Recently diagnosed

Jacquet
Jacquet Member Posts: 29

I was recently diagnosed with PC. Gleason score of 6 (one core positive), PSA 18. Had a bone scan and MRIboth came back excellent. My prostate is enlaged and accordig to the doctor hard in one area and my doctor believes that my prostate sufferes from a cronic infection (the hardness) and that may be contributing somewhat to the higher PSA. I have not discused any options with my doctor, that will come on the 20th of Feb. My doctor says not to panic, I'm not going anywhere in the near future. The doctor expressed to me that she is hopeful and optimistic that it was caught early enough and survival looks great.

 

So yes i will take imediate and forcegul action, but I'm looking for some others to chime in. I realize that we are not all doctors, but actual survivors with similar conditions.

 

What say yee?

 

J

«13

Comments

  • Jacquet
    Jacquet Member Posts: 29
    The gleason was one in 12

    The gleason was one in 12 cores

  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,333 Member
    in error

    .

  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,333 Member
    Option

    To avoid an active treatment option where there can be side effects that can be major, "active surveillance with delayed treatment" is an option.

    Various institutions have criterias; I believe for example Johns Hopkins criteria for low, low risk prostate cancer, that is indolent cancer, not likely to spread is less than 2 cores, less that 50percent involement in each, (that is less thatn 50 percent of the core that is cancerous, a psa of less than 10 and a ratio of less than 0.15 psa/prostte size.

    There are various tests to confirm this ; MRI with a 3.0 magnet to show if there is extracapsular extension.

    There are drugs such as cipro that can be given to see if any potential infection will clear and the PSA number will fall.

    I suggest that you speak with an expert of active surveillance.

    Oh by the way get a second opiniion on your biopsy slides by a world class pathologist since determining Gleason is subjective. This way you will not be over or under treated. In some cases those who have initially been diagnosed with prostate cancer actually do not have the disease

     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 with LRPC, is similar to initally treated patients , 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 if necessary, and still make the same  active treatment decision that   I initially would have choosen.

  • Jacquet
    Jacquet Member Posts: 29

    Option

    To avoid an active treatment option where there can be side effects that can be major, "active surveillance with delayed treatment" is an option.

    Various institutions have criterias; I believe for example Johns Hopkins criteria for low, low risk prostate cancer, that is indolent cancer, not likely to spread is less than 2 cores, less that 50percent involement in each, (that is less thatn 50 percent of the core that is cancerous, a psa of less than 10 and a ratio of less than 0.15 psa/prostte size.

    There are various tests to confirm this ; MRI with a 3.0 magnet to show if there is extracapsular extension.

    There are drugs such as cipro that can be given to see if any potential infection will clear and the PSA number will fall.

    I suggest that you speak with an expert of active surveillance.

    Oh by the way get a second opiniion on your biopsy slides by a world class pathologist since determining Gleason is subjective. This way you will not be over or under treated. In some cases those who have initially been diagnosed with prostate cancer actually do not have the disease

     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 with LRPC, is similar to initally treated patients , 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 if necessary, and still make the same  active treatment decision that   I initially would have choosen.

    Good advice!

    I'm retired military so all of this is coming from a military doctor, but I think she is a good one. I wil seek a second opinion as I have some contacts up at JH where my wifes is a patient at the Wilmer eye clinic. In the meantime I have an appointment with the doctor on the 21st of Feb to go over some treatment options. She did mentione taht Active Surveiilance is an option.

     

    Thanks for the information. I really think this is one of the best places for information that I have come across.

  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,333 Member
    Jacquet said:

    Good advice!

    I'm retired military so all of this is coming from a military doctor, but I think she is a good one. I wil seek a second opinion as I have some contacts up at JH where my wifes is a patient at the Wilmer eye clinic. In the meantime I have an appointment with the doctor on the 21st of Feb to go over some treatment options. She did mentione taht Active Surveiilance is an option.

     

    Thanks for the information. I really think this is one of the best places for information that I have come across.

    I remember reading that

    a Dr. Carter is in charge of the Active Surveillance program at Johns Hopkins. I think that I read that they also have a panel that evaluates new patients and treatment options. The pathology department there is one of the top, if not the top in the world.

    Also suggest that you continue your research, read , research, research....books, go to local support groups......there are two national organizations that you can goggle for a local group near you......"us too" and "man to man"

    Please keep us in the loop.

  • Jacquet
    Jacquet Member Posts: 29

    I remember reading that

    a Dr. Carter is in charge of the Active Surveillance program at Johns Hopkins. I think that I read that they also have a panel that evaluates new patients and treatment options. The pathology department there is one of the top, if not the top in the world.

    Also suggest that you continue your research, read , research, research....books, go to local support groups......there are two national organizations that you can goggle for a local group near you......"us too" and "man to man"

    Please keep us in the loop.

    First, I want to thank everyone on this site for their support and information, it has really hepled me understand and loose my fear. The latest from my doctor:

    The one core out og 12 that came back positive is 10% of the total core volume. Up until then, the other biopsies (4 in the past 5 years) all came back negative.

    PSA is 23.88

    I do have a lot of benign tissue with atrophy

    Also have a fair amount of inflamation

    last DRE revealed that there is some calcification as well, but there do not appear to be any "lumps" that would indicate tumor.

    Bone scan came back perfect as well as the abdominal MRI.

    I have had 5 DRE's since first being diagnosed and all the doctors agree that it is highly likely a good part of the high PSA is the result of inflamation due to infection. My doctor took the time to sit down with me and my wife and explain that the gleason score of 6 (3+3)  is like golf, the lower the score the better. She explained thet there are other lower scores, but that in her 20+ years she has never seen one. So she has me on antibiotics twice a day for 4 weeks and then a PSA  and DRE within 5 days of finishing the mediation. She explained that if my PSA drops at all then that is a good sign and it it gets below 10 that is really good news, and they will determine if more antibiotics are needed. A doctor from each of the disciplines discussed Surgery, beam radiation, and seeds as courses of action. So all said and done, my doctor advised to wait and see if the antibiotics have an impact, and then decide on a treatment option. She also advised taht is my PSA dropped really low dow below 4, that I could be in a monitoring mode with DRE every 60 days, biopsy at least 2 time a year.

     

    So I think that my doctor is giving me good advice and I trust her. Glad to have access to such great care. I do value any thoughts and information from those who have been down the road, bad and good.

     

    Thanks All

     

    Jacquet

     

     

  • Jacquet
    Jacquet Member Posts: 29

    I remember reading that

    a Dr. Carter is in charge of the Active Surveillance program at Johns Hopkins. I think that I read that they also have a panel that evaluates new patients and treatment options. The pathology department there is one of the top, if not the top in the world.

    Also suggest that you continue your research, read , research, research....books, go to local support groups......there are two national organizations that you can goggle for a local group near you......"us too" and "man to man"

    Please keep us in the loop.

    First, I want to thank everyone on this site for their support and information, it has really hepled me understand and loose my fear. The latest from my doctor:

    The one core out og 12 that came back positive is 10% of the total core volume. Up until then, the other biopsies (4 in the past 5 years) all came back negative.

    PSA is 23.88

    I do have a lot of benign tissue with atrophy

    Also have a fair amount of inflamation

    last DRE revealed that there is some calcification as well, but there do not appear to be any "lumps" that would indicate tumor.

    Bone scan came back perfect as well as the abdominal MRI.

    I have had 5 DRE's since first being diagnosed and all the doctors agree that it is highly likely a good part of the high PSA is the result of inflamation due to infection. My doctor took the time to sit down with me and my wife and explain that the gleason score of 6 (3+3)  is like golf, the lower the score the better. She explained thet there are other lower scores, but that in her 20+ years she has never seen one. So she has me on antibiotics twice a day for 4 weeks and then a PSA  and DRE within 5 days of finishing the mediation. She explained that if my PSA drops at all then that is a good sign and it it gets below 10 that is really good news, and they will determine if more antibiotics are needed. A doctor from each of the disciplines discussed Surgery, beam radiation, and seeds as courses of action. So all said and done, my doctor advised to wait and see if the antibiotics have an impact, and then decide on a treatment option. She also advised taht is my PSA dropped really low dow below 4, that I could be in a monitoring mode with DRE every 60 days, biopsy at least 2 time a year.

     

    So I think that my doctor is giving me good advice and I trust her. Glad to have access to such great care. I do value any thoughts and information from those who have been down the road, bad and good.

     

    Thanks All

     

    Jacquet

    PS: sorry for the double posting, not quite got the hang of it yet

     

  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,333 Member
    Jacquet said:

    First, I want to thank everyone on this site for their support and information, it has really hepled me understand and loose my fear. The latest from my doctor:

    The one core out og 12 that came back positive is 10% of the total core volume. Up until then, the other biopsies (4 in the past 5 years) all came back negative.

    PSA is 23.88

    I do have a lot of benign tissue with atrophy

    Also have a fair amount of inflamation

    last DRE revealed that there is some calcification as well, but there do not appear to be any "lumps" that would indicate tumor.

    Bone scan came back perfect as well as the abdominal MRI.

    I have had 5 DRE's since first being diagnosed and all the doctors agree that it is highly likely a good part of the high PSA is the result of inflamation due to infection. My doctor took the time to sit down with me and my wife and explain that the gleason score of 6 (3+3)  is like golf, the lower the score the better. She explained thet there are other lower scores, but that in her 20+ years she has never seen one. So she has me on antibiotics twice a day for 4 weeks and then a PSA  and DRE within 5 days of finishing the mediation. She explained that if my PSA drops at all then that is a good sign and it it gets below 10 that is really good news, and they will determine if more antibiotics are needed. A doctor from each of the disciplines discussed Surgery, beam radiation, and seeds as courses of action. So all said and done, my doctor advised to wait and see if the antibiotics have an impact, and then decide on a treatment option. She also advised taht is my PSA dropped really low dow below 4, that I could be in a monitoring mode with DRE every 60 days, biopsy at least 2 time a year.

     

    So I think that my doctor is giving me good advice and I trust her. Glad to have access to such great care. I do value any thoughts and information from those who have been down the road, bad and good.

     

    Thanks All

     

    Jacquet

     

     

    Dear Jacquet,

    I think that the anitbiotics are a good idea; hopefully the psa will decline...wait and see what happens.

    If you are in a monitoring mode, "active surveillance with delayed treatment" as I am, which is fairly likely, especially if the PSA declines under 10, a biopsy twice a year is too often...I think that you meant to say a PSA test twice a year.

    In the protocol that I have, I had a biopsy with a doctor. The doctor that I see after the initial diagnosis, did a biopsy one year after, and then another one after a year...the one that I have scheduled in June 2013 is 2 years after. Please feel free to click my name to see what I have been doing , the results of my tests, and additional information about an"active surveillance" protocol that you can read..

     

    I am not sure what you mean by an adominal MRI...please detail

    Anyway, so far so good.

     

  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,333 Member
    Jacquet said:

    First, I want to thank everyone on this site for their support and information, it has really hepled me understand and loose my fear. The latest from my doctor:

    The one core out og 12 that came back positive is 10% of the total core volume. Up until then, the other biopsies (4 in the past 5 years) all came back negative.

    PSA is 23.88

    I do have a lot of benign tissue with atrophy

    Also have a fair amount of inflamation

    last DRE revealed that there is some calcification as well, but there do not appear to be any "lumps" that would indicate tumor.

    Bone scan came back perfect as well as the abdominal MRI.

    I have had 5 DRE's since first being diagnosed and all the doctors agree that it is highly likely a good part of the high PSA is the result of inflamation due to infection. My doctor took the time to sit down with me and my wife and explain that the gleason score of 6 (3+3)  is like golf, the lower the score the better. She explained thet there are other lower scores, but that in her 20+ years she has never seen one. So she has me on antibiotics twice a day for 4 weeks and then a PSA  and DRE within 5 days of finishing the mediation. She explained that if my PSA drops at all then that is a good sign and it it gets below 10 that is really good news, and they will determine if more antibiotics are needed. A doctor from each of the disciplines discussed Surgery, beam radiation, and seeds as courses of action. So all said and done, my doctor advised to wait and see if the antibiotics have an impact, and then decide on a treatment option. She also advised taht is my PSA dropped really low dow below 4, that I could be in a monitoring mode with DRE every 60 days, biopsy at least 2 time a year.

     

    So I think that my doctor is giving me good advice and I trust her. Glad to have access to such great care. I do value any thoughts and information from those who have been down the road, bad and good.

     

    Thanks All

     

    Jacquet

     

     

    .

    .

  • VascodaGama
    VascodaGama Member Posts: 3,491 Member

    in error

    .

    Diagnosis of Low risk cancer

    Jacquet

    Your diagnosis so far refers to a low risk type of cancer. Gleason pattern of 3 (Gs 6) and only one out of twelve needles positive, and negative image studies. AS would be recommended by most of the doctors weren’t there a high PSA.

    Your doctor is recommending well for you to wait and check for the results from the anti-inflammatory protocol. In any case the high PSA could be due to other factors not just due to inflammation or cancer. Sex on the night before drawing blood or riding a bike or even hard stool could cause the PSA to spike from 18 to 23.

    The revelation of existing calcification at the prostate should be confirmed in the biopsy samples. In fact the biopsy should have been done including and aiming at those spots felt in the DRE.

    Should your treatment to control inflammation not drive the PSA down, you could wait for the results of still another periodical biopsy aiming at other inner areas of the prostate, and get more specific types of image studies with better contrast agents and higher image resolutions.

    Any radical approach (prostatectomy or radiation) can arm you and deprive you of quality of living. Low aggressive cancers may never bother or be prejudice to normal living. One may well die from other causes.

    Can you share more details of the pathologist report?

     

    Take your time and do things coordinately. Cancer does not spread overnight.

    Wishing you luck in your journey.

    VGama  Wink

  • Jacquet
    Jacquet Member Posts: 29

    Diagnosis of Low risk cancer

    Jacquet

    Your diagnosis so far refers to a low risk type of cancer. Gleason pattern of 3 (Gs 6) and only one out of twelve needles positive, and negative image studies. AS would be recommended by most of the doctors weren’t there a high PSA.

    Your doctor is recommending well for you to wait and check for the results from the anti-inflammatory protocol. In any case the high PSA could be due to other factors not just due to inflammation or cancer. Sex on the night before drawing blood or riding a bike or even hard stool could cause the PSA to spike from 18 to 23.

    The revelation of existing calcification at the prostate should be confirmed in the biopsy samples. In fact the biopsy should have been done including and aiming at those spots felt in the DRE.

    Should your treatment to control inflammation not drive the PSA down, you could wait for the results of still another periodical biopsy aiming at other inner areas of the prostate, and get more specific types of image studies with better contrast agents and higher image resolutions.

    Any radical approach (prostatectomy or radiation) can arm you and deprive you of quality of living. Low aggressive cancers may never bother or be prejudice to normal living. One may well die from other causes.

    Can you share more details of the pathologist report?

     

    Take your time and do things coordinately. Cancer does not spread overnight.

    Wishing you luck in your journey.

    VGama  Wink

    recently diagnosed

    VGama,

     

    Without typing a bunch of information in:

    2 came back with Acute Inflamation no malignancy,

    2 came back with atrophy no malignancy,

    1 came back positive with a core %10,

    7 were normal

     

    Jacquet

  • VascodaGama
    VascodaGama Member Posts: 3,491 Member
    Jacquet said:

    recently diagnosed

    VGama,

     

    Without typing a bunch of information in:

    2 came back with Acute Inflamation no malignancy,

    2 came back with atrophy no malignancy,

    1 came back positive with a core %10,

    7 were normal

     

    Jacquet

    Molecular Profiling

    Jacket

    Thanks for sharing the details.

    Is there any other info regarding the type of cancerous cells? Have they identified only adenocarcinoma?

    The typical prostate cancer is formed at the outer layers of the prostate which makes it critical to check for hard “bumps”.
    Not to worry you but, I have read cases where atrophy was connected to cancer that produces low levels of PSA notwithstanding of being aggressive.
    Atrophy could indicate a breakdown of tissues, involving cellular apoptosis. This is considered in some cases as a cause of low supply of androgens to cells metabolism. In other words, your prostatic cells could have the characteristics and behave as “self-sufficient”, producing its own androgens to survive.

    This apotheosis in your diagnosis with high PSA could well lead to think that the main cause is the acute inflammation; however, since you have been diagnosed with the bandit, now you will have to be vigilant and follow your status with constant periodical test, but any future biopsy would be done only to check for cancer volume (positive cancer found in other areas of the prostate) or to look for higher aggressivity (worse Gleason patterns). I think that such biopsy would be required if you are “set” to follow AS (no radical treatment). Otherwise, I would recommend you to request for other means of testing the progress.

    Due to “atrophy”, I would recommend you to get a testosterone test. I would also recommend you to check your bone health (dexa scan). Free PSA to get the real antigen level, and other markers to follow progress more closely; such as PAP (Alkaline Phosphatase). Also track liver enzymes ALT, AST and as well as BUN and the creatinine.

    In modern monitoring of cancer doctors are recommending to get a DNA profile to more precisely identify the medicines that will work or not in your system. I would recommend you to do it if affordable to you. It will be the way to control cancer with the newer drugs, existent now or in development, that will revolutionize the way we/they treat our prostate cancer cases.

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1069086/

    http://www.urotoday.com/Treatment-of-mCRPC/successful-treatment-of-advanced-metastatic-prostate-cancer-following-chemotherapy-based-on-molecular-profiling-beyond-the-abstract-by-charles-e-myers-md.html?mkt_tok=3RkMMJWWfF9wsRonv6zPZKXonjHpfsX86eklULHr08Yy0EZ5VunJEUWy2YIJSdQhcOuuEwcWGog80B5XCfSUaIVG9edIBg%3D%3D

     

    I wish you good results from your anti-inflammatory treatment.

    Best wishes.

    VGama  Cool

  • Jacquet
    Jacquet Member Posts: 29

    Molecular Profiling

    Jacket

    Thanks for sharing the details.

    Is there any other info regarding the type of cancerous cells? Have they identified only adenocarcinoma?

    The typical prostate cancer is formed at the outer layers of the prostate which makes it critical to check for hard “bumps”.
    Not to worry you but, I have read cases where atrophy was connected to cancer that produces low levels of PSA notwithstanding of being aggressive.
    Atrophy could indicate a breakdown of tissues, involving cellular apoptosis. This is considered in some cases as a cause of low supply of androgens to cells metabolism. In other words, your prostatic cells could have the characteristics and behave as “self-sufficient”, producing its own androgens to survive.

    This apotheosis in your diagnosis with high PSA could well lead to think that the main cause is the acute inflammation; however, since you have been diagnosed with the bandit, now you will have to be vigilant and follow your status with constant periodical test, but any future biopsy would be done only to check for cancer volume (positive cancer found in other areas of the prostate) or to look for higher aggressivity (worse Gleason patterns). I think that such biopsy would be required if you are “set” to follow AS (no radical treatment). Otherwise, I would recommend you to request for other means of testing the progress.

    Due to “atrophy”, I would recommend you to get a testosterone test. I would also recommend you to check your bone health (dexa scan). Free PSA to get the real antigen level, and other markers to follow progress more closely; such as PAP (Alkaline Phosphatase). Also track liver enzymes ALT, AST and as well as BUN and the creatinine.

    In modern monitoring of cancer doctors are recommending to get a DNA profile to more precisely identify the medicines that will work or not in your system. I would recommend you to do it if affordable to you. It will be the way to control cancer with the newer drugs, existent now or in development, that will revolutionize the way we/they treat our prostate cancer cases.

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1069086/

    http://www.urotoday.com/Treatment-of-mCRPC/successful-treatment-of-advanced-metastatic-prostate-cancer-following-chemotherapy-based-on-molecular-profiling-beyond-the-abstract-by-charles-e-myers-md.html?mkt_tok=3RkMMJWWfF9wsRonv6zPZKXonjHpfsX86eklULHr08Yy0EZ5VunJEUWy2YIJSdQhcOuuEwcWGog80B5XCfSUaIVG9edIBg%3D%3D

     

    I wish you good results from your anti-inflammatory treatment.

    Best wishes.

    VGama  Cool

    VGama,

    Thanks for all the insight. I will definately talk about these other ideas with mu doctor when I go back for my PSA test in about 2 weeks. I'm retired military and work for the government so procedures and cost are not usually any problem. So far, the antibiotics seem to at least be maing urination a little better, could be due to reduced swelling. I also seem to have more energy lately. You mentioned the things that can make PSA go up, and I seem to remember that just a day or do before the last test I was out in the yard chopping wood to relieve some stress.

    Might be why it spiked from 18 to 22/23

     

    Jacquet

  • Jacquet
    Jacquet Member Posts: 29
    Jacquet said:

    VGama,

    Thanks for all the insight. I will definately talk about these other ideas with mu doctor when I go back for my PSA test in about 2 weeks. I'm retired military and work for the government so procedures and cost are not usually any problem. So far, the antibiotics seem to at least be maing urination a little better, could be due to reduced swelling. I also seem to have more energy lately. You mentioned the things that can make PSA go up, and I seem to remember that just a day or do before the last test I was out in the yard chopping wood to relieve some stress.

    Might be why it spiked from 18 to 22/23

     

    Jacquet

    So I did the month long treatment withhigh dose cipro and went in for a PSA check It dropped from about 22 down to 20, but my Dr. thinks taht is not enough so she is recomending DaVinci. She specializes in theprocess and has performed arount 80 of the procedures and she is pretty conficant. I'm ok with that. I asked her about cyberknife and she said it was good but that the military does not do that.

  • VascodaGama
    VascodaGama Member Posts: 3,491 Member
    Jacquet said:

    So I did the month long treatment withhigh dose cipro and went in for a PSA check It dropped from about 22 down to 20, but my Dr. thinks taht is not enough so she is recomending DaVinci. She specializes in theprocess and has performed arount 80 of the procedures and she is pretty conficant. I'm ok with that. I asked her about cyberknife and she said it was good but that the military does not do that.

    Could be Micrometastases

    Jacket

    I am sorry for the outcome. The PSA should be much lower after the antibiotic treatment.

    Not to stress something here but some guys have reported about their experience in treating inflammation with different medicines because some bacteria does not “clear” as expected. You could still try to get a urine culture test if you think it would give you peace of mind.

    Mean while you can do your homework researching about treatments. You could get more specific image studies with higher resolution equipment (3-tesla MRI, choline contrast) to verify for any spread. Low Gleason cancer with High PSAs are usually related to micrometastases cases, to which radicals are limited. These are done with defined targets otherwise they cannot assure cure.

    Yours and mine cases are different but to inform you; I also was a low Gs (2+3=5) with high PSA=22.4 and negative traditional image studies, choose prostatectomy but soon after recurrence indicated that I had micrometastases. Later I had Salvage Radiation but that did not cure me too. Specialists indicated again that I was confronting micrometastases. I now believe that what was missing in my initial diagnosis was a proper image study, but at the time (2000) they were not available. The image techniques  are now more precise in detecting small colonies of cancer. I would suggest that you explore this "field" and try to get the best diagnosis possible, and affordable to you.

    You may think that I am proposing you to do nothing but such is not the case. I think you should move forwards but coordenately. Do not jump into anything without fully checking for the pros and cons on a therapy. All treatments for PCa got side effects and some may not be acceptable to you.
    Typically doctors suggest their “trade” as the best approach (your present doctor  Yell ) but typically the outcome suggest the contrary. Remmenber that she will request you, before the operation, to sign an agreement relieving her/him of any wrong doings or outcomes. You will acknowledge that you know what you are doing. Unfortunately this happens everywhere, even in the military.

    Accordingly you need to read a lot and discuss about the disease, its treatments and consequences. Many guys treat indolent cancer that may not cause a problem during their life time, and many get so scary that just want to get rid of it, no matter the consequences.
    Many of those become more involved with the problem of confronting the side effects than the causes of the cancer.

    I think that you got enough time to educate in all type of treatments that best would fit you and your family. I also recommend you to look for modern facilities/hospitals and experienced specialists with many years on the "trade". You also should get several second opinions from specialists in each field (out of the military compound).

    You will need a list of questions when confronting the doctors. Here are some ideas to prepare your own list;

    http://www.cancer.org/Cancer/ProstateCancer/DetailedGuide/prostate-cancer-talking-with-doctor
    http://www.cancer.net/patient/All+About+Cancer/Newly+Diagnosed/Questions+to+Ask+the+Doctor

    A compendium on Prostate cancer and care;

    http://prostate-cancer.org/decision-aide/where-to-start/prostate-basics/

     

    I wish you luck in your journey.

    VGama  Wink

  • Kongo
    Kongo Member Posts: 1,166 Member
    Jacquet said:

    So I did the month long treatment withhigh dose cipro and went in for a PSA check It dropped from about 22 down to 20, but my Dr. thinks taht is not enough so she is recomending DaVinci. She specializes in theprocess and has performed arount 80 of the procedures and she is pretty conficant. I'm ok with that. I asked her about cyberknife and she said it was good but that the military does not do that.

    Incorrect Information

    Your doctor has given you incorrect information regarding CyberKnife, which in my lay opinion, is an excellent choice for treating your low risk cancer.  I am also retired military and Tricare covered the complete cost of my CyberKnife procedure in 2010.  They also paid for the six consulting sessions I had with various experts in the field and I hope you avail yourself of this great benefit by seeking the advice of other specialists.

    By the way, 80 DaVinci procedures does not make an expert.  Not by a long shot.  Most experts agree that a urologist should have performed several hundred DaVinci procedures.

    I appreciate that you like your urologist but you need to seek other expert opinions.  If you do proceed with surgery, make sure you understand the considerable risks to your quality of life.  (This goes for any procedure)

    K

  • Jacquet
    Jacquet Member Posts: 29

    Could be Micrometastases

    Jacket

    I am sorry for the outcome. The PSA should be much lower after the antibiotic treatment.

    Not to stress something here but some guys have reported about their experience in treating inflammation with different medicines because some bacteria does not “clear” as expected. You could still try to get a urine culture test if you think it would give you peace of mind.

    Mean while you can do your homework researching about treatments. You could get more specific image studies with higher resolution equipment (3-tesla MRI, choline contrast) to verify for any spread. Low Gleason cancer with High PSAs are usually related to micrometastases cases, to which radicals are limited. These are done with defined targets otherwise they cannot assure cure.

    Yours and mine cases are different but to inform you; I also was a low Gs (2+3=5) with high PSA=22.4 and negative traditional image studies, choose prostatectomy but soon after recurrence indicated that I had micrometastases. Later I had Salvage Radiation but that did not cure me too. Specialists indicated again that I was confronting micrometastases. I now believe that what was missing in my initial diagnosis was a proper image study, but at the time (2000) they were not available. The image techniques  are now more precise in detecting small colonies of cancer. I would suggest that you explore this "field" and try to get the best diagnosis possible, and affordable to you.

    You may think that I am proposing you to do nothing but such is not the case. I think you should move forwards but coordenately. Do not jump into anything without fully checking for the pros and cons on a therapy. All treatments for PCa got side effects and some may not be acceptable to you.
    Typically doctors suggest their “trade” as the best approach (your present doctor  Yell ) but typically the outcome suggest the contrary. Remmenber that she will request you, before the operation, to sign an agreement relieving her/him of any wrong doings or outcomes. You will acknowledge that you know what you are doing. Unfortunately this happens everywhere, even in the military.

    Accordingly you need to read a lot and discuss about the disease, its treatments and consequences. Many guys treat indolent cancer that may not cause a problem during their life time, and many get so scary that just want to get rid of it, no matter the consequences.
    Many of those become more involved with the problem of confronting the side effects than the causes of the cancer.

    I think that you got enough time to educate in all type of treatments that best would fit you and your family. I also recommend you to look for modern facilities/hospitals and experienced specialists with many years on the "trade". You also should get several second opinions from specialists in each field (out of the military compound).

    You will need a list of questions when confronting the doctors. Here are some ideas to prepare your own list;

    http://www.cancer.org/Cancer/ProstateCancer/DetailedGuide/prostate-cancer-talking-with-doctor
    http://www.cancer.net/patient/All+About+Cancer/Newly+Diagnosed/Questions+to+Ask+the+Doctor

    A compendium on Prostate cancer and care;

    http://prostate-cancer.org/decision-aide/where-to-start/prostate-basics/

     

    I wish you luck in your journey.

    VGama  Wink

    Thanks VGama,

     

    My post got cut short. I'm not concerned that my Dr. is pushing one or the other. She is telling me taht the only option taht they offer at the military hospital is then DaVinchi. In the mean time she has scheduled me to get the MRI procedure you mentioned. It will be done at Walter Reed. She wants to make sure that if there are micro tumors.

    I'll check out the links you provided.

     

    Jacquet

  • Jacquet
    Jacquet Member Posts: 29
    Kongo said:

    Incorrect Information

    Your doctor has given you incorrect information regarding CyberKnife, which in my lay opinion, is an excellent choice for treating your low risk cancer.  I am also retired military and Tricare covered the complete cost of my CyberKnife procedure in 2010.  They also paid for the six consulting sessions I had with various experts in the field and I hope you avail yourself of this great benefit by seeking the advice of other specialists.

    By the way, 80 DaVinci procedures does not make an expert.  Not by a long shot.  Most experts agree that a urologist should have performed several hundred DaVinci procedures.

    I appreciate that you like your urologist but you need to seek other expert opinions.  If you do proceed with surgery, make sure you understand the considerable risks to your quality of life.  (This goes for any procedure)

    K

    Kongo,

    Yes I can use my TriCare if i want another procedure. My Dr. has sugegsted that I explore it and that may be the right choice. At the military hospital taht I'm being seen at, they only have DaVinci. So my options are still open. She is dsending me to Walter Reed for an MRI that includes the induction coil in the colon to get a better view and check for Micro's as Dgama has suggested could be.

     

    I have a friend who also had the Cyber Knife about 5 years ago and so far he has had no further issues, so I will be checking into it and I'll weigh the options. I really appreciate the informatio. If you would, could I askyou to share more information? Not personal but jdut things like any effects, recovery time, etc.  

  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,333 Member
    Jacquet said:

    Thanks VGama,

     

    My post got cut short. I'm not concerned that my Dr. is pushing one or the other. She is telling me taht the only option taht they offer at the military hospital is then DaVinchi. In the mean time she has scheduled me to get the MRI procedure you mentioned. It will be done at Walter Reed. She wants to make sure that if there are micro tumors.

    I'll check out the links you provided.

     

    Jacquet

    googled options

    http://vets.yuku.com/topic/64411#.UXFwI7Vg8g8

    http://www.naturalnews.com/027643_prostate_cancer_veterans.html

  • Kongo
    Kongo Member Posts: 1,166 Member
    Jacquet said:

    Kongo,

    Yes I can use my TriCare if i want another procedure. My Dr. has sugegsted that I explore it and that may be the right choice. At the military hospital taht I'm being seen at, they only have DaVinci. So my options are still open. She is dsending me to Walter Reed for an MRI that includes the induction coil in the colon to get a better view and check for Micro's as Dgama has suggested could be.

     

    I have a friend who also had the Cyber Knife about 5 years ago and so far he has had no further issues, so I will be checking into it and I'll weigh the options. I really appreciate the informatio. If you would, could I askyou to share more information? Not personal but jdut things like any effects, recovery time, etc.  

    Go to Georgetown

    It seems like you are in the DC area.  I suggest that you investigate CK at Georgetown Medical Center that has an advanced CyberKnife center.

    In my own case, I've posted frequently about my experiences with Cyberknife and I would urge you to check them out on this forum.  I have had no issues at all with Cyberknife.  Easy procedure.  No ill effects afterward but I would encourage you to visit a CyberKnife doctor directly and not take advice from strangers on the internet.

    Good luck to you.

     

    K