Confused

For the past 2 years I have been going for a psa test the first 1 was according to my DR. high. I went for 3 more test about 6 months apart the last test showed it had reached 6 . I was sent for a biopsy in Sept. it showed positive 1 core in 8 with less than 5% cancer. I had a second biopsy done a few weeks ago this report say all cores negative . So I guess my question is with a psa of 6 and the first biopsy showing positive what is going on here .

hello fellow Canuck:
- there is a lot of information here at this site you can access - it is at the upper portion of the postings - FAQ's and such ....
- from what you have written - it does sound like small and isolated cancer
- but where exactly and how fast it is growing is the next step in your treatment
- basically , don't panic - time to learn about the prostate, your body - and what you want to do.

-Princess Margaret ( Toronto, Ontario, Canada) has a good site also for prostate cancer information -www.prostatecentre.ca/ - it even has a nifty 3-D rotating prostate pix on its front page - gives a good idea of what the area is like and how it is all affected -

- I would ask for the doctor to put on one page - your PSA timeline to show how slow or fast the PSA is rising - and go from there..
take care.
hugs
BRONSON

With 8 samples if a tumour is small it would be easy to miss. The average prostate is perhaps 2-3cm high and 3-4cm wide and when taking 4 needle core samples from each side, top to bottom, you can see how little of the gland is looked at. It is a little hit or miss. Then again, there is also a condition known as vanishing tumour -------- a very few men have had their prostate removed only to find on post-op pathology there was no tumour. It may well be that in the case of a very small tumour in one place the initial needle plug actually took it out. A prostate in most cases will yield a blood PSA of prostate size (in CCs) x 0.066. If the reading is above this, in all probability, there are other causes. Prostatitis, where the gland is inflamed to varying degrees, will cause it to leak more PSA than it should. Tumour, by disrupting the structure of the cells will also cause it to leak more. My feeling is the more cores the better and get them looked at by someone well known in prostate pathology. If the 1 out of 8 with 5% in one core is the true condition then you should be in no rush to take drastic action.
Bill

Post Edited (BillyMac) : 2/15/2011 4:08:21 PM (GMT-7)

My age is 58 in the 2 years it had risen 1.4 to make it at a 6 . There is no prostate cancer in the family not even my uncles that I know of. TICKER problems run in my family no cancer yet I would hate to be the first .

Some very good information has been posted and I would like to ad this..When a pathologist is looking at a prostate tissue sample, today the first cancerous grade is 3. There can be a very fine line between a Grade 2 (non-cancerous) and a grade 3 (cancerous). This is when having an expert pathologist review the slides and offer a second opinion is so important. You don't want to go through a surgery only to find you did not have cancer....

Canadian Guy,

Thank you for providing the follow up information.

It would appear that you have a right to be concerned about what your next steps should be.  I think the best advice you can follow is that of your Dr, assuming there is some real expertise there in regard to the diagnosing and treating prostate related issues including prostate cancer.

There are a lot of men that are choosing the approach of active surveillance (versus ignoring that the problem and hoping it goes away).

Regardless, if you chose not to take a more aggressive treatment like having surgery, you at least may want to choose to fight this in other ways.  There are a lot of things that can help to slow the growth of prostate cancer like diet, exercise, supplements, etc.

Just be aware that there are some men that chose to wait too long, sometimes they waited only a year or two longer then they should have.  Then, when the do decide to take the more aggressive treatments, the cancer has spread further then they wanted it to.

Also, it is not uncommon for a pathology report after surgery to uncover more cancer then was known before surgery due to the biopsies. 

I am an example of post-surgery surprises.  Before surgery they had only identified cancer in the upper right quadrant of my prostate.  My post prostatectomy pathology report showed that I also had cancer in the lower left apex, which involved that nerve bundle.  That would not have been known until the surgery was done.  As a result, even though all the margins were found to be negative on my pathology report, because the nerve was involved, the prostate cancer cells lined up along the nerve and escaped the prostate witch would also have not been known until over three years after surgery.  Now I am going to go through radiation therapy to kill the reoccurring cancer.

I am wishing you the best, regardless of which road you take in this journey.  Be aware that many prostate cancer experts believe that the younger you are when diagnosed, and with a low grade of cancer, you are best served to take an aggressive approach to remove the cancer sooner than later because this provides you with a far greater chance of a long life cancer free.

Good luck and best wishes,

Ted.

Hey Canadian Guy, I have very similiar journey as yours. I did the first biopsy 12 samples with nothing found 3 years ago. In January I had a saturation or mapping biopsy done, which is about 40 samples. One sample was postive. I am taking a surveillance approach and will have a PSA done in April.

What was the Gleason score on your one sample. That will give you a good indication of how active the cancer is.

Good luck and keep us informed.