Morris

kgf3076, that consensus is certainly correct. Most prostate cancers are slow growing and appear at an age when you don't have that much time left. However, mine appears not to be a slow growing cancer and I don't even qualify for medicare yet. Since 3 of 4 grandparents lived to be in their 90s, I agreed with both of my urologists that I should do something now before it leaves the prostate and goes somewhere else. If that happens treatment can be much more difficult, or even useless.

Morris

Part 2


Skip to March of this year, 16 months after biopsy #3. (that’s 3 biopsies, 36 samples taken, if I was confusing before.) Have a PSA test and it has gone to almost 16. My urologist refers me to a place in San Francisco where prostate research is being done. I am scheduled for a, [quote] a clinical MRI prostate cancer staging exam with MRI spectroscopic imaging, [unquote]. So in May, I go to SF, and while in the waiting room I take an Ativan because they will not put me under and I have to lie still for 45 minutes to an hour with an endorectal coil up the patoot. Boy did that Ativan work good. I slept for the last ¾ of the MRI.


A week later the results were a finding consistent with prostate cancer in the left apex with no evidence of invasion anywhere else except the prostate, which is good. Once the cancer leaves the prostate, it’s a whole new ball game.


On the day that I have the MRI, it is announced by Genomic Health that a test called Oncotype DX Prostate Cancer Test is now available. This test is supposed to help identify whether the cancer in the prostate is a low risk type where the patient can choose to watch and wait instead of a higher risk where treatment is advised right away. I am referred to the urology department where these tests have been done. I am scheduled for another biopsy and I am anxious for this test to be done using my tissue to help me make a decision about what comes next. This test is different than another that has been used for many years, called the Gleason score. I will ask that you Google it as I’m not a great typist and you’ll get a better understanding if you do.


In August it’s biopsy time and I have been informed that they will not put me under. Out comes the Ativan. I thought that since they know the location from the MRI, that they will only be taking 2 or 3 samples. Oh was I wrong. Fourteen. Thank God for drugs.


On September 11, I meet with the urologist (not my first choice of dates) and there was cancer in 8 of the 14 samples. I have two Gleason scores that are 3 plus 4. That means that I should have treatment of some sort within six months. (a later second opinion with my local urologist agreed, only he said two months) Now I get a 30 minute counseling session regarding risks and benefits of different treatment alternatives. I think the treatment options be the subject of chapter 3.

One of my first questions was if they did the Genome DX test on the tissues. When he says no, my temperature begins to rise. Then he explains that they do this test when your risk is low, determined by other factors (I think the Gleason score and the location of the cancer). Since they determined that I was in the mid-range of risk, treatment in the short term was recommended, and further testing was not needed. I might add here that the Genome DX test is not covered by insurance (yet) and could have cost nine thousand dollars out of my pocket.

MsPerky

The Gleason score has two numbers (primary and secondary). It is considered very accurate. The fact that your Gleason score is higher in the second number (4) is positive for you. The total (7 in your case) is in the mid range between 5 and 10, 10 being the worst. My family member's was a 9 (5+4). So the need to act quickly. He did not have the Genome DX test you refer to. Interesting since his risk was high. Perhaps it was too new, a cost issue or the results of the other tests were conclusive enough without it.

Morris

The DX test is used, as I understand it, when all other indicators (Gleason score, location, types of cancer cells) show that the patient is in a low-risk category. The test then determines the chances of remaining in the low risk, and avoiding further necessary biopsies or treatments. Since I, and your family member, MsP, are in mid or high risk, there's no reason to do the test.

MsPerky

^ Gotcha.

Lainey

Why would they not sedate you for your last biopsy? I do not understand why the medical community does not use versed or propofol for the more uncomfortable procedures. Men everywhere have noted the discomfort with this procedure. Granted sedation is costly, may have to be done in a different setting, medications can cause side effects, etc., but I don't get why they are so stingy with the drugs whey they know they will be inflicting pain. As far as any MRI's, pass the valium please, especially if foreign objects are situated in any orifice of mine.

Morris

Lainey I don't know. My guess is that it slows down the system and they would need an anesthetician and more room for wakeup and recovery. When I asked, I was just told that "we don't do that here". They didn't object to my drugging myself, which helped.

Legal Bill

Robot, radiation, knife. Which option are you going with?

Morris

spoiler alert for chapter 3--












surgery.

boltonblue

my co-worker had investigated alpha particle bombardment a few years for treatment of his.
It was only available on the west coast at the time ( might still be) which meant relocating from the east coast for 3-4 months during treatment.