Posted 4/11/2013 4:42 AM (GMT 0)
hopeful and optimistic,
Can you give us more details, including your age, previous PSA history, biopsy staging, etc.?
It does sound strange for a doctor to say you are a candidate for AS while not sure if you might have any extracapsular extension, etc.
Your Gleason 6 is a low risk variety, but it's always wise to remember that a biopsy clinical report is only an estimation. The only way to know the precise nature of a case of PC is through post-op pathology because that is the only way the entire prostate can be examined.
I would tend to place the most trust in the original uro that you saw. It probably IS very unlikely that any PC has escaped the prostate. Gleason 6's seldom do this because these cells cannot live outside the prostate.
At the same time, there ARE uros who do order bone scans & abdominal CTs for a Gleason 6. Usually this is just to establish baseline readings. My uro at home, who diagnosed me, did this. On the other hand, my surgeon at Mayo Clinic said he didn't know why the home uro bothered with those tests. Just to establish those baselines, I guess, because the home uro did tell me in advance that the tests would be negative.
Chances are good that you are a good choice for AS. Does your biopsy report give the location of the positive core?
In any case, I would consider having another PSA test in a few months, then going in twice a year for them. If you do this, be sure that you do NOT have sex or ride a bicycle in the 72 hours prior to the blood draw -- also do not undergo a DRE until AFTER the blood is taken.
Your future would seem to be VERY bright & you should be fine as long as you stay on top of your situation.
Take care,
Chuck
Resident of Highland, Indiana just outside of Chicago, IL.
July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA Sept. 2011 was 5.7.
Local urologist DRE revealed significant BPH, but no lumps.
PCa Dx Aug. 2011 at age of 61.
Biopsy revealed adenocarcinoma in 3 of 20 cores (one 5%, two 20%). T2C.
Gleason score 3+3=6.
CT of abdomen, bone scan both negative.
DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
My surgeon was Dr. Matthew Tollefson, who I highly recommend.
Final pathology shows tumor confined to prostate.
5 lymph nodes, seminal vesicles, extraprostatic soft tissue all negative.
1.0 x 0.6 x 0.6 cm mass involving right posterior inferior,
right posterior apex & left mid posterior prostate.
Right posterior apex margin involved by tumor over a 0.2 cm length, doctor says this is insignificant.
Prostate 98.3 grams, tumor 2 grams. Prostate size 5.0 x 4.7 x 4.5 cm.
Catheter out in 7 days. No incontinence, occasional minor dripping.
Post-op exams 2/13/12, 9/10/12, PSA <0.1.
Semi-firm erections now happening 14 months post-op & slowly getting a bit stronger.