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Posted 5/30/2013 6:34 PM (GMT 0)
Gleason 3+3=6

Right mid lateral 7% 3+3 1 of 2 cores
Right Base lateral <5% 3+3 1 of 2 cores
Left apex medial 5% 3+3 2 of 2 cores
Left mid lateral 20% 3+3 2 of 2 cores
All Adenocarcinoma

Doctor wants to do a CT scan before final staging.

What could the CT scan show?
Are numbers like this good enough if I wanted to do active surveillance?
Posted 5/30/2013 6:45 PM (GMT 0)
Hi Steven - G6 is a good thing! Quick question, how many cores did they take in total?
Posted 5/30/2013 6:53 PM (GMT 0)
Yooper it was a 12 core.
Posted 5/30/2013 7:24 PM (GMT 0)
Those look like very treatable numbers. I wouldn't expect to see much on a CT in your case but you never know. Likely the doc is looking for anything bad/obviously wrong and get better measure of the size. It's standard procedure for many docs. My Uro sent me to the cancer clinic without doing a CT. The RO did one before agreeing to do IGRT.

AS is a possibility but wait for the staging. In your place I'd be asking the doc about AS. You could also consider Brachy. You've got a lot of good options.

and that will be your problem - too many options.

Hang in there you're doing fine so far,
Andrew
Posted 5/30/2013 7:29 PM (GMT 0)
He's doing CT scan as protocol, pointless usually, but a friends dad had one for pca and it revealed a cancerous kidney, saved his life. go figure. you could probably do AS, not up on it.
Posted 5/30/2013 10:49 PM (GMT 0)
Six cores positive out of twelve sounds like a lot for AS.
Posted 5/30/2013 10:58 PM (GMT 0)

142 said...
Six cores positive out of twelve sounds like a lot for AS.

Thats why I asked, been looking on some major cancer center sites but they seem a little vague with their criteria.
Posted 5/30/2013 11:18 PM (GMT 0)
Yeah, I wouldn't suggest AS either but you still have many other options. CT pretty routine, most doctors request it.

Bill from Florida cool
Posted 5/31/2013 12:01 AM (GMT 0)
The CT is more of a formality at this point, extremely unlikely with your numbers that anything would be there to be seen.

But, looks like you should have the full spectrum of primary treatment choices if you choose to treat it. AS may still be viable for you, that is something your doctor needs to call. I wouldn't rule it in or out, consider the jury out.

Good luck ahead,

david
Posted 5/31/2013 12:10 PM (GMT 0)

InTheShop said...

and that will be your problem - too many options.
Andrew

It would almost be easier if I didn't have so many options.
Posted 5/31/2013 12:27 PM (GMT 0)
Steven, I'm in a similar boat with similiar test scores. I had the CT and they found "something" in the lower part of my lungs. I then had a PET scan and it turned out to be "something" with the lymph nodes in my chest. 3 doctors have all told me that it's almost certainly not related to my Prostate Cancer, and could very well be nothing. I'm have a lymph node biopsy this coming Monday. Once we figure out what's going on, then I get back to deciding on treatment for my PCa. My biopsy was in March, My point is, you have time to gather information, talk to uroligists, radiation oncologists, etc and form a good solid opinion of what to do.
Best of luck to you. there are some great people on this site willing to help!

Mike
Posted 5/31/2013 12:54 PM (GMT 0)
Steven, good numbers indeed and you have the entire spectrum of options at this point.  If you go to the Johns Hopkins web site you can find some fairly specific criteria re their AS program which has tended to be on the conservative side.  You might even want to call Dr. Ballentine Carter who runs their program.  In any case if you do decide on AS, then I would recommend that you work with a urologist who has lots of experience in that protocol so that appropriate testing is done as you proceed. I would also suggest that you have your slides read by a PCa pathology expert such as Bostwick or Epstein before proceeding with anything.

If you decide on treatment, I would recommend that you get opinions from highly experienced brachytherapists and surgeons.  Brachy would be something you should consider due to the less generally onerous SE's as compared to surgery.  You might also consider Cyber-knife as recent studies have shown that to be an effective alternative.

Jim

Posted 5/31/2013 12:59 PM (GMT 0)
Mike I sure hope your something turns out to be nothing.
Yes, it is good to have time to decide.
Posted 5/31/2013 1:37 PM (GMT 0)
With the amount of positive cores and the less than 2 year doubling time on the PSA rise IMO AS is very questionable. I think Tudpock gave you some good advice on treatment. LDBT and even CyberKnife could be good treatment options with lower side effects than surgery. The main thing is you have plenty of time to make the decision that is best for you.

Terry

Posted 6/1/2013 7:25 PM (GMT 0)
CT scan set for 6/11 then treatment meeting with my Uro 6/14.

Decisions, decisions.
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