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Medical Forum / Diseases and Disorders / Prostate Cancer / May 2004Options
I was diagnosed In April. I am 57 years old in good health. I am now researching options for the cancer. I had 12 samples taken and only one came back negative and 20% of it was cancer. I am from the Philadelphia area and am seeing a doc at Jefferson Hospital. My PSA was 28 but the doc seems to think that is wrong because of the small amount of cancer found. I am taking antibiotics and will have another PSA done in a couple of weeks. What do you do? Jim, Suggest getting a second opinion on the biopsy. It may cost you $200 or more out of your pocket, but it will be money well spent if the diagnosis is wrong and you can avoid treatment. Doctors categorize cases by "Gleason score" and "Stage." What are yours? With that information you can predict how serious (or not) your case is, by consulting the Partin Tables: http://urology.jhu.edu/Partin_tables/ JH Jim: If memory serves, I had 2 biopsy specimens showing cancer cells, and the invasion was only 6%. The name of the game here is to read, research, study all you can, because in the end you have to make the final decision on what treatment to pursue. Whatever you do, do not be timid about seeking a second, or even a third, opinion. Also, ask the doctor about the number of cases he does per year, what is his statistics on incontinence and impotence, etc. If the doc seems unhappy about being willing to discuss things like that with you, find another doctor. Most urologists, by the way, will likely recommend surgery. Include a radiation oncologist in your search if you want to get information on that alternative. Good luck. You found a good place here to get information and direction. Most are not doctors of course, but we all paid the dues to get in this exclusive little club. Thank you. David S. >I was diagnosed In April. I am 57 years old in good health. I am now >researching options for the cancer. I had 12 samples taken and only one [quoted text clipped - 3 lines] >taking antibiotics and will have another PSA done in a couple of weeks. >What do you do? Indeed. What do you do? Well, first, you take a breath. You are alive and there is no reason to believe you wont' still be 3 years from now, 8 years from now, etc. Reasearch. Start wtih Dr. Patrick Walsh's Guide to Surviving Prostate Cancer. Take a look at www.Phoenix5.org. It's the best site and the webmaster (Caren) says she think she as recent bugs fixed. You sound like an excellent candidate for radiation or surgery. So read up on both.  SignatureProstate Cancer Survivor (so far), not a doctor PSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Erection 05/12/2003 @ 48 HTbegins 07/21/2003 @ 48 PSA .07 .05 Lupron 7/03, 8/03, 12/03, 4/04 > I was diagnosed In April. I am 57 years old in good health. I am now > researching options for the cancer. I had 12 samples taken and only one [quoted text clipped - 3 lines] > taking antibiotics and will have another PSA done in a couple of weeks. > What do you do? > Reasearch. Start wtih Dr. Patrick Walsh's Guide to Surviving Prostate > Cancer. Take a look at www.Phoenix5.org. It's the best site and the > webmaster (Caren) says she think she as recent bugs fixed. This website is still not active. Someone mentioned this last week. I don't know what's going on. It definitely was a good reference site. Rgr I'll email Caren again. But when last I did, she said she had it back up. But, right afterwards, it was down again. I assume she's using Fuse.net, which is a local telco. I can't imagine what the problem is. SignatureProstate Cancer Survivor (so far), not a doctor PSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Erection 05/12/2003 @ 48 HTbegins 07/21/2003 @ 48 PSA .07 .05 Lupron 7/03, 8/03, 12/03, 4/04 > > Reasearch. Start wtih Dr. Patrick Walsh's Guide to Surviving Prostate > > Cancer. Take a look at www.Phoenix5.org. It's the best site and the [quoted text clipped - 4 lines] > > Rgr Don Cooley posted today that phoenix5 will be back up in a few days. the ISP messed something up. Dan FYI: Don Cooley posted this to another site I subscribe to. I don't think he would mind me sharing this here. "To All http://www.phoenix5.org has not been available for the last few days. Had an exchange of email with Caren today and she says it is coming back up - the ISP did something that took it down." MikeH It's still down. SignatureProstate Cancer Survivor (so far), not a doctor PSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Erection 05/12/2003 @ 48 HTbegins 07/21/2003 @ 48 PSA .07 .05 Lupron 7/03, 8/03, 12/03, 4/04 > FYI: Don Cooley posted this to another site I subscribe to. I don't think > he would mind me sharing this here. [quoted text clipped - 7 lines] > up - the ISP did something that took it down." > MikeH Easy..Go to yet another Dr. Take your samples etc. They are yours! I would see a Prostate Cancer Specialist. The Dr,s are in the phone book. Do this, or take the advice of the local, and take what you get? I realize this is very hard John Loomis > I was diagnosed In April. I am 57 years old in good health. I am now > researching options for the cancer. I had 12 samples taken and only one [quoted text clipped - 3 lines] > taking antibiotics and will have another PSA done in a couple of weeks. > What do you do? Take this time to read everything you can on prostate cancer. Obviously you do have cancer as some was found. Hopefully the cancer is organ confined and you will respond well to treatment. Depending on the Gleason score you might be a candidate for brachytherapy. This is where radioactive seeds are implanted directly into the prostate. It might be combined with some external beam radiation. Or you might choose just external beam radiation. There is also temporary seeds, IMRT radiation, cryosurgery and then the various forms of radical prostatectomy. RP, LRP, robotic etc. I think we now have at least one person who can represent a known treatment. What do we do? We have it treated! After you have some idea as to what type of treatment you find comfortable then you begin to look around to see how does it and where. Are you willing to go to Fox Chase, Abington, or Temple? What are their statistics? And which doctor is doing what? You probably can do some research right on the internet about the doctors, the hospitals, and the cancer treatment centers. Bev > I was diagnosed In April. I am 57 years old in good health. I am now > researching options for the cancer. I had 12 samples taken and only one [quoted text clipped - 3 lines] > taking antibiotics and will have another PSA done in a couple of weeks. > What do you do? An excellent website to research is PCRI -Prostate Cancer Research Institute. It's a not-for-profit site developed by two world reknown oncologist. The site doesn't appear to be biased one way or the other and give an excellent description of all treatment options and the advantages and disadvantages of each. Ron S Thank you all very much for the insight. I have researched and talked to some people but the treatment they had was at the latest 4 years old and we all know research is by the minute. Jim > An excellent website to research is PCRI -Prostate Cancer Research > Institute. It's a not-for-profit site developed by two world reknown [quoted text clipped - 3 lines] > > Ron S Hi Jim, Sorry you're joining this club. You will get very good advice and support here. Don't concern yourself with how high the PSA was. It was high and it tipped you off to have a biopsy and cancer was found. That was that. Whether the score was 8 or 18 or 28 is irrelevant at this stage. Next step is to find the best urologist you can get and research your options. You will have to follow up with tests to see if the cancer has spread beyond the prostate. And then the fun begins . . . . Good luck! Larry age 61 initial PSA 14.4 cancer found in second biopsy, clean dre's, first biopsy none found. Bones clear Cancer found in lymph nodes - result of lymph node dissection. Hormones started Completing EBRT Seeds scheduled > I was diagnosed In April. I am 57 years old in good health. I am now > researching options for the cancer. I had 12 samples taken and only one [quoted text clipped - 3 lines] > taking antibiotics and will have another PSA done in a couple of weeks. > What do you do? > You will get very good advice and support here. Don't concern yourself with > how high the PSA was. It was high and it tipped you off to have a biopsy and > cancer was found. That was that. Whether the score was 8 or 18 or 28 is > irrelevant at this stage. Next step is to find the best urologist you can > get and research your options. You will have to follow up with tests to see > if the cancer has spread beyond the prostate. And then the fun begins . . . Jim, I'd like to qualify Larry's first bit of advice here and strongly endorse the second. Because the PSA is high, some additional tests may be desirable. In particular, a bone scan can tell you if there are well developed spots of cancer outside the prostate region. A CAT scan or MRI of the area might also help reveal whether it has spread. If the cancer has already spread, then the conventional first stage treatments - surgery or radiation - may not be desirable. Larry's second piece of advice was to find the best urologist you can. I agree with that 110%. There are two issues. First, is this a doctor you think you can trust? Is he (or she) open, intelligent, caring, focussed on treating his or her patients, or is it a person who zips through his appointments in order to be able to leave early and play golf? Second, is the doctor a specialist in prostate cancer? The first urologist I saw proposed to operate on me, but when I looked him up at his company website I found that he was a specialist in female incontinence. I imagine he would have done a reasonably competent job, but I was hoping for a guy who really focussed on prostate cancer. Finally, think things through, but work quickly. I was told that any PSA over 20 is considered "high risk". That doesn't mean you can't get a complete cure, but it may mean that you don't want to fool around and delay before starting treatment. Well, that's 2 cents worth of advice from a non-doctor. Best of luck. Alan > I was diagnosed In April. I am 57 years old in good health. I am now > researching options for the cancer. I had 12 samples taken and only one [quoted text clipped - 3 lines] > I am taking antibiotics and will have another PSA done in a couple of > weeks. What do you do? Don't depend *too* much on the biopsy. Remember, it's just a sample from some areas. I had 10 cores, one of which had 5% Ca. The most important message my biopsy gave me was that I definitely had PCa. Trying to use it to predict how far it has spread is playing with statistics. Some people try to use a minimally positive biopsy as an excuse to try "watchful waiting". You are like me - young and healthy with PCa. Get rid of it. I'm happy I had an RRP, and am looking forward to many more years of "undectables". Best wishes. SignatureWake PSA 3.8, 11/2003 @58yrs Biopsy positive 5% in 1 of 10 cores T1c Gleason 3+3 RRP 1/12/04 Pathology agreed with biopsy + Negative margins PSA - 4/29/02: <0.1 Befor you decide for any treatment go to the website mentioned below and carefully read all contributions. Regards Oskar http://www.prostatepointers.org/ww/wwopt.htm ********************************************** > > I was diagnosed In April. I am 57 years old in good health. I am now > > researching options for the cancer. I had 12 samples taken and only one [quoted text clipped - 15 lines] > > Best wishes. Exactly. I had one positive core out of six attempts. After surgery the doc said he was surprised at the size of the tumor, 2.3 cm in diameter. This meant that the one positive core had been obtained from the periphery of the tumor while the others where only in healthy tissue. If the urologist who had performed the biopsy had used an ultrasound machine equipped with color Doppler he might have had a better target. The increased blood flow in the tumor could have provided more information. I still can't believe I allowed him to perform the biopsy with his shitty ultrasound system that was way too old for the job in 2003. When I saw the system I should have run like hell. This urologist was not the one who operated on me though. I give great advice but when it's my turn to make a decision I was just a deer in the headlights. Bottom line is that if an interventional radiologist had done the job it would have been performed on good equipment with the idea that not only is it necessary to obtain tissue samples but tissue characterization is of equal importance and a radiologist is the one who does it best. (Not sucking up Dr. W. but as a sonographer and x-ray tech for damn near 35 years (retired) I should have known better). > I was diagnosed In April. I am 57 years old in good health. I am now > researching options for the cancer. I had 12 samples taken and only one [quoted text clipped - 3 lines] > taking antibiotics and will have another PSA done in a couple of weeks. > What do you do? By the way, I think the doctors usually use the word "negative" to mean no cancer and "positive" to mean cancer was found. It's counter to our usual sense of negative and positive. I assume that by "negative" you meant bad, i.e., cancerous or, as the docs would say, "positive". Alan > > I was diagnosed In April. I am 57 years old in good health. I am > now [quoted text clipped - 17 lines] > > Alan It's more like "yes" and "no". Yes, we found the cancer we were looking for in your (fillin the blank). No, we didn't find cancer. |
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