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Newly diagnosed and confused by the numbers

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Posted 6/28/2013 1:08 AM (GMT 0)
I was diagnosed with the following parameters:

PSA 3.6
7/12 cores with cancer
Gleason score 6

I am confused why this is considered T1C, where per my reading it looks like T2C - am I missing something?
Thank you
Posted 6/28/2013 1:24 AM (GMT 0)
Age
Distribution of the 7 (R .. V .. L)
Percentage of each core
Family Hx

My best
Posted 6/28/2013 1:29 AM (GMT 0)
Keep in mind this is initial staging and a best estimate of where you stand at the moment. To get to T2, you typically need to be at a point where the doctor can feel it on a DRE or else it shows up on some kind of imaging. As of right now, you've had PSA tests and needle biopsy with something in both sides...thus the T1C. You may, indeed, be T2 but just may not have had other tests confirm or suggest that (yet).

The "good" news at this point is that you are G6 based on the needles only and you also have a reasonable PSA number. You have lots of options. Congratulations on catching this at what seems fairly early in the process.

..
Posted 6/28/2013 3:02 AM (GMT 0)
Hey jojo-

Sorry you have to be here, but glad we can be a resource for you. I strongly recommend reading the 3 links at the bottom of my signature (especially the first one).

T1C means that the doctor couldn't feel any irregularities in your prostate during a rectal exam, and the only reason it was found at all was due to biopsies after discovery of an elevated PSA. T2C means that the doc can feel the tumor in your prostate during a rectal exam on both lobes of the prostate. See here for more info: en.wikipedia.org/wiki/Prostate_cancer_staging.

-Gedman
Posted 6/28/2013 3:20 AM (GMT 0)
Hi jojo,

Your clinical stats put you in the "low-risk" category per D'Amico classification and you should likely have all options on the table.

My #1 advice is to pick up Patrick Walsh's book "Surviving Prostate Cancer" 3rd edition. It is excellent.

People here are a great resource too, so ask away...
Posted 6/28/2013 9:08 AM (GMT 0)
jojo1397-

The staging for PCa has nothing to do with the biopsy findings. It's only based on the DRE supplemented with any subsequent imaging (e.g., an MRI) if it was done.

You are categorized as "low risk" but not "very low risk." You are nonetheless a good candidate for Active Surveillance as well as radical therapies. Take your time.

- Allen
Posted 6/28/2013 10:44 AM (GMT 0)
Jojo,
It does appear that you are in a position to take the time to determine which (if any) treatment is right for you. Take heart in the fact that there is indeed quality life after a PC diagnosis.
Posted 6/28/2013 10:55 AM (GMT 0)
Welcome jojo. Sorry you have to be here, but you found the right place. Ask questions and do your research, it brings peace of mind. The links gedman has provided are a good start. Learn all you can, and be your own advocat. There is a lot of good info out there. You are in a place where you have time on your side to do what's best for YOU.

Mike
Posted 6/28/2013 7:13 PM (GMT 0)
logoslidat,
Biopsy or clinical stage is used for risk stratification purposes to help one decide on appropriate treatments. Post-op stage is called the pathological stage and has a p in front (e.g., pT2c). It tells you what was actually there.
Posted 6/28/2013 10:15 PM (GMT 0)
Logo,

I can't speak to your case other than to say that T2b means that a tumor was felt or imaged in more than one half of one lobe, but not both lobes. If nothing was felt or imaged, your stage was T1c.

The American Joint Committee on Cancer (AJCC) agreed on staging criteria based on their analysis of risk. My understanding is that it is palpation and imaging that determines stage:"Tumor found in one or both lobes by needle biopsy, but not palpable or reliably visible by imaging, is classified as T1c."

In addition to clinical stage, highest Gleason score, # positive cores, % cancer in the cores, and PSA are factored into the current NCCN risk stratification scheme. The CAPRA risk stratification scheme also includes age.

- Allen
Posted 6/28/2013 11:58 PM (GMT 0)
You are at low risk so I wouldn't really worry if I were T1 or T2. I had 3 urologists say they didn't feel anything before the biopsy was done, and then after another guy (knowing full well I had prostate cancer) said "Oh yeah, I feel it!" He was a surgeon out for my business. Was I a 1 or 2? Who knows. What's more important is your low Gleason number.
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