somewhat confused...

OK so I'm at my clinic or primary care doc and he told me to get all the paperwork copied from my Cancer or Uro doc and add it to my medical records....while doing this I found some paperwork I had never seen before....basically a letter from my Uro to The Radiation Onc. whos in the same building.

The following is a list of my path report...trying to make sense of this..

PSA of 94...high grade cancer on both sides..

Left mid portion  Gleason 4+4=8  involving 15% of biopsy in one section and 5% in other

At the base...gleason 4+5=9  involving 40% of specimen and 50%.

At right Apex...gleason 4+5=9 involving 90% in one specimen and 4+4=8 in second biopsy.

At right  mid portion gleason 4+5=9 involving 90%

At right base gleason 4+5=9 involving 90% of specimen  and second one 4+4=8

I'm not exactly sure whats going on because at the end he wrote a stage of T2BN0M0

I was under the impression from what I read online that a stage T2B is still confined to the prostate and on only one side...but yet my Uro stated by using the Partin Tables that I had a 93% chance it was already outside the prostate...which I will never know because I did'nt have surjery. 

So my question is...what do you guys think my proper staging should be...I don't think T2B is right....I think maybe a T3B or A.  This does,nt really affect anything as I have already been treated yet I wonder why my Uro tells me Its more than likely already outside but the radiation guy writes a T2B...This also kind of irks me as to why they kept this info hidden from me and Im going to let them know about it next time I see them.

 Thanks, Chris

 

This is a clinical staging, not a pathological staging (which can only be done after surgery). I am in the same boat.  As I understand, the T2b is based on what the doctor feels during the DRE.   Like you I am a T2b but have biopsy evidence of the cancer throughout the gland.  The probability of escape is high due to your PSA and G scores, similar to mine. N0, M0 means they can not detect evidence in lymph nodes or bone per their scanning, same as mine.

I pay less credence to the clinical staging than I do to the PSA, G, and evident tumor volume based on the biopsy. I don't think changing the staging to a T2c or T3 would have them treat it any differently due to the high probability of escape already. It is possible that a pathological staging would have come up different, but not necessarily.   I believe David's staging was pathological after his surgery.

I would get on my doctors for not sharing this with me sooner. I demand full disclosure from my docs and they always comply.

A question, why only Lupron/Eligard? Many doctors add Avodart/Proscar to reduce the potent DHT when treating high risk guys like us. I would also suggest you double check all this with a very good prostate oriented medical oncologist. Any future recurrance will likely be outside the expertise of the urologist and rad onc.

Jack  

Chris,

I agree that it's a clinical staging.

As far as the additional drugs, it depends on the medical oncologist. My local med onc put me on just Lupron. Myers told me to add casodex and avodart. Myers trumps local guy.

Hang in there...we G9s have to stick together....

Jerry L.