Excellent News Today

hopeful and optimistic
hopeful and optimistic Member Posts: 2,333 Member
edited June 2011 in Prostate Cancer #1
As part of the Active Surveillance protocol that I am under, today I received the results from my third biopsy. There were six samples that were targeted using an MRI machine, and eleven that were random for a total of seventeen...............all were benign......I will be having another biopsy in two years, and at least a DRE and PSA in six months, an office visit. Last year there were 3 that three that were targeted and eleven that was random...all clean.....two yars ago in 3/09 when I was diagnosed, 2 of 12 were postive, 3+3=6 with less than 5 percent involvement...except for this PSA, all others were about the same at about 2.5.

Additionally this time, my PSA results were elevated. It was 3.9 versus my average of 2.5.....I did ride a bike the day before which may account fot the PSA rise....my doc focused 100 percent on biopsy ...and zero on the PSA.

Comments

  • Beau2
    Beau2 Member Posts: 261
    Great news!
    Ira,

    Congratulations on the good news. No PCa detected ... fantastic!

    You rode a bike before a PSA !?!? Sounds like a rookie mistake...., or something I would do.

    Here's hoping for more good biopsies.
  • Beau2
    Beau2 Member Posts: 261
    Great news!
    Ira,

    Congratulations on the good news. No PCa detected ... fantastic!

    You rode a bike before a PSA !?!? Sounds like a rookie mistake...., or something I would do.

    Here's hoping for more good biopsies.
  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,333 Member
    Beau2 said:

    Great news!
    Ira,

    Congratulations on the good news. No PCa detected ... fantastic!

    You rode a bike before a PSA !?!? Sounds like a rookie mistake...., or something I would do.

    Here's hoping for more good biopsies.

    Thanks for the good wishes
    Your right, it was a rookie mistake........I was thinking that I was only going for a biopsy....which wasn't true at all.......in fact, in addition to a PSA, I had a PCA3(no fun at all), a blood test, a questionnaire to fill out......I also had an enigma before, and had to drive home in stop and go traffic on the freeway for about two hours, feeling where the needles went into my prostate during the ride............what a day of fun
  • VascodaGama
    VascodaGama Member Posts: 3,491 Member

    Thanks for the good wishes
    Your right, it was a rookie mistake........I was thinking that I was only going for a biopsy....which wasn't true at all.......in fact, in addition to a PSA, I had a PCA3(no fun at all), a blood test, a questionnaire to fill out......I also had an enigma before, and had to drive home in stop and go traffic on the freeway for about two hours, feeling where the needles went into my prostate during the ride............what a day of fun

    Let's celebrate with a glass of red-wine
    Hopeful
    Should we celebrate with a glass of red-wine?
    Good news indeed. Hope for more similar excellent news in two years time.
    I would appreciate if you explain about the PCA3 (no fun at all) test. There exist very few reports on this important “tool” for the diagnosis of PCa which is reported as better than PSA.

    Congrats
    VGama
  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,333 Member

    Let's celebrate with a glass of red-wine
    Hopeful
    Should we celebrate with a glass of red-wine?
    Good news indeed. Hope for more similar excellent news in two years time.
    I would appreciate if you explain about the PCA3 (no fun at all) test. There exist very few reports on this important “tool” for the diagnosis of PCa which is reported as better than PSA.

    Congrats
    VGama

    PCA3
    This test is a new investigational ( only an indicator) urine gene test that is available. The test is a molecular biologic assay. This test has a specificity of 75% and a sensitivity of 57%. (What that means is that among 100 bad tumors, for example, they only can identify 75 of them. And among 100 good tumors, they identify them as bad in 57). The test is done by a doctor who does a DRE and vigorously massages(the fun part...my doc is very experienced, has muscles on his finger, and can make a grown man cry) the prostate; the patient gives urine and the results are sent to Bostwick Laboratories(the only laboratory that does this) for analysis. It is a pretty expensive test, at I think about $500.

    So the way the results work, 35 is the magic number, so the less one score is below 35 the better. Mine was 8.3 "Prostatic cells are present but do not over express the PCA3 gene", "value of 35 or greater suggests a high likelihood of prostate cancer"

    It is also stated that only a prostate biopsy can diagnose prostate cancer. The test's preformance has been established by Bostwick Laboratories. It has not been approved by the United States Food and Drug administration and should not b4e used as the sole evidence for or against the diagosis of prtostate cancer. Clinicco-patholological correlation iws indicated.

    -------------------------------------------------------------------------

    Also here is something that I had found on the internet

    . I am about to have a prostate biopsy
    Can the PCA3 test replace a prostate biopsy?
    How does the PCA3 test help in making a decision about a biopsy?
    The Progensa™ PCA3 test is not a replacement for a prostate biopsy
    But the PCA3 test result can be a significant criterion in discussing the need for a biopsy. This is
    particularly true for males with an elevated PSA value in which an earlier biopsy was unsuspicious (“negative”).
    The result of a PCA3 test, given additional clinical and laboratory findings as well
    as the patient’s history, may lead to the joint decision between the patient and the doctor not to carry out a repeat biopsy.
    You can read a summary of the scientific basis for this conclusion here
    Latest research results demonstrate that the PCA3 test results make it possible to estimate the malignancy
    of an existing prostate cancer. This may result in sparing patients invasive therapy, should the test result
    indicate that the patient suffers from a carcinoma with a low malignant potential.
    You can read the opinions of practical urologists on the PCA3-test here
    Yes, I would like a PCA3 test
    How should I proceed? What is the next step?
    5. Opinions of practical urologists on the PCA3 test
    Prof. Dr. med. Bernd Schmitz-Draeger (Fürth, Germany) states:
    “… with a PCA3 score below 35 the risk for prostate cancer is decreased, above it is
    elevated.” Moreover he states “Let’s take a patient with a very low PCA3 value of – say
    - 5: this patient has a three-time lower risk as other patients with a similar PSA
    value. If we assume the risk for prostate cancer at 25% in patients with a PSA value
    between 4,0 and 10,0 ng/ml, then the patient with a low PCA3 score has a risk of 8%.
    This does not provide final certainty, but causes relief for the patient and the
    doctor.”

    4. I am about to have a prostate biopsy
    Can the PCA3 test replace a prostate biopsy?
    How does the PCA3 test help in making a decision about a biopsy?
    The Progensa™ PCA3 test is not a replacement for a prostate biopsy
    But the PCA3 test result can be a significant criterion in discussing the need for a biopsy. This is
    particularly true for males with an elevated PSA value in which an earlier biopsy was unsuspicious (“negative”).
    The result of a PCA3 test, given additional clinical and laboratory findings as well
    as the patient’s history, may lead to the joint decision between the patient and the doctor not to carry out a repeat biopsy.
    You can read a summary of the scientific basis for this conclusion here
    Latest research results demonstrate that the PCA3 test results make it possible to estimate the malignancy
    of an existing prostate cancer. This may result in sparing patients invasive therapy, should the test result
    indicate that the patient suffers from a carcinoma with a low malignant potential.
    You can read the opinions of practical urologists on the PCA3-test here
    Yes, I would like a PCA3 test
    How should I proceed? What is the next step?
    5. Opinions of practical urologists on the PCA3 test
    Prof. Dr. med. Bernd Schmitz-Draeger (Fürth, Germany) states:
    “… with a PCA3 score below 35 the risk for prostate cancer is decreased, above it is
    elevated.” Moreover he states “Let’s take a patient with a very low PCA3 value of – say
    - 5: this patient has a three-time lower risk as other patients with a similar PSA
    value. If we assume the risk for prostate cancer at 25% in patients with a PSA value
    between 4,0 and 10,0 ng/ml, then the patient with a low PCA3 score has a risk of 8%.
    This does not provide final certainty, but causes relief for the patient and the
    doctor.”
    ---------------------------------------------------------------------------
    Yes Celebrate, with Red wine, white wine, ginger ale, a walk in the sunshine, party or whatever you enjoy........celebrate every day
  • mrspjd
    mrspjd Member Posts: 694 Member

    PCA3
    This test is a new investigational ( only an indicator) urine gene test that is available. The test is a molecular biologic assay. This test has a specificity of 75% and a sensitivity of 57%. (What that means is that among 100 bad tumors, for example, they only can identify 75 of them. And among 100 good tumors, they identify them as bad in 57). The test is done by a doctor who does a DRE and vigorously massages(the fun part...my doc is very experienced, has muscles on his finger, and can make a grown man cry) the prostate; the patient gives urine and the results are sent to Bostwick Laboratories(the only laboratory that does this) for analysis. It is a pretty expensive test, at I think about $500.

    So the way the results work, 35 is the magic number, so the less one score is below 35 the better. Mine was 8.3 "Prostatic cells are present but do not over express the PCA3 gene", "value of 35 or greater suggests a high likelihood of prostate cancer"

    It is also stated that only a prostate biopsy can diagnose prostate cancer. The test's preformance has been established by Bostwick Laboratories. It has not been approved by the United States Food and Drug administration and should not b4e used as the sole evidence for or against the diagosis of prtostate cancer. Clinicco-patholological correlation iws indicated.

    -------------------------------------------------------------------------

    Also here is something that I had found on the internet

    . I am about to have a prostate biopsy
    Can the PCA3 test replace a prostate biopsy?
    How does the PCA3 test help in making a decision about a biopsy?
    The Progensa™ PCA3 test is not a replacement for a prostate biopsy
    But the PCA3 test result can be a significant criterion in discussing the need for a biopsy. This is
    particularly true for males with an elevated PSA value in which an earlier biopsy was unsuspicious (“negative”).
    The result of a PCA3 test, given additional clinical and laboratory findings as well
    as the patient’s history, may lead to the joint decision between the patient and the doctor not to carry out a repeat biopsy.
    You can read a summary of the scientific basis for this conclusion here
    Latest research results demonstrate that the PCA3 test results make it possible to estimate the malignancy
    of an existing prostate cancer. This may result in sparing patients invasive therapy, should the test result
    indicate that the patient suffers from a carcinoma with a low malignant potential.
    You can read the opinions of practical urologists on the PCA3-test here
    Yes, I would like a PCA3 test
    How should I proceed? What is the next step?
    5. Opinions of practical urologists on the PCA3 test
    Prof. Dr. med. Bernd Schmitz-Draeger (Fürth, Germany) states:
    “… with a PCA3 score below 35 the risk for prostate cancer is decreased, above it is
    elevated.” Moreover he states “Let’s take a patient with a very low PCA3 value of – say
    - 5: this patient has a three-time lower risk as other patients with a similar PSA
    value. If we assume the risk for prostate cancer at 25% in patients with a PSA value
    between 4,0 and 10,0 ng/ml, then the patient with a low PCA3 score has a risk of 8%.
    This does not provide final certainty, but causes relief for the patient and the
    doctor.”

    4. I am about to have a prostate biopsy
    Can the PCA3 test replace a prostate biopsy?
    How does the PCA3 test help in making a decision about a biopsy?
    The Progensa™ PCA3 test is not a replacement for a prostate biopsy
    But the PCA3 test result can be a significant criterion in discussing the need for a biopsy. This is
    particularly true for males with an elevated PSA value in which an earlier biopsy was unsuspicious (“negative”).
    The result of a PCA3 test, given additional clinical and laboratory findings as well
    as the patient’s history, may lead to the joint decision between the patient and the doctor not to carry out a repeat biopsy.
    You can read a summary of the scientific basis for this conclusion here
    Latest research results demonstrate that the PCA3 test results make it possible to estimate the malignancy
    of an existing prostate cancer. This may result in sparing patients invasive therapy, should the test result
    indicate that the patient suffers from a carcinoma with a low malignant potential.
    You can read the opinions of practical urologists on the PCA3-test here
    Yes, I would like a PCA3 test
    How should I proceed? What is the next step?
    5. Opinions of practical urologists on the PCA3 test
    Prof. Dr. med. Bernd Schmitz-Draeger (Fürth, Germany) states:
    “… with a PCA3 score below 35 the risk for prostate cancer is decreased, above it is
    elevated.” Moreover he states “Let’s take a patient with a very low PCA3 value of – say
    - 5: this patient has a three-time lower risk as other patients with a similar PSA
    value. If we assume the risk for prostate cancer at 25% in patients with a PSA value
    between 4,0 and 10,0 ng/ml, then the patient with a low PCA3 score has a risk of 8%.
    This does not provide final certainty, but causes relief for the patient and the
    doctor.”
    ---------------------------------------------------------------------------
    Yes Celebrate, with Red wine, white wine, ginger ale, a walk in the sunshine, party or whatever you enjoy........celebrate every day

    Cheers

    Congrats and wishes for continued success. This is very good news indeed! It almost seems as if there has been a “reversal” of the PCa! If I understood correctly, and not to second guess or question a good thing, wondering...did the doctor suggest any reasons why he thought the first biopsy pathology might have determined low risk, low % core positive PCa, but subsequent path reports for targeted biopsies came back clean/negative?
  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,333 Member
    mrspjd said:

    Cheers

    Congrats and wishes for continued success. This is very good news indeed! It almost seems as if there has been a “reversal” of the PCa! If I understood correctly, and not to second guess or question a good thing, wondering...did the doctor suggest any reasons why he thought the first biopsy pathology might have determined low risk, low % core positive PCa, but subsequent path reports for targeted biopsies came back clean/negative?

    Thanks for the good wishes
    The doctor did not discuss why the first patholoogy determined low risk cancer while the newer biopsies were clean, however, my guess is that only a small sample of the prostate has been sampled, and that cancer within the prostate is small, not large enough to be identified by the MRI machine, or that there is human error in taking a biopsy in the exact place identified by the MRI. In any case, I strongly believe that there is stil cancer within the prostate; however, I am an excellent candidate for Active Surveillance with Delayed Treatment.

    When I first choose AS as a treatment, I was uncomfortable with the decision, since the possible consequences are scary, however, as I am better educated about this treatment option, and the benefits of a closely monitored surveillance program, I am more and more comfortable with the decision I made to follow an active surveillance program, however I have concerns, that the technology to identify cancer within the prostate and the aggressveness of these cancers by type on a molecular level still need to improve in order to more effectively identify patients that need treatment versus those who do not. Additionally I think that developing a program of various markers that are current and new ones is another way to help in monitoring this disease among patients.
  • BRONX52
    BRONX52 Member Posts: 156

    Thanks for the good wishes
    The doctor did not discuss why the first patholoogy determined low risk cancer while the newer biopsies were clean, however, my guess is that only a small sample of the prostate has been sampled, and that cancer within the prostate is small, not large enough to be identified by the MRI machine, or that there is human error in taking a biopsy in the exact place identified by the MRI. In any case, I strongly believe that there is stil cancer within the prostate; however, I am an excellent candidate for Active Surveillance with Delayed Treatment.

    When I first choose AS as a treatment, I was uncomfortable with the decision, since the possible consequences are scary, however, as I am better educated about this treatment option, and the benefits of a closely monitored surveillance program, I am more and more comfortable with the decision I made to follow an active surveillance program, however I have concerns, that the technology to identify cancer within the prostate and the aggressveness of these cancers by type on a molecular level still need to improve in order to more effectively identify patients that need treatment versus those who do not. Additionally I think that developing a program of various markers that are current and new ones is another way to help in monitoring this disease among patients.

    Great news Ira----hopefully
    Great news Ira----hopefully all of your follow up tests will render the same results and you you won't have to worry about this beast any more---take care- Dan