Just returned from visit with urologist. We reviewed the biopsy summary and had lengthy discussion about
treatment alternatives. He, being a surgeon, naturally favors cutting it out. I can tell that he doesn't think much of proton therapy but encouraged me to explore all options. He puts high value on the pathologists examination of the prostate which can't be done with radiation.
As to the biopsy summary, I was very disappointed with what I read and our discussion. All 24 specimens were benign tissue except for 1. That 1 core had 1mm of cancer, which is 6% of that core. In total approximately 360 mm were submitted, so the 1mm is a very tiny amount of the total. Sounded pretty good until later in the report the CaPStage Risk Assessment showed my probability of Seminal Vesicle or Lymph node involvement at 12.7% Baseline average probability is 8.8%, so I am 44.6 increased risk. We discussed that at length and he said the
location of the cancer was in the neighborhood of the seminal vesicle and the Gleason of 7 is why they probably increased the risk. He feels it needs to come out, but did acknowledge again that many urologists might opt for AS. As I tend to do, my focus after that was on the likelihood of spread and how it would be treated, and I left feeling much worse than I did before our discussion. He tried to be optimistic, but under questioning he had to admit that maybe 20-25% of his patients have some spread after surgery. He kept remaining me that I have a miniscule cancer and it probably will be just fine, but I know the statistics and it's depressing.
Post Edited (hrpufnstuf) : 6/24/2014 5:07:14 PM (GMT-6)