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1st Uro visit post biopsy

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Posted 4/23/2010 11:32 PM (GMT 0)

Greetings, Folks-

Well... Hello!  First Post.

2 days ago, I received the news from my Uro by phone that my biopsy was positive for PCa.  Yesterday, I spent all day trying to catch my breath, and today I spent visiting a bunch of websites to learn more, especially treatment options, of course. I can now rattle off 8 treatment options, with pros and cons. I have also scanned a bunch of threads on this forum that were pertinant to me at this early time. I intend to buy and read a couple of books recommended on this forum.  No doubt a well-informed, caring, and helpful group of folks here. 

My question:  I meet with the Uro next Wed. for initial consultation to go over the biopsy rpt and a bunch of other stuff I am sure. What should I not overlook to bring back from that initial meeting?  I have written down a lot of questions or topics to cover if not addressed in the review.  I just don't want to forget something I don't know yet (huh?!). 

Now, understand I know virtually nothing as compared to what I will know after that meeting.  Here is all I know.  PSA done at the internist was 6, after trending from the 3's to a lower 4, then the jump.  The Uro says Gleason 6, slow growth, early onset. Nothing more - the rest I learn on Wed. Now these nmbrs dont necessarily jive with those spoken here in what seems like a foreign language, a language in which I necessarily will soon become proficient.

So, advice on preparing for the first consultation with the Uro to review biopsy results would be appreciated.

Thank you,

Hal

age 55

Posted 4/24/2010 12:03 AM (GMT 0)
Welcome Hal, sorry that you have to be here, but you have found a good spot for your questions. Others will weight-in. I can only tell you about my boipsy experience and initial meeting with Uro. My biopsy glaeson was (3+4 = 7). My Uro told me about the same thing that yours told you. Slow growing, early onset. He tended to down-play the seriosness of the condition. The problem was that I ended up having a gleason 8, and the 3.5 months that I waited to have surgery was probably ill advised. I don't want to worry that your biopsy was mis-read. Just strongly consider getting a second opinion on the biopsy.
Posted 4/24/2010 12:55 AM (GMT 0)
Hal,
My biopsy showed a very aggressive PCa so I opted for immediate robotic surgery. I'm glas that I took action right away. If you are in Austin (I live in Austin) and if you opt for surgery then you have access to one of the best robotic surgeons in the country.
Posted 4/24/2010 1:45 AM (GMT 0)
Hal, welcome to our corner of the world.

With your initial stats, the good news is that you have plenty of time to study, learn, and ponder any potential primary treatment. Don't let your doctor push you into some just because. Its even possible, once you see the full results of your biopsy report, that no immediate action is even needed.

Please keep us posted, and when you get more info, set up a signature at the bottom of your posts, makes it easier for people to understand where you are at in your journey.

Good luck


David in SC
Posted 4/24/2010 2:12 AM (GMT 0)
Welcome,

Sounds like you do not need to hurry. I opted for surgery because I thought it had better chances of getting rid of the cancer, and better options if it didn't get rid of it. Glad I did now. Every case is different, so I think that after you study the options and ponder what best suits you, one of them will feel right. Ask the Doctor what happens if your PSA rises after the first tretment and compare options at that point. Keep us posted.
Posted 4/24/2010 4:21 AM (GMT 0)
Hey, Hal, bummer news. I remember how freaked out I was when the doctor called --- and he was so calm about it, he just left a message on our answering machine. There's a reason my user name here is "Sleepless.' "Basket Case" would have done as well.

Lots of good advice above, and more will come. However, one critical thing stands at the top: Get Your Slides Re-read. Pathology is an art as well as a science. Two top prostate tissue people can come to different conclusions. If they do, then you go with the worst case in making your treatment plan. If they both agree you are a 3+3 Gleason then you can take the summer to golf and figure out what to do next.

I had my slides re-read and while it didn't make a difference to urgency of treatment, it did make a difference to my treatment decision.

Keep us posted on what you learn.

Sheldon AKA Sleepless
Posted 4/24/2010 1:23 PM (GMT 0)
Welcome to the club, sorry you had to join... smilewinkgrin Your experience so far seems to match mine, psa's slowly increasing from 3 to 4 to 5, with a sudden increase to 7.6, antibiotics and recheck to 6.7. I will be interested in hearing what the uro has to say. I can't offer much advice for you now, as the others have covered it good, so be sure to come back and let us know what the discussion was, ok?
Posted 4/24/2010 1:46 PM (GMT 0)
Hal, Sorry you are having to be here. Some told you that the G score went up after surgery. Mine was different biopsy was 3+4=7 after surgery it came back 3+3=6. I was one of the lucky ones.

One of the question I whis I had asked my Dr was. "What % of his patients with a 3+3 G score after surgery not no ED problems or should I say Have ED Problems? Same question for Continence.

That is the one questions that I did not ask.

Cajun Jeff
Posted 4/24/2010 5:08 PM (GMT 0)
Be sure to get copies of all your reports as well. The doctor will read and tell you a lot of stuff, but if you get written copies of the report, you can review and study it later when you can think more clearly.

Welcome to HW. We will go with you on your journey.
Posted 4/24/2010 6:11 PM (GMT 0)
Hal, Best of luck to you. 1. What my background pattern is in the biopsy samples. 2. Number of positive cores and the location of the individual cores 3. Percentage of each positive core 4. Estimated volume of prostate 5. Have a copy of the complete pathology report in your hand when you exit the office, You’ll kick yourself if you don’t. (the report is yours don’t let the office staff keep you from having a copy). If they tell you it is going to take an hour …wait, read a book, change your oil in your car, do what ever, just get the report.
Posted 4/24/2010 8:12 PM (GMT 0)
Thanks Folks - this is what I was looking for. I've added more lines of interest to my 1 1/2 pages of notes I am preparing to take to the consultation. I appreciate your insights.

A bit off topic, but relative:  should I advise the Uro at this mtg of my interest in visiting with a Da Vinci surgeon and a Oncology Radiologist (assuming those remain options)?  Do most Uros encourage the patient to get other professional opinions?

Posted 4/25/2010 1:02 AM (GMT 0)
HM - Again, a welcome.
If you only have 1 1/2 pages of questions, you need some more. I don't have the link in front of me, but there is a list on another site, also the link is in a post from the past here - look for 'Stan Klein'. I'll check it later and update here.

Also, at the top of this page there is a thread for info. It is a combination of a lot of experience, so we all will want you to read it.

If the Uro does not insist that you talk to each of a DaVinci, open, and radiation oncology specialist, he should have, and you should undertake that on your own. You need all those opinions, knowing that all will suggest their specialty, but at least get success, ED, and incontinence estimates from each, if they were to do what they suggest.

Take a mini recorder with you to each session. If you ask, the docs will likely say sure, no problem. I was amazed how much I missed.
Posted 4/25/2010 1:59 AM (GMT 0)
142:    Haha, I hear ya. Did I mention its a legal pad with 2 columns of Q's?  It's been 72 hrs since the notice and I've been all over the web, etc; after that exercise in both basic and detail knowledge, I have found this forum and its wealth of knowledge and reality filling in a lot of the blanks, and for that I thank you all.  I've got 72 more hours to add to that list before the app't.  I see the sticky, but haven't gone there - yet.  I have not used the search function as I should because current posts keep my brain, and gotta admit, emotions at full throttle.  Scratched one Q off - I was gonna bring a recorder and hope he says yes.

To the participants of this forum - your compassion, experiences and love to those of us new to this cancer is so important and is invaluable.  For those of us over 50, 'man-talk' around the campfire rarely includes whats going on with our crotch.  (BTW - spouse perspective, to me, is very important - spouses, keep posting, please).  It's nice to have a place to go where you can be open and honest. We're all in this together...   

Thanks, y'all

Hal

Posted 4/25/2010 7:39 AM (GMT 0)
Links for question list -
www.healingwell.com/community/default.aspx?f=35&m=1300628
www.yananow.net/questions.htm
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