The "New" Prostate Cancer InfoLink Social Network
A Service of Prostate Cancer International
Bill J's Page
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Men who choose not to have immediate conventional treatment have very few forums to discuss their minority position, known as Active Surveillance or Watchful Waiting. This can be the forum they are looking for
Profile Information
- Have you been diagnosed with prostate cancer?
- Yes
- What brings you to the New Prostate Cancer InfoLink social network?
- Discussion of biopsy and treatment options
- Would you help us grow the network? Would you tell others about it?
- sure
- About Me:
- 50 years old (2009); diagnosed w/ Gleason 6 in June '08; done a ton of research (consults and reading); still not certain which way to go. . . .
The synopsis:
In prep for getting remairried (Sept '08), I went in for a life insurance application-required physical in July. PSA = 4.3; Local uroligist took 8 cores; 1 was atypical and sent to Epstein at JH, who recommended a second biopsy; 8 more taken, with 1 showing 5% -- also sent to Epstein (whose #2 guy read it because Epstein was out that day).
Spent next 7 mos studying. Had the benefit of lots of time with a senior person in prostate research at NCI (undergrad friend of my wife) who layed out the controversy about over-screening/over-treating months before the two recent NEJM studies hit.
But I plowed ahead and interviewed 4 docs (3 surgeons, 1 radiology), settled on DaVinci with a very experienced guy.
Though my docs said it was unnecessary, I took the advice of my NCI guy and did a full imaging study with diffusion-weighted spectroscopy -- the whole deal. Which revealed nothing problematic.
At my pre-op phsyical 9 days before the surgery date, I asked that they take one last PSA -- strangely, they were not going to, saying that they never do that even for prostate surgery pre-ops. But I insisted -- and it came back 1.6.
Turns out --when I went back to look -- it had been 1.5 in '06 and 1.6 in '04.
So I pulled the plug on the surgery. I didn't know that sex (or motorcycle riding, or anything other similar stimulating activity) within 24 hrs of a PSA test can elevate the reading.
Back to the drawing board. My current thinking is that if I could be 80-90 certain that my current 5% of 1 of 16 cores was accurate -- i.e., that i'm not missing other foci -- I'd continue monitoring developments with the focal therapies (cryo, HIFU).
I asked my docs if they knew about 3d biospsy mapping (aka, saturation biopsy) and they don't. They're skeptical and essentially said, "look, you're 50, you have gleason 6, do something. Pick your poison and get on with it"
Anybody here do the 3D mapping? If so, your experience? And what do you think about my current thinking?
For what it's worth, I have cancer in the family -- but no prostate cancer.
- Website:
- http://www.successtrackesq.com
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© 2009 Created by Arnon Krongrad, MD on Ning. Create Your Own Social Network
Comment Wall (5 comments)
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Welcome to the network. Good, clear presentation. Have a look around and consider starting discussions (+Start Discussion) related to specific topics of interest (ex., cancer staging) within groups as Angela suggested. Please let us know if you need any help navigating.
Arnon
You are exactly at the point of the screening controversy. We have to be able to tell you if your cancer is agressive and needs to come out immediately, OR that it is not aggressive and and you can do watchful waiting. This cannot de determined with present day tests. A 3D CDI Trus may help but is not the answer, Docs say G=6, age 50 do something. You say G=6, age 50, maybe I can leave it in and you are probably more right but maybe. Steve Z is the most experienced with 3D mapping and I do know Al Barquawi well. I think you have a watch and wait. Goerge
Hard to ignore prostate cancer at age 50 - hard to want to take the risks associated with treatment for so small an amount.
3-D mapping biopsy positions biopsy needles using a 3-D grid that fits between your rectum and scrotum that is similar to what they use when implanting brachytherapy seeds. Rule of thumb is prostate size in CC + 20 = number of cores required, 51 in my case. Any cancer that isn't found is going to be minute. I felt that I knew where I stood after the biopsy. My cyrosurgeon's patients have gone on and done everything from surveillance to RPs depending on what the biopsy found.
The procedure itself is more rigorous than the conventional sort. It's done under sedation (I remembered nothing) as an inpatient procedure. The first 24 hours were no walk in the park - most men require a catheter, as I did. There was a fair amount of discomfort and I took some vicodin more to sleep than for the discomfort. Things improved rapidly after the first day, but there was some blood in my urine for the first 60 hours and my ejaculate was more blood that semen for the first couple of week. I feel I would have fully recovered without effects, but elected to have focal cryo five weeks afterwards.
If you want to learn more about 3_D mapping biopsy, Dr. Barqawi's (my doc's) web site is http://alprostate.com/ or you can look at Dr. Onik's site http://www.hopeforprostatecancer.com/ and they both return calls.
That's just what I need, a thriving practice and a balanced life.Being a lawyer I can say that there is always room for another lawyer here. Welcome to the site, glad you found us. Give us some detatied reports on you PCa and this will help us offer some ideas. Click on my image to see what I am talking about. Once again, welcome aboard. George I shall get back to you.