Volume of Cancer in one Core

Pratoman,
I know you are in the decision making stage of what treatment you want. Do you have your stats posted anywhere? (I just ask this because we run into each other all the time and have replied back and forth and I still don't have a full picture of what you're dealing with). Of course we have to wait on our experts to weigh in because you know I'm new to this too. I would assume the percentage would depend on where exactly that particular core hit like you said but that's just me thinking out loud.

Don't know why, but suddenly the signature block reappeared.

Btw, biopsy report also indicated no evidence of PNI, Lymphovascular, or SV invasion

Pratoman, first of all, I agree with your first paragraph, % of one core doesn't mean much by itself.
So here's my logic; you have one core at 80%, that represents the amount of Cancer in that ONE core NOT 80% of the tumour. IF the 12 cores represent the size of the tumour (which it doesn't) then roughly 25% has a saturation of 80% at THAT core site maybe 2mm to the right or left it could be 100% or 20%. In my opinion you're trying to make assumptions based on faulty information. You don't know the size of the tumour, you don't know the size of your prostrate, you don't know when the tumour began to grow, you don't know the shape or orientation of the tumour so these are arbitrary percentages in your context.

The biopsy is a random, subjective sampling of the prostrate, 80%, to me means he nailed close to a bulls eye on the tumour, nothing more nothing less.

You've had a second opinion from Hopkins and now seem to be second guessing that, not very constructive. The fact is, again my opinion, you won't have answers to your worries until your prostrate is out and sliced and the pathology report in your hands.

If I knew what I know now AND my Gleason was a 6 (with my percentages!), I would probably have gone with a TURP to fix urinary problems then AS. But that's me.

Please try to stop putting yourself through this, you're going to be a total wreck!

Cheers, Doug

Pratoman, you're welcome. Here is what worked for me.

1. I accepted the fact I had Cancer, pretty quickly actually,
2. I researched then made a primary treatment decision and didn't second guess myself,
3. I considered what I would do next if my primary failed, it did,
4. I accepted the fact I will not be cured of PCa;
5. I've accepted that I must remain objective and pragmatic.

I know I have a bumpy road ahead and I know I don't need any self induced stress so I try and stick to number 5. Works pretty well for me. I have 30 years in the Airforce behind me and am sure that's a factor in my thinking, common sense, logic and get the job done.
Cheers, Doug

There is a point where worry becomes so counter productive that it outweighs the disease as a health risk factor. One can always find something to obsess about. Why fixate on this? None of us know the actual probability you seek. You will have the surgery and then you will have a more complete picture. But understand that you will never get complete answers. There are always unknowns with this disease, stemming from the disease itself or the txs.

Give it a break.

I am also one of the worriers, but generally only when I am awaiting test results, which will happen this week.

Mel

Pratoman -

I'm coming a bit late to this thread, but I'm responding because my numbers and situation are pretty similar to yours in a couple of ways.

I'm also a G6, and after biopsy was informed that the PCa was in 90% of one core and 70% in another (see signature below). So like you it seemed that I had a lot of it in two cores.

However, following RT in 2012, my PSA has been undetectable since then, and in fact my uro recently put me on annual rather than six months testing.

My point is that, while granted each man's situation is indeed unique, it stands to reason that there's a good chance that our similar numbers may suggest similar outcomes. That is, if I had a large percentage in a core (actually two in may case), and it still seems to be working out OK for me, then it may well work out OK for you too.

I wouldn't worry.

Prat:

Hope I wasn't too hard on you in my last post.

I think you are worried about the wrong thing. I mean, who cares what the % is, when it is all G6. IF it turns out to be G6, you are pretty much home free. Seriously, the chance of getting Mets is under 1%.

I agree with you about not being an AS candidate due to your make-up. In fact, as we read more HW posts, we see that many of us are just not cut out for AS. With surgery, at least you will get some definitive answers. In fact, you may well be one of the rarer birds: definitive answers WITHOUT more questions! That would be unusual...but GREAT!

Mel

I have seen several publications which cite the importance of % of cancer within the sample core. In my particular case, the one core of 24 which contained cancer was 1mm from a 16mm sample, or about 6%. I asked Dr Epstein what he thought the odds were of the biopsy needle missing the main part of the tumor and he said 20%. Of course, he has no way to know that, but I guess that's been his experience or he's seen studies with statistics on the odds. Even if it did miss the core of the tumor, it does not mean that a sample taken from the middle of the tumor would have shown a higher percent of cancer. The % factor is just one of many. You've had Dr Epstein look at your samples. He thinks you're a Gleason 6. You may have a rather high % of Gleason 6 in your samples, but it's still Gleason 6. Some very smart doctors argue that Gleason 6 should not even be labeled cancer. Dwell on that.

Yep, means nothing but, I would like to know how you measured your rumors and why you would want to.

Cheers, Doug

Especially when the postop pathology will do it for you. I assure you the worries will not end after treatment. This has nothing to do with cancer. This is a neurosis. Hey we all got him and they can be be overcome, but not on a pca forum. Im not suggesting professional help, heck if I thought that would work Id go myself to a shrink, but I'd end up counseling the shrink by the end. Just acknowledge stuff for what it is and its all different for each of us. But each of us does deep within, know ourselves, Its just a matter of,...do we want to.

Doug, You mean the typo where I said rumors instead of tumors? Or misspelling of the word Length? That's all I was able to find, results of typing on a stupid ipad, which as I lay in bed every night, lately seems to be attached to my lap.

It's ok though, the operative word in my post was probably "nuts". And logos was right about everything else. Learn to live with it.

Pratoman
You are quite fortunate compared to many of us.
I would give anything to have your stats.
GS3+3 is so slow moving.

If you have not gone ECE you can do an
mpMRI or Color Doppler Ultrasound to see the PCa
Then either a cryo or thermal ablation could kill all of it.
No Prostatechtomy or Radiation. Lucky you !

You have a great shot at a cure as far as I see it.
And that is the Holy Grail of this disease.
Check it out with you Uro

You will be sleeping like a baby very soon.