New guy 727DWB looking for help

In another thread 727DWB posted:

"I just had my third biopsy in three years. My PSA has been rising for the last 5 years. I had the first biopsy at 61 with a PSA of 5.8.......All negative cores. My second biopsy at 62 with a PSA of 6.1 had all negative cores.

The third biopsy taken last Thursday (PSA 7.9) was a saturation one with 24 cores. In the Right Apex, I have adenocarcinoma of the prostate with a Gleason Score 3+4=7 with a PTI of 25%. My urologist says that we should take a wait and see attitude. He said he wouldn't do anything if it was him.

I'm going to a big city hospital for a second opinion. What say you? It's my 63rd birthday. Some present but I'm alive and feel great!

Not sure what do to...I'm scared to tell you the truth..........Thank you for your help.

Berk"

i started this thread for you Berk and welcome you.

Post Edited (A Yooper) : 9/20/2013 6:23:53 AM (GMT-6)

I'll welcome you again Berk, and others will be showing up soon to weigh in with their support and advice.

It would be helpful if you could provide us with all of your PCa statistics by creating a "signature" in the "My Profile" section when you're logged in.

I would suggest getting a 2nd read on your biopsy - Bostwick or Epstein are two of the most recommended. And BTW "going to a big city hospital for a second opinion" is a great step! I would try to hook up with an oncologist who specializes in prostate cancer, they're more often than not 'unbiased' and will help you understand the beast and various treatment options.

Again, welcome - and please share your stats with us so we can help. Also, where do you hail from?

Thanks guys for the information.

I'm going to visit a friend this morning who recently had surgery about 2 years ago. He's doing great and he told me everything works! He's a few years younger than me.

I will post additional stats when I receive the same from my Urologist. I live in Western Pennsylvania and will be going to UPMC for a "Second Opinion".

Berk

I agree with the others. If there is a Gleason 7 there, it means that -- even as a 3+4 -- there are grade 4 cancers lurking within. And the biopsy is just an educated guess -- could have more aggressive cells in other places within the prostate.

Just imagine if there is another area in the prostate that bears mostly grade 4? That would mean a Gleason score of 8. Nothing to fool around with. Not to try and scare you, though, because I believe that biopsies are accurate about 70% of the time. But that other 30% usually finds out that there WAS higher grade cancer that was missed by the biopsy needle.

So, I would first do as the others are suggesting -- get a 2nd opinion from a different lab. And if the G7 is confirmed, I would NOT just sit with it. Anything above a Gleason 6 really does require some form of treatment, whether it is radiation or surgery.

If this uro is really saying not to do anything, I'd also seek a second opinion from another uro because I do not believe the first doctor is giving you the best possible advice.

Good luck!
Chuck

Welcome aboard Berk!
I agree with the second opinion being suggested here. I am a GL7 with 10 of 12 core last year at aged 61. Biopsies can miss some of the cancer and Gleason scores can go up after treatment. Mine went from GL6 to a 7 after I had surgery and the cancer was beginning to leave the prostate capsule.
Not trying to scare you but you are doing the right thing by getting a second opinion.

Good luck
Bill from Florida

Berk, good luck with your upcoming visit to UPMC on Thursday, let us know how it goes.

I would also like to suggest that you hook up with an oncologist who specializes in prostate cancer; what you will find is that surgeons will recommend surgery and RO's will recommend radiation. A good/unbiased oncologist will be able to give you some good overviews - that makes it easier when you then visit the specialists.

IMHO you've got time, no need to rush. Get yourself educated about this beast as well as the different treatment approaches. Then get out there and meet with the various professionals - and when you do please realize that while experience is important, so are results! One of the guys made that analogy to me early on in my journey by telling me "I've been golfing 3 times a week for years, but I still suck at it!"

More food for thought for you!

Also during that part of my early journey I gathered lots of studies, reports, data, and information in general that I'd be happy to share with you. You can send an e-mail my way by clicking on the envelope below "A Yooper" in the left column of my post if you're interested.

Continued best to you.

Hi Berk and thanks for getting back to us. As I understand it Dr. Nelson is a very accredited surgeon and also serves as the chairman for the Department of Urology at UMPC. From his bio he specializes in nerve-sparing radical prostatectomy. Looks to me to be a great guy to go with if you have indeed settled on surgery.

The only additional comment I would add is to ask if you've had the chance to meet up with any radiologists and get their input as potential options / 2nd-3rd-4th opinions? Only reason I'm asking is that surgeons will of course recommend surgery and radiologist will recommend radiation - it might be interesting for you to hear another angle of attack here. Particularly since you mentioned that "the Ca is located in a place where it might invade surrounding tissue" - if it is in a place subject to positive margins or extracapsular extensions then brachy/external beam would be more effective than surgery as it treats the prostate bed, nerves and seminal vessicles. If it has escaped you would be looking at some form of radiation on top of the surgery.

Please understand that I'm not trying to put any doubt or undue worry out to you Berk, I'm just throwing out other considerations for you at this stage of your journey!

Hopefully others will weigh in as well.

With your stats you've got time to research more on all of this, no need to rush anything at this point.