HealingWell
Search Close Search
☰

Help in uderstanding my Prostate Pathology report

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
1 2
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 1/10/2017 7:04 AM (GMT 0)
Thanks for the input! It sounds like that my next step after receiving my 2nd opinion report, should be to get an appointment with an Oncologist, before deciding which direction to go in. Is my thinking correct?

Oh, and my Urologist that I see is in Bakersfield Ca.
Posted 1/10/2017 10:58 AM (GMT 0)
Sleep, naw, you don't need a medical oncologist (a chemo guy or gal). You need to see radiation oncologists who are experts in the various sub-specialties of brachytherapy and external beam radiation for PCa. Also good to talk to an expert prostate surgeon who has done lots of RALP or open procedures. By lots we mean thousands, not dozens.

And don't forget to ask any and all of them if you're a candidate for AS with your diagnosis.
Posted 6/3/2017 9:44 PM (GMT 0)
Just received finding on an MRI for my prostate cancer. My oncologist was concerned and ordered one, seeing that my PSA went from 6.1 to 7.4 in 3mo need some help understanding it before meeting with Urologist, so i'm not flying completely blind. I posted my biopsy report, Gleason score on this site 1st reading was G3+3, 2nd opinion from John Hopkins G3+4

Findings:
Prostate: Measures 4.4x3x4.0 cm there are of decreased ADC signal in the left peripheral zone at the level of the mid gland measuring 1.2 cm posterolatorally and 1.0 cm laterally. Corresponding increased signalon DWI, more pronounced with the larger nodule. Associated mild early arteria phase enhancement. The capsule appears intact. Neurovascular bundles appear uninvolved. The seminal vesicles appear unremarkable.

LYMPH: Several bilateral external iliac chain nodes include a mildly prominent 1.9 x 0.9 cm node on the right
Bladder No focal wall thickening or mass.
Bone: No focal lesion is identified. Moderate to sevre degenerative disc disease at L5/S1

Conclusion:
1. PI-RADS 4. clinically significant disease is likely present. Specifically, a 1.2cm nodule in the left posterolateral peripheral zone and a 1.0cm nodule in the left lateral peripheral zone at the level of the mid gland Recommend correlation with biopsy results.
2. Capsule appears intact.
3. Several small iliac chain nodes, nonspecific.
4. Sigmoid diverticulosis.

Sorry for so much, but was not sure how much to put.
Posted 6/3/2017 10:39 PM (GMT 0)
Sleepallday, First off, you can trust the 2nd biopsy opinion as the best you can do. With G3+4, you MAY qualify for some AS programs, on the other hand, any of the typical treatment modalities are likely to be curative.

The best thing to do now is to consult with the best treatment teams you can find, and consult with all the available treatments and then make a sane and informed decision. The other good news is that you have (some) time to do the research and make a good decision.
Posted 6/4/2017 2:16 AM (GMT 0)
The only use of the PIRADS 4 is it tells you where to biopsy next time. Having a confirmatory biopsy is an important thing to do if you want to continue to postpone treatment. I suppose you do, or you would not have bothered to have that MRI. So let us know what the targeted biopsy finds. If the amount of Gleason pattern 4 has become significant, it's probably time for treatment. And if you've had grade progression, those swollen lymph nodes may be important. If not, they are probably just inflamed lymph nodes.
Posted 6/4/2017 3:36 AM (GMT 0)
Thanks for the info, yes that is what I was hoping to due, but if the MRI was showing that I needed to do something soon, I wanted to know before I see my Urologist on June the 7th. but because I could not make sense of the MRI, and would not have a face to face with my oncologist for a few weeks, I needed crash course in MRI understanding. So, does anyone think that when I see my Urologist, that he will tell me the MRI results shows I need to do something right away. Also, if anyone knows how soon after having a biopsy, can you request another? Thanks!
Posted 6/4/2017 4:21 AM (GMT 0)
MRIs don't do that. They only find suspicious areas to be biopsied.
Posted 6/4/2017 5:00 AM (GMT 0)
Got it! Thanks, that was very helpful.
Posted 6/4/2017 4:41 PM (GMT 0)
Sleepallday, Sometimes (and I get it, because I'm the same way), we can make it more complicated than it really is. With a G6/G7 diagnosis, like you have, the high end diagnostic tests such as MPMRI are really not needed, because it appears you have localized disease. Those fancy tests are there for two reasons: to help figure out what to do with high volume/high risk disease, and to make the clinics rich.

Also, when you refer to an Oncologist....are you talking about a RADIATION oncologist (who you should be talking to) or a MEDICAL oncologist (who will only become part of your life if you move from local PC to metastatic PC)?
Posted 6/5/2017 6:35 PM (GMT 0)
currently, i only have a medical oncologist at this time. I did not know there was a difference between the two. Thanks for letting me know. What additional information would I receive from a Radiation Oncologist, vs a medical Oncologist?
✚ New Topic ✚ Reply
12