Just received my Prostate Cancer diagnosis

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Campisi
Campisi Member Posts: 4 *

I'm 63 years old and in otherwise excellent health. High PSA prompted a Prostate Biopsy procedure.

  • 3.2 on 1/15/2019
  • 3.6 on 10/14/2022
  • 6.8 on 4/30/2024
  • 5.0 on 5/234/2024 (check on reading from 4/30/24)

Did Biopsy on 6/24/24, 14 cores, 2 of the 14 cores showed problems. Below are the summaries:

PROSTATE, RIGHT BASE, BIOPSY -- PROSTATIC ADENOCARCINOMA, GLEASON SCORE 3 + 4 = 7(PATTERN 4 = <5% OF TOTAL TUMOR, GRADE GROUP 2), INVOLVING 1 OF 2CORES (TUMOR MEASURES 2 MM IN A 12 MM CORE; TUMOR MEASURES 0 MM INA 15 MM CORE) -- INTRADUCTAL CARCINOMA (IDC) (SEE BELOW)

A focus of cribriformglands with an intact basal cell layer consistent with intraductalcarcinoma (IDC). The presence of IDC raises the possibility of moreun-sampled pattern 4 tumor in the prostate. Clinical and imagingcorrelation is suggested.

PROSTATE, LEFT MID, BIOPSY -- PROSTATIC ADENOCARCINOMA, GLEASON SCORE 3 + 3 = 6(GRADE G ROUP 1), INVOLVING 1OF 2 CORES (TUMOR MEASURES 1 MM IN A 14MM CORE; TUMOR MEASURES 0 MM IN A 15 MM CORE)

My doctor rated this as "Stage 1" and gave me options of aggressive treatment or Active Surveillance. I immediately chose AS because I don't want to deal with side effects of surgery. I never considered radiation but maybe I should re-think that? I say this after coming here and reading what others have experienced. Did I choose AS too quickly?

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  • centralPA
    centralPA Member Posts: 313 Member
    edited July 9 #2
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    Did your doctor not have you do an MRI first?

  • Marlon
    Marlon Member Posts: 45 Member
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    Do you think you will eventually need surgery? Yes the surgery was no picnic, but radiation will also have side effects. I had the choice of treatments, and my decision was based on knowing I had cancer, and wanting it out of my body as quickly as possible.

  • Campisi
    Campisi Member Posts: 4 *
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    My doctor did not mention an MRI. I feel like I've learned a lot more since I had that discussion with my Urologist. I should talk with her again. She did offer to set me up with a 2nd opinion and I said "No. I'll go AS". Maybe I should revisit that and get some kind of imaging procedure. "Clinical and imaging correlation is suggested." That's a quote from the pathologist (see above). Is that an MRI that he/she is suggesting? I will say that I am the type of person that doesn't care if there's cancer in my body as long as the risk of doing AS is moderate to low.

  • Campisi
    Campisi Member Posts: 4 *
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    Thank you both for your comments/questions.

  • centralPA
    centralPA Member Posts: 313 Member
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    Well, whoever recommended the biopsy without first requesting an MRI, I would fire them and never look back. It is absolutely standard of care to look for lesions first, then do the biopsy both targeting any identified lesions, and doing a sample on a grid. Biopsy samples are pretty small and it is fairly easy to miss lesions, if you don’t know what you’re shooting for. You can be positive and not have any lesions, but typically people that are positive will have specific lesions in their prostate.

    my recommendation for your next step is to get the MRI. You’ll need to wait up to 90 days for your prostate to heal so you can get a clear image, which is another reason to get the MRI first. But no matter what, get a Doctor who is applying the standard of care.

  • Campisi
    Campisi Member Posts: 4 *
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    Turns out I'm pretty glib about my health - I said above I was otherwise healthy, well, actually I had a heart attack when i was 58. Had 3 blockages on the LAD artery, two stents put in, third was too small to stent. Funny, but I AM pretty 'healthy', LOL. 5'9", 155 lbs, never smoked or drank other than socially, always been a runner (have run 35 marathons and numerous other races competitively for my club) and train on an almost daily basis. So I kinda 'forgot' about that heart attack! Never had so much as a warning on that one and nothing, so far, ever again. Now this … great.🙄

  • Old Salt
    Old Salt Member Posts: 1,420 Member
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    PROSTATE, RIGHT BASE, BIOPSY -- PROSTATIC ADENOCARCINOMA, GLEASON SCORE 3 + 4 = 7(PATTERN 4 = <5% OF TOTAL TUMOR, GRADE GROUP 2), INVOLVING 1 OF 2CORES (TUMOR MEASURES 2 MM IN A 12 MM CORE; TUMOR MEASURES 0 MM INA 15 MM CORE) -- INTRADUCTAL CARCINOMA (IDC) (SEE BELOW)

    A focus of cribriform glands with an intact basal cell layer consistent with intraductal carcinoma (IDC). The presence of IDC raises the possibility of moreun-sampled pattern 4 tumor in the prostate. Clinical and imaging correlation is suggested.

    Unfortunately, the above finding should be taken seriously. I would consult with a (prostate cancer) center of excellence to see what the best follow-up would be.

    https://www.cancer.gov/research/infrastructure/cancer-centers

  • lesjanes
    lesjanes Member Posts: 26 Member
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    Well, everyone is different. I am like Marlon, I want it out and that will happen in 2 days. The members on this board are very saavy and have very useful information. So I think you have come to the right place to gather more information before you make a decision you are comforable with.

  • Clevelandguy
    Clevelandguy Member Posts: 1,087 Member
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    Hi,

    Got to agree with other survivors that have chimed in, get an MRI after your prostate heals and also add in a PET scan to look for spread outside of the Prostate. Then you can make a decision on what kind of treatment plan to follow. Based on what your current doctor did I would get a second opinion from another doctor team/hospital network.

    Dave 3+4