Visit with Radation Onogologist

Thanks Rick. I see my Radiation Oncologist today at 1:30pm so hope it goes as well. If you can maybe include some of your stats in your signature it would be helpful as I am not sure if you have been thru surgery as I have been. We are heading down the same trail it looks like and I wish you the best.

Michael

I'm a 59 year old male, and live in Texas. In August, diagnosed with prostate cancer. My wife and I decided on the da Vinci procedure with Dr. Randy Fagin in Austin, Texas. Initial biopsy: LEFT PROSTATE BIOPSY SHOWED: PROSTATIC ADENOCARCINOMA, GLEASON SCORE 5, INVOLVING APPROXIMATELY 25% OF THE SUBMITTED SPECIMEN. ALSO SEEN ARE NUMEROUS AREAS OF HIGH GRADE PIN AND A FOCUS OF PERINEURAL INVASION. RIGHT PROSTATE SHOWED: BENIGN PROSTATE TISSUE SHOWING ADENOMATOUS HYPERTROPHY. Dr. Fagin called and thought we caught it early enough and scheduled surgery for September 30th, 2009. Surgery was performed and released the following day with a followup in 8 weeks. Never had 1 day of problem with leakage and never wore a pad. Went through physical therapy to strengthen muscles. Then back to work. Post Biopsy report: DIAGNOSOS: PROSTATE AND SEMINAL VESICLES(RADICAL PROSTATECTOMY):
Histologic Type: Prostatic adenocarcinoma.
Histologic Grade: Gleason grade 3+4=7
Laterality: Bilateral, involving approximately 35% of left prostate and less than 5% of right prostate.
Margins: Focal involvement of peripheral surgical margin measuring 3mm in greatest dimension.
Extraprostatic Extension: Focally present
Seminal Vesicle Invasion: Not identified
Perineural Invasion: Present
Angiolympatic Invasion: Not identified
Lymph Nodes: Not identified
Stage (AJCC, 2002): pT3a, NX,MX

Michael hopefully this will help. I posted this on 12/23/2009

PET SCAN: The Dr did tell me that the PET scan was more expensive and that medicare and insurance usually frown on this type of scan. But under new laws and guidelines he pointed out, if re-occurrence is suspect, through contestment if they don't approve it, then medicare and insurance usually pay for the procedure. He did tell me that the cost of other scans, MRI, CAT, etc.,( a total of 4) would be equivalent to the cost of a single PET scan, and that the PET scan would give them a 4-deminsional image to look at to make a more concrete decision as to where the cancer exactly is. He said the PET scan could detect cancer the size of a pencil eraser, naturally we are hoping for no signs of tumor, but if it's present, they will know the exact area to treat with radiation. Just telling you what the Dr told me. Hope this helps.
Orickster (Rick)

Rick,
Did you read the link in my last post? It only recommends PET Scans for those engaged in Clinical Trials looking at new agents and FREE OF ANY CHARGES. There is a very good reason that Medicare and Insurance companies won't pay for it. I would definately get a 2nd opinion as you may be stuck with a expensive procedure that will add little to your DX.
JT

Hey Rick, glad you got your consultation over with. Be interesting to see what they come up with in the end for you. I agree to, that's not the best use of an expensive PET scan, but then I am not your doctor. Sounds like expensive overkill to me. Hope he comes up with a good plan for you soon.

David in SC

Hey orick,

You lucky dog with no leakage from the start!

Hope all other recoveries go quickly too.

I had to wonder what the heck you mean by a Ultrasonic PSA (and that your wife requested it)!

At first I though you maybe meant a TRUS (Transurethral Ultrasound), but heck, there's nothing left to ultra!!

Then it dawned on marblehead that you mean Ultrasensitive PSA of course!!!

Glad to have gotten that out of the way.

Take care ... we will now return to our show already-in-progress, eh?

According to both my Uro/Surgeon and my Radiation Oncologist, recurrance after surgery is three consecutive PSA rises above .10. .20 is a threshold that some radiationists draw a line in the sand, while others use .50 or in a few cases, 1.0.

David in SC

thanks everyone, i have learned so much from this website. my 3rd post surgery rose to .050 and i didnt know anything from the intern that spoke to me about the need to wait and the 'doubling factor' . i have gone on a non dairy mostly vegetarian and very little sugar for the next few months as i have heard this helps. has anyone heard of apricot kernels for rising psa's