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Recently Diagnosed

Gmann
Posts: 2
Joined: Feb 2020

Hello All,

Just looking for some input. Over the last 2 years my PSA has went from 3.06 to 5.5. My GP sent me to an urologist and he did a DRE. He informed me that all felt normal and my prostate was slightly enlarged but, he felt i should have a ultrasound biopsy. Two weeks later he performed the biopsy and again said he didn't see anything with ultrasound and if their was any cancer it would be microscopic. His nurse called me Tuesday and gave me the results of the biopsy. Out of 14 needles 7 came back positive. 4 of the 7 were 2-3% and 2 of the remaining 7 were 15% and the final one was 30%. She said I had a Gleason of 6. I meet with him Monday to disuss my options. I'm 58 years old overall good health a little overweight and no family history of any cancer. Not really sure what all that means and don't know what to expect. What little I have read stated that a Gleason 6 is a very low grade and some doctors don't even classify it as cancer. Thanks in advance!

 

VascodaGama's picture
VascodaGama
Posts: 3224
Joined: Nov 2010

Gmann,

Welcome to the board. Prostate cancer (PCa) is slow growing when comparing with other forms of cancers but they require attention and treatment even if they are made of well differentiated type of cells (Gleason rates below 3). The fact for having 7 positive cores out of 14 it classifies your risk at the top of the group Gs6. The voluminous cancer may justify the high PSA. Your next step is to identify if cancer has spreaded out of the gland. Ultrasound or CT images have limited possibility in detecting PCa so that in your shoes I would look for an mpMRI. This exam will provide better details from which you can formulate a decision.

Some doctors recommend to Gleason score 6 patients a sort of WW (watchful waiting) and some advice in follow a postponement type of action called Active Surveillance, that incorporates a series of vigilance commitments via periodical tests and exams. However, AS in certain clinics is only recommended to patients that fall into defined requirements. For instance; these should have a maximum of three positive needles, PSA lower than 3.5 ng/ml, negative EPE in MRI exams, etc.

I recommend you to get a good book on prostate cancer and read on the risks involved in each type of treatment. Discuss the matters with your family and take your time without rushing. Try finding a doctor you trust and consider the quality of life in all decisions.

Can you provide details of the biopsy report. What are the location of the positive cores? 

Best wishes and luck in this journey.

VGama

Clevelandguy
Posts: 583
Joined: Jun 2015

Hi Gmann,

Good advice from Vasco, even if its a 6 it is cancer and it possibly can grown and spread depending on where the cancer is(ie:deep inside or near the edge of the gland).  With AS you will need biopsies every so often to check the gleason score and size of the tumor.  No need to go nutzo yet but vigilance is needed.  Check back with updates and we will see if we all can help.  There are some AS guys on the board that have been AS for years and might chime in with some insight on what to expect. A second opinion once you gain more of a complete picture about your Pca might not be a bad idea if you feel a need to.

Dave 3+4

Gmann
Posts: 2
Joined: Feb 2020

I go in tomorrow for my follow up with my urologist. He is one of the top in the country and even though I'm not big on AS I'll will more than likely do what he recommends. As I'm just in the beginning of this adventure i would lie if said I was not concerned but I'm not scared. I have a really close friend that is a pathologist and he is also looking at my report. He pretty much assured me that the chances that my cancer has spread at this point is "slim to none and slim as left the house". He did say that my urologist will more than likely recommend some type/types of treatment since My PSA has increased rather quickly in the last two years. I'm thinking I just want it gone. I'm not real excited about the radiation options from what I've read. Removal might be best for me as I'm not much of a watch and wait guy. I guess when I meet with him tomorrow I'll know more about what's going on. Thanks Again!!!

Chaunceym
Posts: 3
Joined: Apr 2020

Found myself in a similar spot and opted for removal. Radiation can kill cancers but also damages other things and never gets any better. With removal you can recover and function normally in all ways even sexually. Obviously it's your decision to make and I recommend you do all the research you can in order to make the best choice for you. God bless and good luck!!

lighterwood67's picture
lighterwood67
Posts: 264
Joined: Feb 2018

I would echo all the above, but there is no need to.  3/18 RARP.  Gleason 4+3=7.  Status:  Fully continent; intimate with wife; most importantly PSA undetectable.  Good luck on your journey.

curren
Posts: 4
Joined: May 2020

Hi everyone, Sorry if I sound a little scater brianed but was just diagnosed. PSA 15 (in Sep. 2019 PSA was 3) I have had CT scan April 9th nengative, MRI a week ogo showing something insde the prostate and two spots on my tailbone, A Bone scane showing two hot spots on tailbone but no wear else on skeleton. Did prostrate biopsy and 5 0f 6 cores showes 60 to 90% Gleason score 9 (4+5) grade group 5. Dr is starting me on Hormone therapy. I want to go to a cancer center preferably on the Weat coast, any recommendations and or thoughts on my situation would be greatly appreciated!

Georges Calvez
Posts: 458
Joined: Sep 2018

Hi Curren,

Can you start a new forum topic for your problem?
This is Gmann's topic so it is less confusing if people do not post new problems into his topic.
Copy your stuff and then go to the front page, choose Add new Forum topic and then paste your stuff into the first post.
I could do it for you if you like.
When you have done this we can discuss your case further.

Best wishes,

Georges

curren
Posts: 4
Joined: May 2020

Thank you, Grorges!!

 

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