFU therapy related changes.


    B. PROSTATE, LEFT MIDDLE, BIOPSY:  Benign prostate tissue with HIFU therapy related

    changes.

     

    C. PROSTATE, LEFT APEX, BIOPSY:  Benign prostate tissue with HIFU therapy related changes.

     

    D. PROSTATE, LEFT LATERAL BASE, BIOPSY:  Benign prostate tissue with HIFU therapy related

    changes.

     

    E. PROSTATE, LEFT LATERAL MIDDLE, BIOPSY:  Benign prostate tissue with HIFU therapy

    related changes.

     

    F. PROSTATE, LEFT LATERAL APEX, BIOPSY:  Benign prostate tissue with HIFU therapy related

    changes.

     

    G. PROSTATE, RIGHT BASE, BIOPSY:  


    PROSTATIC ADENOCARCINOMA without treatment effect, Grade Group 1 (Gleason Score 3 + 3 =

    6), involving 10% of one (1) core.


    Total linear length of cancer is 1 mm.


    H. PROSTATE, RIGHT MIDDLE, BIOPSY:  


    SMALL FOCUS OF PROSTATIC ADENOCARCINOMA without treatment effect, Grade Group 1 (Gleason

    score 3 + 3 = 6), involving less than 5% of one (1) core.


    I. PROSTATE, RIGHT APEX, BIOPSY:  


    PROSTATIC ADENOCARCINOMA without treatment effect, Grade Group 2 (Gleason Score 3 + 4 =

    7), involving 20% of the total fragmented specimen.


    Percentage of Gleason pattern 4 = 10%.


    The pattern 4 of this carcinoma lacks a large cribriform morphology.


    J. PROSTATE, RIGHT LATERAL BASE, BIOPSY:  


    SMALL FOCUS OF PROSTATIC ADENOCARCINOMA without treatment effect, Grade Group 1 (Gleason

    score 3 + 3 = 6), involving less than 5% of one (1) core.


    K. PROSTATE, RIGHT LATERAL MIDDLE, BIOPSY:  


    PROSTATIC ADENOCARCINOMA without treatment effect, Grade Group 1 (Gleason Score 3 + 3 =

    6), discontinuously involving 80% of one (1) core.


    Total linear length of cancer is 2 mm.


    L. PROSTATE, RIGHT LATERAL APEX, BIOPSY:  


    PROSTATIC ADENOCARCINOMA without treatment effect, Grade Group 1 (Gleason Score 3 + 3 =

    6), involving 50% of one (1) core.


    Total linear length of cancer is 4 mm.

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  • 12tugod
    12tugod CSN Member Posts: 23 Member
    #28

    My biopsy. You would think the MRI would of picked up something.

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  • Rob.Ski
    Rob.Ski CSN Member Posts: 194 Member
    #29

    Biopsy confirms PCa. MRI can be useful if lesions are detected but, they aren't always seen and if they are seen they aren't always cancer. Quality of MRI may be a factor as well. My first MRI showed nothing when PCa was creeping up. 6 months later Biopsy confirmed my PCa.

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  • Clevelandguy
    Clevelandguy CSN Member Posts: 1,361 Member
    #30

    Hi,

    Biopsy confirms cancer in your right side of your Prostate. As I stated earlier sound like you need some kind of treatment to kill it. The MRI it seems did not pick up any indications of cancer which I have heard from other survivors.

    Dave 3+4

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  • centralPA
    centralPA CSN Member Posts: 431 Member
    #31
    https://csn.cancer.org/discussion/comment/1705591#Comment_1705591

    From your report…”discontinuously involving 80% of one (1) core.”

    MRIs pick up where the cancer is collected in one spot (lesion). You have cancer where it is scattered throughout your prostate. Discontinuous. That’s not as likely to show up. It is also, I think, more dangerous, since your cancer seems to want to spread out.

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  • 12tugod
    12tugod CSN Member Posts: 23 Member
    #32
    https://csn.cancer.org/discussion/comment/1705611#Comment_1705611

    Thanks for your response.

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  • 12tugod
    12tugod CSN Member Posts: 23 Member
    #33

    Hey Guys,

    Here I am again. I opted for AS. I am very concerned that PSA is steadily rising.

    5/6/228/9/2211/8/224/13/238/22/23

    2.100/ 1.580/ 1.970/ 3.570/ 5.420 H

    I am not really sold on treatment due to life changing side effects and possible recurrence.

    I posted treatments I had before, HIFU left side. PSA went down but all of a sudden going back up quickly. I had a biopsy which revealed a 3/4 and several 3/3 on the right side. I reason given for not total ablation was the 3/3 on the right was not a concern at the time. (3/4 on right side).


    Any comments. I love my sex life even at 70 YRS.

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  • 12tugod
    12tugod CSN Member Posts: 23 Member
    #34


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  • Old Salt
    Old Salt CSN Member Posts: 1,693 Member
    #35

    Several of us posted earlier that therapy should be considered because cancerous foci have been detected. Note that there could be more because a biopsy samples only a small portion of the prostate. Consequently, a rise in PSA is not unexpected and it's likely that your PSA will continue to go up beyond the current value (5.4 ng/ml). You really don't want the cancer to spread outside of the prostate!

    Whereas surgery MAY have consequences, several radiation therapies are unlikely to affect your sex life long-term. Please read up on brachytherapy (there are two kinds), Stereotactic Body Radiation Therapy SBRT) and Intensity-Modulated Radiation Therapy (IMRT). After you have become somewhat familiar with these therapies, please consult the best radiation oncologist you can find to get his/her advice.

    You can also consult with the Johns Hopkins Active Surveillance group to see whether you CAN continue with AS. What does your current AS program recommend?

    Best wishes on the path forward.

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  • centralPA
    centralPA CSN Member Posts: 431 Member
    #36

    Most radiation seems to have a delayed effect on things like ED and incontinence, which would seem to make them suitable for a 70 year old who wants to keep on keeping on. I'd seek out an opinion.

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  • 12tugod
    12tugod CSN Member Posts: 23 Member
    #37

    Had a NM Pet/Ct Skull Base To Thigh: results:

    Impression

    1. PSMA avid lesion involving the prostate gland on left side consistent with a primary prostatic neoplasm.

    2. PSMA avid subcentimeter left external iliac lymph node consistent with a metastasis.

    Gallium-68 PSMA PET/CT SCAN

    DATE: 10/13/2023

    INDICATION: Malignant neoplasm of the prostate

    FINDINGS:

    Head/Neck:

    * No significant Gallium-68 PSMA avid abnormality is identified in the image portion of the head.

    * Streak artifact limits evaluation of the oral cavity.

    Chest:

    * Limited assessment of the lungs, due to low dose, thick slices, low lung volume technique obtained during shallow breathing.

    Mediastinum/Hilar:

    * No evidence of any abnormal Gallium-68 PSMA avid mediastinal lymphadenopathy.

    * No evidence of any abnormal Gallium-68 PSMA avid hilar lymphadenopathy.

    Axilla:

    * Right axillary lymph node with SUV 2.0.

    Lungs:

    * No evidence of any abnormal Gallium-68 PSMA avid lung nodules. Left lung base atelectasis.

    Pleura:

    * No evidence of pericardial/pleural effusion.

    Chest wall:

    * Unremarkable.

    Abdomen/Pelvis:

    * Liver: No suspicious focal Gallium-68 PSMA avid lesion identified within the liver.

    * Gallbladder: Gallbladder is unremarkable.

    * Spleen: No suspicious focal Gallium-68 PSMA avid lesion identified within the spleen.

    * Gastrointestinal tract:

    * Stomach: Unremarkable.

    * Bowel: Nonspecific bowel uptake is identified

    * Pancreas: Physiologic uptake identified.

    * Lymphadenopathy: Left external iliac lymph node, subcentimeter in size, SUV 16.1.

    * Peritoneum / mesentery: No abnormal Gallium-68 PSMA avid masses or lymph nodes seen in the abdomen or pelvis.

    * Kidneys, ureters and bladder: Unremarkable.

    * Prostate gland: Intense focal radiotracer uptake in the left prostate mid gland, SUV 7.6.

    Musculoskeletal:

    * Nonspecific Gallium-68 PSMA uptake is seen throughout the osseous structures with no focal uptake identified.

    * Multilevel degenerative changes are identified.

    * Right lower extremity intramuscular focus of increased uptake with SUV of 2.8.

    Skin/Subcutaneous tissue:

    * No abnormal Gallium-68 PSMA avid lessions found:


    Any comments: take note of last item and I was concerned about the right side. The test make no mention of right side

    only the HIFU left side!








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  • Clevelandguy
    Clevelandguy CSN Member Posts: 1,361 Member
    #38

    Hi,

    If I was in your shoes I would discuss the results of the PET scan with a Oncologist/Radiologist familiar with Prostate cancer. Your correct, your last biopsy showed cancer on your right side, thats why you need to discuss the results of the recent scan and biopsy.

    Dave 3+4

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  • 12tugod
    12tugod CSN Member Posts: 23 Member
    #39

    I think you right Dave 3+4. More confused at the end of PSMA report: * No abnormal Gallium-68 PSMA avid lessions found:

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  • 12tugod
    12tugod CSN Member Posts: 23 Member
    #40

    PSMA impression #1. 1. PSMA avid lesion involving the prostate gland on left side consistent with a primary prostatic neoplasm.

    Last comment: * No abnormal Gallium-68 PSMA avid lessions found

    Am I reading this wrong.

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  • Old Salt
    Old Salt CSN Member Posts: 1,693 Member
    edited October 2023 #41

    That last comment relates to your skin etc.

    What is relevant is the first paragraph (Impression). They found cancer in your prostate (no surprise there) and a lymph node.

    I can't explain the RIGHT vs LEFT issue.

    Further treatment will be necessary, but you already knew that, I think.

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