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Watchful Waiting Would Have Been A Mistake

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Posted 10/8/2009 8:01 PM (GMT 0)
This past Monday I did testing before the start of radiation at the Dattoli Clinic in Sarasota.

First was an MRI using a endorectal-coil MRI at Sarasota Memorial Hospital. Then on to the Clinic for blood tests, a helical CT scan, and a color flow doppler ultrasound. The ultrasound showed cancer activity in both lobes rather than one lobe as the biopsy found. It also indicated a breach of the capsule, which was a surprise to me.

The biopsy had been 1 sample of 12 positive (10%) for Gleason 6. Stage T1c. I had recommendations for watchful waiting. That would clearly would have been a mistake. Dr Dattoli, using the ultrasound results was able to feel the tumor on manual examination. He did say that it was in a difficult place for the biopsy gun to reach. I forgot to ask what my staging is now. I think either T2c or T3.

This coming Monday I start the 1st of 30 external beam radiation treatments. A couple of weeks following completion I will have seeding done. Another 3 months may bring an additional 2 weeks of "touch up" beam treatment. I've also started Casodex and Avodart.

I think you could make a strong case for anyone being diagnosed with PCa to have the color flow doppler test.

For anyone considering going this route, I don't think you could go wrong at the Dattoli Clinic. It is first class all the way. Their facility is top notch and the people are extremely well versed in their job and made me feel welcome and at ease.

Mike
Posted 10/8/2009 8:25 PM (GMT 0)

Best of luck

This stuff is really confusing and doesn’t seem to be the same for anybody. Please keep posting, I feel like I’m doing something when I learn from reading the individual post.

Jack
Posted 10/8/2009 8:33 PM (GMT 0)
Good luck on your treatments and glad they caught it for you.

Larry
Posted 10/8/2009 8:52 PM (GMT 0)
Mike, the more I hear about biopsies, the less I like the idea of relying on them to determine treatment. Your breach of the prostate capsule is a perfect example of why active surveillance can be the wrong decision and why more tests need to be done before a doctor should recommend this approach. I believe the breach of the capsule puts you at a t3a (extraprostectic extension) which is what my husband had on his surgical pathology report. Treatment is called for so thank God you opted to do something rather than wait.

Good luck with your treatment!
Posted 10/9/2009 12:45 AM (GMT 0)
My oncologist would never suggest Active Survelience without a color doppler ultrasound to confirm the original biopsy. I believe that a color doppler is a good idea for anyone diagnosed with PC. Some may think that it is an overkill but Mike and I are living testatments that they are worth their weight in gold when it comes to staging PC. How many others on this site have had positive margins identified in surgery that could have been identified by a color doppler before surgery.
JohnT
Posted 10/9/2009 1:33 AM (GMT 0)

Your story illustrates the question about biopsies: did it find the needle in a haystack, or the tip of the iceberg. Obviously it was the tip of the iceberg.

You did a great follow-up for yourself.

Best wishes,

Ted

Posted 10/9/2009 10:43 AM (GMT 0)
Greetings, Mike.  Glad you were able to find out just what you are dealing with and have been able to begin an appropriate treatment. I think for those who choose active surveillance the key word is active.  Trust your treatments will go well. David
Posted 10/9/2009 4:18 PM (GMT 0)
I guess my question is, although a high percentage can wait, why wait. The main positive is that over time treatments improve, but a big negative is that repeated biopsys are not good for the prostrate and can cause scarring to increase future complications.
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