New and Overwhelmed

ASAdvocate said:

Hopeful and optimistic has

Hopeful and optimistic has asked the necessary questions, but I will add one more. Was there an MRI before the biopsy, or was it a systemic (blind) procedure?

The reason you hear of someone having a low risk biopsy, and then a high risk biopsy or post-RP report is not becasue the cancer grew fast, but because the first biopsy missed the more serious lesion(s).

As h&o said, the concern with a lot of Gleason 6 is that there is an increased risk of higher grade cancer that was not sampled by the biopsy needles. So, the percentage of cancer in the cores is important.

I've never heard of a CT scan for a "pre-volume study". What is the reason for that?

This is why I am overwhelmed.

I'm going to try to answer both posts w/1 post.

1st. I had a Prostate Biopsy done in 2016, because the doctor was "concerned", my PSA went from low 4.x to 7.x 

He ordered an MRI than and there were lesions. He was not overly concerned but wanted to get a "Base Biopsy" so to speak to establish where we were. Based on the Biopsy than, negative with anomalies that could turn cancer. 

... Over the 4 years from 2016, my PSA climbed until it reached 10.1 for which than he ordered another MRI. The lesions had grown and a couple of news ones were in this one.

... He than strongly suggested another MRI - Infused Prostate Biopsy and core samples were taken.

... The Core samples ranged from 10% to 25 % and one was 50%

After the 2020 Biopsy, Doctor stated, "Okay, you have Prostate Cancer ... but it's low risk." But he sent me to the Hospitals Prostate Cancer Care Oncologist / Radiation Therapy.

Here I was told a basic message of "Don't worry ..." to literally saying, "You are on the precipice of being serious." ??

As stated one of the therapies: Seed Implants, I am unable to have, because I am allergic to some of the Pre & Post Op medications.

I was handed a print out from: NCCN - National Comprehensive Cancer Network and was told I was in the "FAVORABLE INTERMIDIATE RISK GROUP".

So that left 2 options on the table:

.... Removal of Prostate.

... An external Radiation Therapy. Not the Seed Implant one. ( NOT Proton )

.... The "Pre-Volume Study" CT Scan was to see if I can have the External .. bone and physiology were going to work.

Basically if Dr. Alex Hsi, pronounced " C " ... says I'm not a candidate for that, the Surgery is apparently the only option available, which again does not excite me, at this moment. But than, it would seem the choice has been made for me.

At this point, I'm seriously leaning towards Active Surveillance .. because I'm being told - Don't worry, it does not grow that fast ... and yet I'm reading some similar reports from my OP.

Now even two close friends went through the same " growth spurt " and they have friends too. Where it was G-6 and 1 went to G-7 in 3 months, the other G-8 in 5 months. So it would seem, even in my ' small circle ', wow, and if it's because other " cancer cells were hiding " .

Sorry, I'm really just trying to wrap my brain around all of this and was not allowed some time to " decompress " ... than late yesterday I was told I have ".. Several Complex Renal Cyst .. "" in my L-Kidney and apparently that's a "FLAG"... So much for having time to decompress! . o O ( Sigh ... )

Hope this helps?

>> THANKS SO MUCH!! From all that I have read this is an amazing group of guys!  

ASAdvocate said:

Your Available Treatment Options

I'm a bit more conservative about AS when there are more than three cores involved, especially one with fifty percent involvement. I would be thinking treatment if I were you.

Since you aren't enthusiatioc about surgery, why are your being told that your other options are limited? Does high dose rate brachytherapy use those drugs that you are adverse to; or are they only used for low dose (seeds)?

Why is proton beam therapy beinjg ruled out? That has great results, and protons centers are rapidly multiplying. Was only IMRT offerered? Whar about SBRT/Cyberknife? That also shows impressive results, and only requires five sessions.

And, some men are happy with HIFU and the new TULSA-PRO protocol. Those appear to have few lasting side effects. You want to find the treatment that you are most confident with, even if that means seeking another provider that offers it.

ASA - Basically I was told the "Seed" treatment was off the table. 

Oh, they could do it, but it would involve staying the in hospital overnight to insure no reactions ( something about one or more drugs specific to "seed implant" ) The techno jargen went over me. The Doctor just told me, some of the meds for that specific treatment I am allergic to, thus it would be best if it's off the table. I had to agree.

We will be looking at other treatments on Aug. 10. I see Dr. Alex Hsi ( "C" ) and will go over the options. 

I'm 65 years odd, as stated and have had more surgeries since I was 20 years odd than I care to list. So I've gotten to the point that unless I'm told YOU NEED THIS ... I hold off. I'm just tired of surgeries and this one seems to hold on longer than 1 - 2 years side effects, than I want to deal with, unless I'm left with no choice. Than the choice is made for me. :P

Also, which is not listed ... part of the "cloud" is that with my last Colonoscopy, there were too many pulups that were borderline on the cancer side. Instead of the 5 year bump, they had to bump me to 3 years. I have one next year. IF that's cancer ... than apparently the situaion gets "complicated" ... so I am hearing it might be best to wait until after the colonoscopy to see what that shows?

I have 2 Challenges thrown at me ... and being reminded things like this come in 3's. :P So, NO I'm not excited if a 3rd hardball decides to get thrown at me.