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Prostate size vs. PCa %

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Posted 4/2/2009 1:58 AM (GMT 0)
So, had the biopsy today...more uncomfortable than painful...about what I expected after reading myself silly on this site and others.  Uro noticed what he termed "an odd protuberance" extending from the left apex.  He's been doing this 17 years and said that was exceptionally rare.  Swell...I'd rather not be different...and, of course, in my paranoid mind it is certainly a pocket of cancer fighting its way out.  Uro took a couple extra core samples in that area...apologized for the two extra minutes and sticks.  What the heck, I figured...you're already up there...take a good look around.

Ultrasound showed a small prostate of about 20cc.  That stoked my paranoia as well.  It seems (to me) that high PSA readings are often caused by an enlarged gland...so having a (relatively high for my age) PSA and knowing that the prostate is small just seemed to make the likelyhood of PCa greater.  So, I went home and Googled it and found this summary http://cat.inist.fr/?aModele=afficheN&cpsidt=2930945 that seems to indicate there's some rational behind the thought.  And then I did some more thinking??? Do they detect more PCA in smaller prostates because it is simply a smaller area and 12 cores have a better chance of hitting something in a 20cc prostate than in an 80 cc prostate???  Or is it because of what I hinted above...high PSA leads to biopsy and small prostate rules out one cause of high PSA...making PCa more likely?  I need to stop reading/thinking so much (but it's so hard not to!!)

Results should be in Friday afternoon...will be an interesting 48 hours.

I'll work on the signiture thing if/when it needs updated Friday...until then...45 yrs. old 3 recent PSA tests all similar and averaged 3.06.

Posted 4/2/2009 4:32 AM (GMT 0)
Welcome Riverbend, as they say, I'm sorry your hear, but you have come to the right place for help. I am recently new here myself, and have found invaluable support here fromt he members.
I too had a very small prostate not exactly sure on the cc, but measured 3.5cmx3.0cmx2.5cm. I think this may be about the same as yours around 20-25cc. Doc only shot 8 cores, because I assume there was only a small target. 6 out of 8 positive as you can see by my signature.
My total tumor volume was 0.98cm (3 sep tumors), so again my tumor size was small, less than 10% of prostate volume, which I believe is a pretty good result.
Good Luck with your results on Friday!.........and stay positive
Posted 4/3/2009 8:40 PM (GMT 0)
Biopsy results today...positive.  Of course, I wished for negative...but if it had to be positive, I almost wish it had been a "worse" result...I know that sounds horrible, but the decision making process for guys my age with stats like mine is agonizing...especially in light of all of the "overtreatment" talk out there now.

Posted 4/3/2009 10:10 PM (GMT 0)
Hey riverbend...sorry for the news, but at least now you know. The percentage of cancer is small and with the gleason grade of 6, you will have plenty of time to decide what you want to do. The numbers may even qualify for active surveillance (AS)...but at your age your doctor may think differently and with good reason. But because all treatments have some side effects (including AS), take the time to properly research all options and then make the best decision.

Sorry you had to join this club so young...but lots of folks here that have vast knowledge in all of the treatment forms and will be glad to give you their take on them.

Best of luck to you...and you are right with your stats...makes it really hard to know what to do.
Posted 4/3/2009 11:34 PM (GMT 0)
riverbend

Welcone to the board that no one should have to join but now you are no longer alone. My path. report did not give a cc weight but gave a size of 6.5 x 4.0 x 0.7 cm. Gland involvement was less than 10%. Your 3 + 3 = 6 Gleason suggest a very treatable PC. I'm sure you have more test scheduled and consultation with your urologist concerning treatment options. Study as much as you can in the mean time and remember you are no longer alone. All the best to you from here on out. Hang in there.
Posted 4/4/2009 12:04 AM (GMT 0)
Riverbend-
Sorry you have to be here, but it sounds like you caught it early and have a fantastic shot for a cure. Take your time, and do your research (which you are obviously already doing). Let us know how we can continue to help!
Posted 4/4/2009 4:49 PM (GMT 0)

Riverbend,

Sorry you are here but welcome.  As you can see from my stats I was in a similar situation as you and can absolutely sympathize with you in regard to making a decision.  It was an agonizing process for me and I made that decision in a time when all these studies came out questioning whether treatement was even nessasarry for most.   After briefly considering active survalance and ruling out radiation because of my age, I opted for an rrp.  I had a small focal point of cancer according to the biopsy…thing about a biopsy is that you don’t know if there is more cancer than was detected or if that cancer is dangerously close to the margins.  My thought was  there is no advantage to early detection if you don’t treat the problem.

Anyway I wanted to share some of the factors that played into my decision making process.  Best of luck!  Take your time, do your research, make sure you are at peace with whatever treatment you choose…I took me a few month to be at peace with my decision. 

Regards,

Steve

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