New guy with questions

Two weeks? Are they chiseling it into stone tablets?

Just kidding. . . the waiting is one of the harder parts of all this. Remember, whatever it may be, they can deal with just about anything. So can you.

Ron, that's as good as a diagnostic biopsy gets (except for a 'nothing'). AS is certainly something to seriously consider--and going down that road has the huge advantage of no side effects at all.

Congrats!

jmadrid said...
I agree, relatively good results. Do you mean psa density 0.09?
According your results, AS is surely a good option. Follow a protocol reliable enough to promptly show you any further red flag in the future, if necessary.

Yes sir I made a mistake it is .09 and Thanks

Hi Ron...sorry to officially have you on our team here. Still, as mentioned, if you're going to have PCa, finding only a small amount of G6 is certainly preferable. Also glad to hear you're considering AS--just keep in mind that the "A" stands for active and you do want to be actively monitoring it.

I don't know if a high BMI is associated with any additional risks re PCa, but it clearly has other health risks. Also, if you ever do get to a point where you need treatment, being slimmer likely gives you more options. I've been doing more diet and exercise in recent years and have managed to lose about 15 pounds, but I seem to be stuck there. (If I could lay off the wine with dinner, I'm sure I could drop another 10.)

Good luck and hope we can be of help to you here.

There are so many factors go into choosing Surgery or AS and in my opinion having a G6 makes it harder. My AS lasted 3 days. After the shock of diagnosis and the stress of not knowing what to do I went straight back in and signed for surgery. You can see my stats below. Pretty similar to yours apart from age (me being 9 years younger). The clincher for me was age. I had so many years for something more to develop. I also thought , Im young , I have the best chance of a good recovery. I also thought that biopsies are not always the true indicator of the cancer that there....and so on. Like you Ron I did my reading. That started before my diagnosis like you.

Im 3 weeks post op and I am fully continent and just had sex last night with no pills. I do not yet know my pathology. Thats on the 1st of May. If I was 53 would I be more likely to have chosen AS... honestly.... maybe. If you were to decide on surgery in future.... get that BMI down buddy. I lost weight before mine. It reduces chances of complications during surgery and will help a great deal during recovery. I had lots of time to decided but I didn't need it. You have lots of time to decide.

I know that my G6 may never have caused any problems and I know as of todays stats life expectency of G6 surgery and G6 AS are no different. Everything is a gamble. Its a very personal choice buddy. I just wasn't the boy for AS.

Dharmacolm said...
There are so many factors go into choosing Surgery or AS and in my opinion having a G6 makes it harder. My AS lasted 3 days. After the shock of diagnosis and the stress of not knowing what to do I went straight back in and signed for surgery. You can see my stats below. Pretty similar to yours apart from age (me being 9 years younger). The clincher for me was age. I had so many years for something more to develop. I also thought , Im young , I have the best chance of a good recovery. I also thought that biopsies are not always the true indicator of the cancer that there....and so on. Like you Ron I did my reading. That started before my diagnosis like you.

Im 3 weeks post op and I am fully continent and just had sex last night with no pills. I do not yet know my pathology. Thats on the 1st of May. If I was 53 would I be more likely to have chosen AS... honestly.... maybe. If you were to decide on surgery in future.... get that BMI down buddy. I lost weight before mine. It reduces chances of complications during surgery and will help a great deal during recovery. I had lots of time to decided but I didn't need it. You have lots of time to decide.

I know that my G6 may never have caused any problems and I know as of todays stats life expectency of G6 surgery and G6 AS are no different. Everything is a gamble. Its a very personal choice buddy. I just wasn't the boy for AS.

Sounds like you are doing very well and also very quickly. I think the surgery would cure my symptoms for sure and hopefully the cancer as well. Just got to get back on the workouts and get that BMI down like you said and it would be easier to face surgery. I have had both knee cartilage tear surgeries in the past and in Jan on this year I slipped and fell on ice and tore both sides of my right knee cartilages and damaged the tenon as well. It is driving me nuts but I do not want to have surgery again as I do not have much cartilage left and if I do have surgery I am pretty sure I will be bone on bone and looking at knee replacement sooner than later. That makes just necessary walking pretty painful, large knee braces help but enough complaining. I appreciate your comments and it is nice to hear from someone who had surgery and is doing so well. Thank you and I wish you the best on your recovery.

Just a follow up after over 2 months of Avodart and Flomax after bx of Gleason 6. I wanted to post the results of the report here and ask a few additional questions.
J:Right Lateral Mid:Adenocarcinoma, Gleason Score 6(3+3) (Grade Group 1), 1mm 12%
K: Right Apex: Adenocarcinoma, Gleason Score 6 (3+3) (Grade Group 1), 1mm 12%
L: Right Lateral Apex: Adenocarcinoma, Gleason Score 6 (3+3), 0.8mm 10%
3 of 12 (25%) cores involved by cancer
Gleason score 3+3=6 adenocarcinoma, conventional acinar type, is present in 3 of 12 sites, right sided cores involved. Peripheral perineural invasion and Extra Porstatic Extension (EPE) are not identified.

Ok, with that said, I had pretty much decided that AS was my choice and was hoping the Avodart would reduce my prostate size and help with symptoms. After taking 2 months of Avodart while continuing the Flomax my symptoms do not seem to be getting better. I have constant low back pain, and right side hip pain that both are probably arthritis, but I cannot help wonder if its the PC. Follow up with Uro is on 7/22/18 for another psa and talk about treatment plans. Does anyone have an idea of how long it would take for Avodart to reduce prostate size and reduce the psa results? Also, still have not sent my slides to Epstein and I wondering with such a low grade PC would this be necessary? Thanks for all your help and I am still following the forum just not posting as much.

Pratoman my mistake in the signature PSA was 4.79 at DX not 3.79 so I updated it. I realize the low PSA is probably not the reason for the pain but was mainly interested in the Avodart questions. I had L5 back surgery about 8 years ago to repair the disc, and was also told at that time that I was one of the few lucky ones who had an L6 which I believe is causing some of the low back pain. I was hoping the main symptoms were from the 53cc prostate and that the Avodart would reduce the size and hopefully the PSA. Which I hoped would reduce frequent urination, dribbling, stopping and starting etc. Thanks for your help.

Pratoman said...
Ron, you should send the slides to Epstein. Better if he confirms G6. Mine was originally G8(3+5), he downgraded me to G6. Then I was upgraded to g7(3+4) after surgery.

It’s worth the $250 and the time it takes to get the second opinion.

Getting a second reading from Epstein's lab is always a good investment.

Note that the cost has just gone up to $450, probably because Prato keeps calling him.

Pohaku53 said...
It takes 3 to 6 months for Avodart to provide significant benefit. I take finasteride which is similar and have had about a 15%reduction in Prostate size after a year. Stats I have seen suggest about a 26% reduction for Avodart after 4 years. So while these drugs do work, the effect isn’t immediate. On the other hand, my PSA dropped by 50% after 7 months and is down even further after 14 months.

Pohaku53 Thank you for that information, that helps a lot as I really had no idea of what time frame to expect. I have read that if youre PSA does not drop that it maybe a bad thing, as it normally drops it by 50% and some folks do not believe in taking it due to that reason. I am sure my my problem is BPH and just hoping that it works for that and the PSA dropping will ease my mind as well. Thank you for your reply.

Short update on first visit to urologist after my dx, he wanted me to do surgery or radiation and did not want to discuss AS. He said he give me avodart to reduce prostate size for treatment. He wanted me to go get 2nd opinion from another Dr in Carolinas network which I am going to do next week. Symptoms have improved some and psa came back at 2.93 after 4 months of avodart from 4.79. I am going to request slides to be sent to Epstein next week. One question I have for the group is do I double the psa
now since it's been 4 months or is this a new baseline? I just don't agree with him that I need treatment yet. If I do have to double the reading that puts me at 5.86 which is still low right guys?

What was his reason for not recommending AS? If he doesn't recommend AS for three G6 cores, what is his standard? Only two cores? One core? Or is it something else?

BTW, if it's age I disagree with him. If you can safely put off treatment for some period of time, that's still a win in my book.

Prostate was 53 dbell, and I believe he goes with no more than 2 cores, but not sure. Michael T I also want to put off treatment but I don't want to do something i will regret later either? I guess that is something we all have decide. His other opinion Dr does robotic surgery and he doesnt. Incontinence is my concern as well as over treatment. He didn't want to do an MRI to verify if anything else was in there larger than 6. Confused as always guys. Other Dr will probably agree with him if I was a betting man. Does anyone know about doubling the psa for avodart?