Diagnosed with PC today

Hello All,
It has been great reading through the Healing Well forum for PC and it has helped me immensely through the early part of my journey. I received the Guided MRI Biopsy results today and the results were positive for PC.

DIAGNOSIS
(A) LEFT LATERAL BASE:
Prostatic tissue, no tumor present.
(B) LEFT LATERAL MID:
Prostatic tissue, no tumor present.
(C) LEFT LATERAL APEX:
Prostatic tissue, no tumor present.
(D) RIGHT MEDIAL APEX:
Prostatic tissue, no tumor present.
(E) RIGHT LATERAL BASE:
Prostatic tissue, no tumor present.
(F) RIGHT LATERAL MID:
Prostatic tissue, no tumor present.
(G) REGION OF INTEREST #1, ANTERIOR REGION OF INTEREST X4 CORES:
PROSTATIC ADENOCARCINOMA, GLEASON SCORE 7 (3+4), 8 MM, 5 MM, AND 2 MM FOCI INVOLVING THREE SEPARATE
TISSUE CORES.
(H) REGION OF INTEREST #2, LEFT BASE REGION OF INTEREST X2 CORES:
PROSTATIC ADENOCARCINOMA, GLEASON SCORE 6 (3+3), 1 MM FOCUS.
(I) REGION OF INTEREST #3, RIGHT LATERAL APICAL REGION OF INTEREST X2 CORES:
Prostatic tissue, no tumor present.
(J) REGION OF INTEREST #4, LEFT ANTERIOR APICAL X2 CORES:
PROSTATIC ADENOCARCINOMA, GLEASON SCORE 6 (3+3), 9 MM AND 3 MM FOCI, INVOLVING TWO SEPARATE TISSUE CORES.

All tests and procedures were done at MD Anderson and my Dr. has setup an appointment for 4/24/2015.
I have read through the sticky post regarding first but I thought I would post with the initial results to see if others may have had similar results. Thanks to everyone for this forum...
_______________________________________
Age: 46
9/15/13 PSA = 9.8 DRE Neg.
9/30/13 PSA = 8.9 DRE Neg.
1/15/2014 PSA = 7.9 DRE Neg.
4/24/14 PSA = 5.8 DRE Neg.
8/28/14 PSA = 6.0 DRE Neg. 12% fPSA
10/31/2014 Guided MRI Biopsy (results above)

Welcome to HW, sorry you need to be here.

Reads something like my report. With a G7 in there, I am guessing you're thinking about some kind of treatment. The frustrating part of the problem for you is that almost any of the treatment paths are likely to work just fine for you. Most docs would first recommend surgery for a guy your age but RT would work too.

and is that right, your follow up is in April? Seems a long time out.

Hang in there and keep us updated on your progress,
Andrew

Welcome to HealingWell, BigRich. As you've found, there's a wealth of information and support here. However, I'm sorry you had to join our little club.

I agree with Mr. DisAbelard; this doesn't sound terribly dire, although it's clearly something you'll need to deal with. I also agree with Andrew that April sounds like a long time out for a follow up. And while the chances are pretty good that they found everything there is to find given the nature of the test, I'd personally feel more comfortable addressing this a little sooner.

However, you certainly have time to consider your options. I recommend that you get two or three opinions on this and consider all your treatment options, including surgery, beam radiation and brachytherapy. Even if you're pretty sure you know what you want to do, getting those opinions will give you some peace of mind. If I had it to do over again, I would have more seriously considered the treatment options.

Hang in there and don't worry too much about this, although you don't seem like the type to freak out. There are lots of Gleason 7 patients running around with undetectable PSA scores years after treatment. This year will by my 4th year, and I'm hopeful about many more. I'm confident that you'll do fine with this.

Best,

Jonathan

Yes, it appears that you have too much Gleason 7 (3+4) to just do Acitve Surveillance.

If you are told you have prostate cancer, the best case is Gleason 6 (3+3) and the next best is Gleason 7 (3+4) the two you have.

It would have gotten progressively worse had you been told:

Gleason 7 (4+3),

Gleason 8 typically (4+4) but just read a thread on (3+5),

Gleason 9 (4+5) or

Gleason 9 (5+4) or

Gleason 10 (5+5).

So while it is a shock, your type of PCa is very treatable with surgery or radiaiton in several flavors.

If radiaiton, I have a personal preference for Cyberknife/SBRT since it can be done in 5 fractions @ 8 Gy every other day in a week and a half rather than spread over 7 weeks daily, but all are very effective whether IMRT, brachy low dose seeds, high dose HDR etc.

Do have a second reading of your biopsy by Dr. Jonathan Epstein at Johns Hopkins

pathology.jhu.edu/department/services/secondopinion.cfm

Then form a medical team of a urologist/surgeon or two, a radiation oncologist and a medical oncologist with the latter the QB of your team with you reserving the right to call audbles based on suggestions of all team members.

Conventional wisdom seems to be surgery for guys under 60 in good shape and radiaiton above age 60 but either would work in your case.

If you update your HealingWell profile to indicate what area of the country you live in, chances are that several here can suggest good urologists, and oncologists in your area.

Good luck and keep us posted as you get more info.

LupronJim

bigrich,

Your Gleason scores look similar to mine; and my oncologist (who says he only deals with men with prostate cancer) said I was low-intermediate risk but "should get it treated in the next few months....". I came away thinking he meant in the next three or four months.

If your like me, you'll become more expert on PCa over the next few days than you ever thought possible.

Hi BigRich (Being from Houston, TX, that have anything to do with the duo "Big and Rich?"), and welcome to our little corner of the world. You have come to a good place with immeasurable help and knowledge from those that have "been there, done that" with respect to being told we have PCa, learning about the beast, deciding on a treatment path and moving on. Please keep in mind that with your statistics, you do have time - time to learn about PCa and the various treatment options - so don't panic!

Others have already asked about getting a 2nd read on your biopsy slides yet, and I agree that should be one of your next steps. Labs such as Bostwick and Epstein are two of the best and a 2nd opinion is usually a good thing to add to your decision making tree.

Along with forums such as this where you can learn from people that have and are going through what you are, do as much internet research as you can. When I was at your point in my journey I encountered the "paralysis by analysis" syndrome as I was spending several hours a day doing all of the research and reading as much as I could - but that's o.k. as it will put you in a better place in terms of deciding your choice of treatment.

There are a number of great books out there as well - Dr. Patrick Walsh's "Guide to Surviving Prostate Cancer" and Strum and Scholz' "Invasion of the Prostate Snatchers" are two that I found incredibly helpful during that part of my journey.

You will also want to talk to and if possible meet with as many of the medical experts in the different treatment approaches as you can. When you do, be sure to ask for their specific outcomes post treatment - % regression free, continency (and have them define what "continent" means - to you and I it means NO issues, while others may qualify that with "only one pad per day" or "only when straining") - same goes with ED. They all have these statistics and if they say they don't or are unwilling to share that would be a cause of concern for me.

At my young age (not quite as young as you) and excellent health, and with no symptoms or issues - while curing the cancer was / is my top priority, at the same time preserving my quality of life ran a very, very close 2nd. Be aware of this while doing your research and get those statistics from the practitioners and treatment modalities as you learn. You only get one shot at this - one of the most important decisions we're likely to make in our lives.

As part of my journey to learn about the various treatment options I downloaded, purchased, and copied a number of studies and results that I would also be happy to share with you, so if you are interested shoot an e-mail my way and I'll reply right away.

We are all out here to help - my very best wishes to you in this journey.

BigRich, you have already been given a lot of really good info for consideration, I just wanted to chime in and say welcome. Although every one of us wishes we had never met you here.

Being here for 5+ years I can also attest to the fact that this is a very knowledgeable and supportive place.

My best to you and your family as you move forward,

Sonny

Hi bigrich and welcome to Healing Well. Such a young guy and sorry you had to join us.

Your score is pretty much the same as my own that I received a week ago, apart from your PSA that is much lower than my 19. Unfortunately you are out of the “watchful waiting” zone, but with 3+4 you are much closer to it than a 4+3. You will most certainly want to look at some kind of treatment, but time is certainly on your side in that respect. With your score it looks like all options are open to you at this point, so use the time to educate yourself on the treatment options of which there are many. As others have mentioned, you should certainly get a second opinion on your slides before deciding on treatment options.

All the best to you on your journey.

My stats are similar to yours except for your interesting downward trend in PSAs. After months of research and advice like you have received the following link made the difference for me.

http://prostate-cancer.org/PDFs/Is14-2_p3-11.pdf

Page 6 speaks to us low intermediate guys. You will indeed have great outcomes from different thearapies and the final choice is the one you live with.

I wish you the very best and please keep us updated.

Many thanks Browntrout. I think this will also make interesting reading for me.

Hi Bigrich22,

Welcome to HW where you'll find lots of great guys with a great deal of information. I'm somewhat new here and was DX too late for anything other than ADT2.

Like others have said, read, learn, read some more and learn all you can!!

Will keep you in my thoughts and prayer!


Taking it one day at a time.

Dave in Bartlett, TN

Thanks all for the great info! Researching daily and waiting for a call from my doctor either today or tomorrow... Will update soon.

Rather than hand written notes scrtibbled while trying to make eye contact with the urologist or oncologist, invest $20 in a USB that doubles as a recording device, or use your phone to record the session.

Saves on having to do triple duty with your list of questions. You may be able to get them all answered but invariably hte conversation goes in a different order than your questions.

My spouse Karen got mine on PulseTV.com

www2.pulsetv.com/Voice_Audio-USB-Recorder/productinfo/6165/

Amazon markets them too.

LupronJim