Furious with urologist

 Hubby went for his biopsy this morning.  Wouldn't let me go.  Said it wouldn't be bad, nothing I could do, etc.  OK.  No problem.
He came home and said the urologist told him (and showed him on the ultrasound) that he had cancer. Urologist did 6 cores. He had told us Tuedsay that he would do 12+! I AM FURIOUS that he only did 6. Of course hubby took that as a good sign- must not be bad, etc. I wanted to tell him, but didn't- that it might NOT be such a good sign. Hubby said it looked to him like about 30 % of the prostrate was affected and that it couldn't have spread because it didn't look 'spider-like'. I told him that didn't indicate anything. Prostrate cancer can spread via blood and lymph, etc and not 'look' bad. Urologist did say that the bladder 'looked good'. Oh- and the urologists said once he got the pathology report he'd see if he needed to order bone scans, ct scans, etc. Hubby took that as good ,too, because Tuesday the urologist had said he WOULD be ordering them. I don't want to discourage hubby- and won't say anything- I want him to keep positive. But I am afraid he is being a bit too optimistic and not realistic at all. Now he's saying no need for a second opinion.... etc.
I guess it's just my thought processes. I'd rather get as much info as possible. Prepare myself for the worst- then if it's better, great. If not, I'm prepared to handle it.
Still wish they had done more than 6 cores. Just doesn't seem prudent to do so few.

I have a related-but-opposite story. My first urologist took 6 cores (old school--modern potocol is 12) and found NO cancer, despite rapidly-rising PSA (and no BPH or other indications of non-cancerous ways to increase the PSA). He shoulda taken 12 cores, as by the time of my next biopsy--cancer was WAAY too evident AND the pc had expanded beyond the "capsule". Maybe, maybe not, but I think if the urologist had done his 12 cores, he might have found something that we could have worked on BEFORE it escaped the capsule. Can't "prove" it either way, and the Gleason 9 monster within me might well have "taken off" from zero to T3 in short order.

Since your urologists found cancer in the six cores, what difference, really, would 12 cores have made??

But a second opinion is a good thing, and warranted here, methinks. There is the "danger" of different interpretations of the same data. Like a man with two watches never really knows what time it is!!

I think you are getting mad for the wrong reasons. The number of cores in this case is no longer material, he came back positive for PC. I had 3 biopsies. 12 core, a year later 12 core, then 2 months later only 7 core, it was the 7 core one that found the cancer, with all 7 being positive.

My wife never came with me for any of them, my choice, I am a big boy and knew her busy nursing schedule would made it hard for her to get the time off.

The scans next, are usual and typical, and rarely serve any purpose other than establishing a base line for the future.

So what were the results? How many positive cores? What was the Gleason assigned? Does he know any of this yet, or are you having to wait?

Will be looking for an update, good luck.

david

Wow, I am sure you will hear from many people that will tell you to get a second opinion. Please do so. When I had my biopsy they did 12, 6 on one side and 6 on the other, that is how they properly obtain the Gleason score. 3+3=6 was mine and that tells you how aggressive the cancer is. When I had my surgery done by Johns Hopkins here in Maryland they would not even talk to me unless their pathologist had taken a look a my slides. Their are many options now that a patient has to choose from, please take in consideration his age and how aggressive the cancer is. I am 46 years young and by no way did I want to jeopardize my sex life and to deal with incontinence for the rest of my life. I chose robotic prostatectomy (nerve Sparing). It has been six weeks since my surgery and I am working through the incontinence and impotence issues.

Regardless of your decision please be there for your husband and never assume he is ok with any of his options or results. Tell him every day that you are there for him and you both will get though this together. Like I said I have had my surgery, however, I am still scared of what my remaining life will be like dealing with this life altering disease.

On the lighter side, Doctor said that I am progressing extremely well and should be back to a comfortable level sooner than later. So your husband, with your help, can get through all of this with good communication with all of your doctors and don't hesitate to ask questions because no two cancers and recoveries are the same. Good luck and God bless you both.

The number of cores may have to do with your insurance provider. Mine (a big national company) will only allow 6. Just 6. Someone said it was old school, but they still only pay 6, old or new.

Now, on the other hand, my uro is aggressive, and did 12 anyway. At the time I didn't know anything about it, so I did what he said to do. It caused quite an insurance battle, and in the end, Bostwick wrote off the costs for the extra 6 as a courtesy to me. It would have been a very expensive issue if they had not.

So don't be angry with the uro until you know the circumstances.

My reading is this Uro is "guessing" that prostate cancer is present owing to the variation of shading on the ultrasound used to guide the biopsy needles. While the shading may indicate suspicious areas there is no pathology yet so there is no definite tumour. Unusual that he states he can "see" the tumour.

I hope your husband does not treat this lightly. If PC is confirmed, I sure hope he considers all the options that are available to him. There are no do-overs and there are SE that will last a lifetime.

Good luck to you.

Hey worriedabouthubby,

Don't be angry with the Uro for only taking 6 samples. Odds are he is like mine and knew something had to be done after performing the DRE and seeing hubby's PSA. My PSA was 22 and I had planned on surgery before I even had the biopsy. That's why I picked my uro/surgeon in the first place. At our first meeting he did the DRE and could readily feel the tumor. He said he was required to do the biopsy before he could schedule surgery but the results would not be surprising nor would they change my treatment decision.

Also like hubby when I first got my high PSA results I truly believed there was a mix-up in the hospital. They gave me someone else's results. Poor guy.
I think they call that Denial !

Jeff in NY