Posted 3/4/2016 3:00 PM (GMT 0)
Age 54, 6'3" 215 lbs. very active in many sports (biking, basketball, golf, walking, etc...). NJ, metro Philly Area.
Tough month. Feb 5, 2016 have Urologist Appt. Some urgency during the waking hours, none at night, did not consider it a big deal, but my GP retired and my annual in Aug, 2015 with my new GP did not include a DRE. PSA in Aug was 2.5. (Last 4 years annually, 2012: 2.1, 2013: 1.6, 2014: 1.9, 2016: 2.5.) So, I make this appt on my own. Lo and behold, the DRE finds a small nodule. Freaking out now, sound familiar? (BTW, no DRE for 1.5 years......can this thing grow that quick or did my old GP miss it?)
Biopsy about 2 weeks later on Feb 22, 2016. Not really bad experience, 12 cores, plus he added one at the end for 13 total. Seems that 13th was the painful one, but over in 5 seconds. No issues afterwards. Urine was clean, but ejaculate somewhat bloody. All in all, not a bad experience.
The biopsy was Monday, and on Friday of the same week, I got a call from the Dr telling me of the positive result. We really new it was going to positive, based on the DRE alone. But, I found some comfort in that maybe I can now focus on treatment specifics rather than "maybe's". Maybe this is because the Dr, over the phone, stated that "I have a little cancer and I would like you to come in next week so we can discuss ways to 'cure' it." I thought that was a good sign, but then I thought that that may be his spiel to everyone over the phone until they see him in person.
Saw him at 4:00PM last night (March 3, 2016). Had my wife with me, for two reasons. She is, and has always been, my partner. And second, I wasn't sure I would hear anything from the Dr. Oh, I would hear him fine, but anything actually registering was a concern. I wanted information and I needed a second set of ears.
So, here is my pathology (Looks like the 13th stick was the Right Mid done a second time):
Specimen # Pcs L (mm) Diagnosis Gleason Grade % tumor tumor L (mm)
Left Lateral Base 1 21 Benign N/A N/A
Left Lateral Mid 1 21 Benign N/A N/A
Left Lateral Apex 1 18 Benign N/A N/A
Left Base 3 21 PCA - adenocarcinoma 3+3=6 1 5% 1
Left Mid 1 18 Benign N/A N/A
Left Apex 1 17 PCA - adenocarcinoma 3=3=6 1 6% 1
Right Base 1 18 PCA - adenocarcimona 3+4=7 2 67% 12
Right Mid 1 18 PCA - adenocarcinoma 4+3=7 3 67% 12
Right Apex 1 17 PCA - adenocarcinoma 3+3=6 1 18% 3
Right Lateral Base 1 17 PCA - adenocarcinoma 3+3=6 1 18% 3
Right Lateral Mid 1 16 Atypical Small Acinar Prolif N/A N/A
Right Lateral Apex 1 19 PCA - adenocarcinoma 3+3=6 1 74% 14
Right Mid 2 17 PCA - adenocarcinoma 3+4=7 2 71% 12
So, it looks like 7 out of 12 positive (remember, Right Mid done twice, both positive). 4 gleason 3+3=6, 2 gleason 3+4=7 and 1 gleason 4+3=7.
PSA 2012: 2.1
PSA 2013: 1.6
PSA 2014: 1.9
PSA 2015: 2.5
PSA at time of Diagnosis: ???? (For all I know, my PSA shot up from 8/31/15, when it was 2.5, to "who know's")
The Dr is not alarmed, however, I am. He was very good, spent over a half hour going over everything and answering my questions. He main point is that this must be treated and he believes I have a good chance of getting this thing before it gets bad. He actually mentioned 'cure', although I guess when you have cancer, you always have cancer, just in remission. He mentioned many outcomes by percentage and used data to explain things to me. Me, being in the IT world, I liked that. I had something to hang my hat on. I am off to xrays and bone scans now. I am worried, because I have some back and hip pain, but I have always had some because of my level of activity. But, now, my mind wonders if something 'got out' and is causing me some issues. My Dr tried to reassure me, that based on data alone, my pathology report, my PSA and the DRE, he thinks these tests are just a formality and will find nothing. We'll see.
Anyway, he suggests surgery and I am inclined to believe that is my best shot. He mentioned that radiation is an option, but seeds are not. He based this on the DRE, ability to feel a small nodule, and the one 4+3=7 Gleason score. This is my local guy and I am getting a second opinion from UPENN in Philadelphia. I really trust this guy with what he knows and what he is telling me. I don't know if I trust him if I need surgery. Seems to me that a major teaching hospital is my best bet on someone that does the surgery all the time and teaches others how to do them. I am seeing UPENN Urology in the coming weeks and understand their top guy is a top guy around the world. One good thing, is that my Dr tells me that I have a little time to decide on a path. I asked him what does that mean? He said I should have this treated by the beginning of summer, within 2-3 months, no longer. Oh, there is one thing I did want to mention, I asked him about the DRE and whether he felt, based on his opinion, that the cancer was contained. He said the nodule was small (what is small??) and that he did not feel any outcroppings, etc.....if that means anything.
So guys, ( and some wives or significant other's), what do you think based upon the data you see? Do I have a shot at a decent life or will I be one that battles this darn thing until the day I die. I kind of know the answer.....we just don't know. I would like to hear from others in a similar situation. Like to hear of UPENN or some Philadelphia options. I've been on here looking around for several weeks. Also on YANOW. I've already researched many things, but it's always good to hear from the people who experienced similar situations and what their outcomes have been. I want to be in control of my path and make informed decisions.
So, you got me as a member now........I hope to be a quality addition and will post updates as I get them.
Jay