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Medical Forum / Diseases and Disorders / Prostate Cancer / May 2008

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MRSI, and Gadolinium

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Dwight - 07 May 2008 06:22 GMT
I'm being asked to take part in a study at UCSF where they do an MRSI
on me.  They also want to use a contrasting agent called Gadolinium.
I wasn't told at the time that some of this is considered
experimental.  I'm now reading that in some documents they sent me.

If one has severe or chronic kidney problems, the Gadolinium could
cause serious harm.  I don't have these.

I"m a bit put off that the experimental aspect of this was not made
clear at the beginning.

Anyone have any experience with this?

Can MRSI show extracapsular extensions?

Dwight
Steve Kramer - 07 May 2008 11:27 GMT
> I'm being asked to take part in a study at UCSF where they do an MRSI
> on me.  They also want to use a contrasting agent called Gadolinium.
[quoted text clipped - 10 lines]
>
> Can MRSI show extracapsular extensions?

I have not experience, but I am curious.  Is this for diagnostics?  Have you
had a biopsy?
Dwight - 07 May 2008 15:20 GMT
> > I'm being asked to take part in a study at UCSF where they do an MRSI
> > on me.  They also want to use a contrasting agent called Gadolinium.
[quoted text clipped - 13 lines]
> I have not experience, but I am curious.  Is this for diagnostics?  Have you
> had a biopsy?

I just want to know if it's contained or not.  However, with the
surgery just two days later, and that risk of a perforated rectum from
the MRSI probe, I'm thinking I won't have it done.
Dwight - 07 May 2008 20:05 GMT
> > "Dwight" <nodamnspa...@yahoo.com> wrote in message
>
[quoted text clipped - 23 lines]
>
> - Show quoted text -

I cancelled it.  The guy said that if I just had color doppler done, I
didn't need to do MRSI.
Steve Kramer - 08 May 2008 02:10 GMT
> I have not experience, but I am curious. Is this for diagnostics? Have you
> had a biopsy?

I just want to know if it's contained or not.  However, with the
surgery just two days later, and that risk of a perforated rectum from
the MRSI probe, I'm thinking I won't have it done.

==>  I'm sorry.  Is this the artist formerly known as "Doofy"?
Dwight - 08 May 2008 14:56 GMT
> > I have not experience, but I am curious. Is this for diagnostics? Have you
> > had a biopsy?
[quoted text clipped - 4 lines]
>
> ==>  I'm sorry.  Is this the artist formerly known as "Doofy"?

The answer is "Yes", and I'm sorry too. ;-)

Still trying to find an insignia to use as my name.
Steve Kramer - 08 May 2008 23:27 GMT
On May 7, 6:10 pm, "Steve Kramer" <skra...@cinci.rr.com> wrote:
> > I have not experience, but I am curious. Is this for diagnostics? Have
> > you
[quoted text clipped - 5 lines]
>
> ==> I'm sorry. Is this the artist formerly known as "Doofy"?

The answer is "Yes", and I'm sorry too. ;-)

Still trying to find an insignia to use as my name.

==>  No problem.  I was just getting confused.  Now that I know who you are,
my question was silly.

So, what is the date of your surgery and on what type of surgery did you
decide?

Signature

PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA  <.1  <.1  <.1  .27  .37  .75            PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA  .34 .22 .15 .21 .32                       PSAD .056 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA  .07 .05 .06 .09 .08 .132 .145       PSAD 1.4 years
Casodex added daily 07/06
PSA <0.04, <0.05, <0.04, <0.04, <0.1  2/12/08
Non Illegitimi Carborundum

Dwight - 09 May 2008 01:08 GMT
> ==>  No problem.  I was just getting confused.  Now that I know who you are,
> my question was silly.

I've been practicing meditation to know who I"m not.  We're at cross-
purposes.

> So, what is the date of your surgery and on what type of surgery did you
> decide?

5/14 is the big day.  I'm designating it "Be Kind To Robots Day",
which answers your next question.
Steve Kramer - 09 May 2008 03:23 GMT
On May 8, 3:27 pm, "Steve Kramer" <skra...@cinci.rr.com> wrote:

> ==> No problem. I was just getting confused. Now that I know who you are,
> my question was silly.

I've been practicing meditation to know who I"m not.  We're at cross-
purposes.

==>  Well, you're not me.  I hope that helps narrow things down.  :-)

5/14 is the big day.  I'm designating it "Be Kind To Robots Day",
which answers your next question.

==>  You and R2D2 will be in my prayers Wednesday.
Dwight - 09 May 2008 18:47 GMT
> On May 8, 3:27 pm, "Steve Kramer" <skra...@cinci.rr.com> wrote:
>
[quoted text clipped - 10 lines]
>
> ==>  You and R2D2 will be in my prayers Wednesday.

I'm sort of relating to a robot in a scene I saw on "Ice Pirates",
where these robots are being forced into battle, and one of them,
evidently scared, stops and spews hydraulic fluid and washers out of
it's anal area.

I wonder if the doc will check my dipstick while he's at it.

I'm actually starting to feel pre-surgery buyers remorse.  I have to
keep reminding myself that all of the other treatments have their own
set of side effects that I even more preferred not to have.  And I
think cancer is effecting my sentence construction.

Dwight
Steve Kramer - 09 May 2008 21:30 GMT
I'm actually starting to feel pre-surgery buyers remorse.  I have to
keep reminding myself that all of the other treatments have their own
set of side effects that I even more preferred not to have.  And I
think cancer is effecting my sentence construction.

==>  Don't do it, Dwight.  You are an intelligent man who made an
intelligent decision based on all the facts you were told and that you could
find.  There is no direction to look but forward.
Dwight - 10 May 2008 00:11 GMT
> I'm actually starting to feel pre-surgery buyers remorse.  I have to
> keep reminding myself that all of the other treatments have their own
> set of side effects that I even more preferred not to have.  And I
> think cancer is effecting my sentence construction.
>
> ==>  Don't do it, Dwight.  

Thanks Steve.  I didn't get a chance to read the rest of what you
wrote, but I took your advice here and cancelled the surgery.  Thanks
so much for the validation.  ;-)
Steve Kramer - 10 May 2008 01:13 GMT
On May 9, 1:30 pm, "Steve Kramer" <skra...@cinci.rr.com> wrote:
> "Dwight" <nodamnspa...@yahoo.com> wrote in message
>
[quoted text clipped - 6 lines]
>
> ==> Don't do it, Dwight.

Thanks Steve.  I didn't get a chance to read the rest of what you
wrote, but I took your advice here and cancelled the surgery.  Thanks
so much for the validation.  ;-)

==>  Good one.  I had to read it twice before I realized the smiley was
winking.
Heather - 10 May 2008 02:45 GMT
Oh oh....you two are totally dangerous together!!  8-))  Same dry sense
of humour.  That oughtta get you thru everything, Duh-wight.  You are
needed here, you know.  (to keep Steve K in line....lol)

Cheers......the Canuck

> On May 9, 1:30 pm, "Steve Kramer" <skra...@cinci.rr.com> wrote:
>> "Dwight" <nodamnspa...@yahoo.com> wrote in message
[quoted text clipped - 14 lines]
> ==>  Good one.  I had to read it twice before I realized the smiley
> was winking.
Dwight - 10 May 2008 16:30 GMT
> Oh oh....you two are totally dangerous together!!  8-))  Same dry sense
> of humour.  That oughtta get you thru everything, Duh-wight.  You are
> needed here, you know.  (to keep Steve K in line....lol)

My fear and worry is locked up in holding pattern, and a sarcastic
demeanor helps me talk through it and maintain.  I've been ON HOLD
since 3/12 when I got my biopsy done.  I'll be relieved when I can
come out of the holding pattern, but then again, that might never
happen, totally.
John - 12 May 2008 19:04 GMT
> > Oh oh....you two are totally dangerous together!!  8-))  Same dry sense
> > of humour.  That oughtta get you thru everything, Duh-wight.  You are
[quoted text clipped - 5 lines]
> come out of the holding pattern, but then again, that might never
> happen, totally.

I have my biopsy tomorrow morning. Age 46 PSA 1.0, no family history,
but an abnormal DRE. Biopsy was advised and scheduled back on 4-15 and
that's how I feel. On hold. And I guess the worry continues until the
results.

John
Dwight - 12 May 2008 19:09 GMT
> I have my biopsy tomorrow morning. Age 46 PSA 1.0, no family history,
> but an abnormal DRE. Biopsy was advised and scheduled back on 4-15 and
> that's how I feel. On hold. And I guess the worry continues until the
> results.

The hardest period for me was between the biopsy and getting the
results.  After I got the results, I was "Right.  Ok, what has to be
done next?"  At least you're on here talking.  I didn't even think of
this group, and was not telling anyone for fear of needlessly scaring
people.  Find someone to talk to if you can, and if you haven't
already.
John - 12 May 2008 19:40 GMT
> > I have my biopsy tomorrow morning. Age 46 PSA 1.0, no family history,
> > but an abnormal DRE. Biopsy was advised and scheduled back on 4-15 and
[quoted text clipped - 3 lines]
> The hardest period for me was between the biopsy and getting the
> results.  

I bet. My urologist appointment isn't until the 27th, but there's no
way I'm waiting that long. The literature they gave me said it takes
about a week to get the results back. I'll be on the phone with them
after a week.

> After I got the results, I was "Right.  Ok, what has to be
> done next?"  At least you're on here talking.  I didn't even think of
> this group, and was not telling anyone for fear of needlessly scaring
> people.  Find someone to talk to if you can, and if you haven't
> already.

Well, I have been, but I haven't been handling things too well I'll
admit. Although I try to fight it constantly, I'm a worrier. I do have
people to talk to...actually guys who've had PCa. I guess I just want
to hear those two words "no cancer".

John C.
Dwight - 12 May 2008 20:48 GMT
> > > I have my biopsy tomorrow morning. Age 46 PSA 1.0, no family history,
> > > but an abnormal DRE. Biopsy was advised and scheduled back on 4-15 and
[quoted text clipped - 21 lines]
>
> John C.

I've just reread what I've typed below, and realize it can come across
as telling you you shouldn't be feeling the way you're feeling (i.e.
"not handling it well").  That is such a normal reaction to "The BIG
C".  So please don't think I'm passing judgment.  I'm trying to share
something that has helped me.

I'm a worrier too, but my meditation practice (or is it benign denial,
I don't know which) has helped me develop at least some courage to
meet what heads my way.  Considering how much of a worrier I am (some
anxiety boogeyman runs in my family genes), I seem to be doing damned
well.  Probably just the gravity of the situation kicked me up a
notch.

I know I'm stepping into the realm of unasked for advice here (and you
get what you pay for), but you might consider preparing yourself for
what you will do if you do have cancer.  I started by buying books
(which is a habit of mine), to start researching what my options
were.  But to tell the truth, I can't remember what I did before the
biopsy results and what I did after.  I know I was online researching
before the results were known.

Having this thing hit you in the face can be a very pointed way of
prioritizing one's life, and figuring out what's important, and what's
too unimportant to worry about.

Mindfulness techniques helped me immensely. You can Google
"mindfulness" or "vipassana" or "Jon Kabat-Zinn" to get more info.
"Mindfulness" is "Vipassana" stripped of its Buddhist roots.  It can
work regardless of what your faith is.  Part of my practice has been
to concentrate on my breath (breathing in, breathing out) as a way to
help the mind quit chasing thoughts.  This also helps to focus on what
is going on RIGHT NOW.  It's very easy for my brain to rush to the
future and paint just the right scenario that will send me into weepy
land.

When I got the news that I did indeed have cancer, I went home,
climbed the stairs to my bedroom, stopped for a moment, started
imagining who would come to my funeral, etc, etc, and broke down
crying.  And at the same time, I started thinking "None of that is
happening right now, and may never happen, and it is not useful for me
to dwell there because I can't be effective, because I have to save my
energy to make proper decisions for myself.  It's just my mind running
away with me."  And I stopped crying and just started researching.
Luckily within the last year I've also developed some slight
confidence in the ability of the human mind to exert control over
mental states.  It really is possible to select another tack.

I'm NOT a "guys don't cry" fella.  I'm fairly based in my emotions,
and have no problem crying if that's what my body wants to do.  I
wasn't ashamed that I was crying.  In fact, I had some previous
experience from a few years ago when I had to put a beloved cat to
sleep.  The worst part of the whole ordeal was imagining it having to
happen.  I really ripped myself up with that.  My mind was ripping me
up, not the situation itself.  However, it is so EASY to get side-
tracked in emotions around created scenarios in the mind, that short
circuiting that mental process can only make me more effective.

I don't know how helpful this would be, but, if you find yourself
caught up in worrying or getting upset, just tell yourself "That's not
happening right now, and may not happen at all."  It will take
repetition, and more repetition, and still more repetition.  The mind
is not always your friend.

I hope I've made some sense here.  I'm sort of poking about looking
for something useful to say as I'm proceeding, and also realizing what
works for one person may not work for another.

Take care.

Dwight
John - 12 May 2008 21:13 GMT
> > > > I have my biopsy tomorrow morning. Age 46 PSA 1.0, no family history,
> > > > but an abnormal DRE. Biopsy was advised and scheduled back on 4-15 and
[quoted text clipped - 94 lines]
>
> - Show quoted text -

Dwight,

Having had a heart attack last year (and a diabetes diagnosis to boot)
I could've written exactly what you just wrote to me. What you've said
are the things I've been telling myself over and over.

Thank you for saying them. You have no idea how reassuring it was, not
only to read your post, but to know there are people going through the
same emotions, thought-processes etc.

John C.
Dwight - 13 May 2008 00:37 GMT
> > > > > I have my biopsy tomorrow morning. Age 46 PSA 1.0, no family history,
> > > > > but an abnormal DRE. Biopsy was advised and scheduled back on 4-15 and
[quoted text clipped - 108 lines]
>
> - Show quoted text -

Uncertainty is the most wearing thing for me so far.

Dwight
Steve Kramer - 13 May 2008 01:51 GMT
I have my biopsy tomorrow morning. Age 46 PSA 1.0, no family history,
but an abnormal DRE. Biopsy was advised and scheduled back on 4-15 and
that's how I feel. On hold. And I guess the worry continues until the
results.

==>  I suspect it goes past the results.  Wondering whether or not the
needles missed cancer will probably bug you for awhile even after a good
report.  And then, if you find you do have cancer, there's the worry about
the post-op report, then the worry about each PSA test after that.  It's
hard not to worry once the seal is broken.

Signature

PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA  <.1  <.1  <.1  .27  .37  .75            PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA  .34 .22 .15 .21 .32                       PSAD .056 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA  .07 .05 .06 .09 .08 .132 .145       PSAD 1.4 years
Casodex added daily 07/06
PSA <0.04, <0.05, <0.04, <0.04, <0.1  2/12/08
Non Illegitimi Carborundum

Steve Kramer - 13 May 2008 11:38 GMT
> I have my biopsy tomorrow morning. Age 46 PSA 1.0, no family history,
> but an abnormal DRE. Biopsy was advised and scheduled back on 4-15 and
[quoted text clipped - 4 lines]
> needles missed cancer will probably bug you for awhile even after a good
> report.

I guess I called that one.

Just got an email from my brother in Vegas.  His PSA has been good (started
testing when I was dx'd), but the doc noted a firmness in one lobe on a DRE.
Sent him in for a 12-needle biopsy.  No cancer found and the prostate is
about "double" in size.  He's still worried.  So am I.

Signature

PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA  <.1  <.1  <.1  .27  .37  .75            PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA  .34 .22 .15 .21 .32                       PSAD .056 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA  .07 .05 .06 .09 .08 .132 .145       PSAD 1.4 years
Casodex added daily 07/06
PSA <0.04, <0.05, <0.04, <0.04, <0.1  2/12/08
Non Illegitimi Carborundum

Steve Kramer - 14 May 2008 00:41 GMT
> Just got an email from my brother in Vegas.  His PSA has been good
> (started testing when I was dx'd), but the doc noted a firmness in one
> lobe on a DRE. Sent him in for a 12-needle biopsy.  No cancer found and
> the prostate is about "double" in size.  He's still worried.  So am I.

Further.  He has gone from 1.0 to 2.1 in five years.  With the doubling of
the prostate size, that makes sense.  So, the only real concern is the
firmness of one lobe.
John - 13 May 2008 19:32 GMT
> ==>  I suspect it goes past the results.  Wondering whether or not the
> needles missed cancer will probably bug you for awhile even after a good
> report.

Nope. If I receive good news, I'm done worrying. Sure, I'll have my PSA
monitored and keep on top of things, but with no family history, a normal
PSA, I refuse to let this worry me any more....provided a negative biopsy of
course.

John
Dwight - 13 May 2008 22:15 GMT
> > ==>  I suspect it goes past the results.  Wondering whether or not the
> > needles missed cancer will probably bug you for awhile even after a good
[quoted text clipped - 6 lines]
>
> John

Not to worry you, but my PSA was .8.  Then went up to 1.0.
Steve Kramer - 14 May 2008 00:34 GMT
>> ==>  I suspect it goes past the results.  Wondering whether or not the
>> needles missed cancer will probably bug you for awhile even after a good
[quoted text clipped - 4 lines]
> PSA, I refuse to let this worry me any more....provided a negative biopsy
> of course.

That would certainly be our recommendation.
Lud - 13 May 2008 02:24 GMT
> > > Oh oh....you two are totally dangerous together!!  8-))  Same dry sense
> > > of humour.  That oughtta get you thru everything, Duh-wight.  You are
[quoted text clipped - 12 lines]
>
> John

Folks

I worried too being diagnosed with a PSA of 34 - that is a serious
number and have been fighting it since Jan 1999 - it has not been fun.

John & Dwight - I would love to have been in your shoes! You have the
very best chance of beating the damned delinquent cells.

There are other tests that can help better define a diagnosis.

1 -  Biopsy with color doppler ultrasound as practiced by Drs Duke
Bahn or Fred Lee.

2 - Prostascint scan combined with CTscan by an artist.

3 - MRi with spectroscopy as done at UCSF

4 - PCA3 test

5 - Bostwick Labs uPM3 test

6 - Combidex test for lymph node involvement

None of the test are perfect but a combination may give more precision
and sometimes confusion.

That is the problem with this disease - too many unknowns and most men
don't care to fight for a cure.

Lud
Larry - 07 May 2008 14:19 GMT
Gadolinium has been used as an MRI contrast agent for years. I suggest
that you have your kidney function tested prior to each test to make
sure it can handle it (if you agree to it).

Larry E.

> I'm being asked to take part in a study at UCSF where they do an MRSI
> on me.  They also want to use a contrasting agent called Gadolinium.
[quoted text clipped - 12 lines]
>
> Dwight

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