I’m 65 yrs old. On 03/24/14 my total PSA was 3.3 —04/15/14 it was 2.4 —07/28/14 it was 2.5. At the same time the PSA’s were taken they also had 2, PCH-3 tests done. On 03/31/14 the score was 133 —on 08/07/14 it was 178. a biopsy was recommended. I just got the results this week. 12 samples were taken, eight of the 12 showed cancer. One sample showed 20% another showed 10% and 6 showed 5%. My Gleason score is 6. I will have a full body PET scan and a CT scan on 10/23 to determine if it is anywhere else besides the prostate. I do have BPH and have been on Rapaflo on and off. I have tried saw palmetto, nettle root and pygeum extract over the years to help with urination but the rapaflo seems to work the best. I don’t like the retro-ejaculation side effect from the Rapaflo. I am in good health. I work out 4-5 times a week eat a healthy diet keep my weight down. I have found this web site and I am writing to get some opinions of what might be a course off action towards treatment once the scans are done and I consult with my doctor. Right now I am leaning towards watchful waiting.
Eight of 12 cores with cancer is somewhat concerning.
I understand that if the free psa is over 20% the odds of the total psa being caused be cancer progression would be relatively small. (higher is better?)
My high psa is caused by BHP, so in my mind it’s the free psa to watch, am I looking at this the right way?
from the date of my biopsy/diagnosis my psa has stayed the same at 6.5
I guess I confused the question, I know the amount of cancer found. It’s the amount in % of free PSA I am wondering about, and its values of watching.
That’s what the urologist wont comment on.
Not sure why not. Isn’t 15 percent of some significance? I remember when I first had mine tested I waa just shy of that. Didnt seem to matter.
Two years ago I was diagnosed with Gleason 6 PC, one positive core 1mm and
found mostly BHP, my psa was 6.5 at that time.
I’ve been watching and waiting since.
My one year “gold standard” last Dec/2013 biopsy was refused by myself and opted for an
MRI with the latest high resolution Tesla 3 it saw nothing other than some spinal
stenosis, it also measured my prostate at 66cc.
My psa has hovered around 6.5, with a 66cc prostate that would be a normal range.
This new urologist is reluctant to tell me my free psa or % ratio, saying it’s irrelevant
knowing that there is cancer present.
My question is, is it irrelevant? it would seem to me it’s rather important to know how much
of the psa is caused by cancer. I am by no means down playing the PC,
but I just cant help but feeling like they are trying to break me down and not showing me all
Your urologist is nuts not to tell you the percentage of cancer in each positive core.
Just back from appt with Dr Scholz in Marina del Rey. 6 months check up. Got sonogram, regular blood tests as well as brand new test, not covered by insurance–$412–supposed to give same results as biopsy with getting one. Sonogram–doc said–”not bad”, same low blood flow since first test in Jan 2013, same size, same place on gland. So no changes. Then new blood test—guesses i have gleason 7-8–have high chance of advanced stage–although there has been no changes in each 6 months test since Jan 2013. I read article that says low risk prostate cancer has gleason 6 0r 7. So once again they are pushing much harder to get biopsy–then move to treatment–surgery, chemo, radiation. I always send my results on blogs or forum to get feedback from other guys, plus what their prostate, conditions, decisions are–or what you would do in my position?
Your post is confusing. You aren’t sure of your Gleason score?
So get the biopsy and then you’ll know what your Gleason score is.
Yes Bob, The way I see it you only have three real choices. (1) Run out and get operated on and “cut it out” and get “cured” (that is if the cancer isn’t spread by the surgery) and live out the rest of your life dealing with the all of the debilitating side effects while continually watching and hoping that your PSA never recurs. (2) Follow Michael’s advice and doctor shop and deal with your cancer that shouldn’t be called cancer by watching and waiting … and watching and waiting … watching and waiting … now 12 years and counting … watching and waiting … it worked for him … watching and waiting … kind of a catchy phrase … might be a perfect name for a website … watching and waiting … a pleasant sounding never ending way to while away the hours of your golden years. Or (3) Do just a little bit of research and realize that you made a horrible mistake ever getting a PSA test, let alone a biopsy, and forget it ever happened and go out and try your best to just enjoy the rest of your life.
Ed, just a note of appreciation for your sensible approach which contributed to my decision to forgo any further PSA tests and everything that results therefrom. It’s been almost four years since a urologist said I had “no choice” but to submit to a biopsy based on a fluctuating PSA that could have been explained by any number of benign conditions. No problem so far. Thanks also to Michael for the free exchange of ideas on the site.
I am 63 and just found out I have PC (hard to even say the C word). My Gleason score is 3+3=6 and PSA is 1.94. I am T2a. After hearing that the cells were malignant (2 core samples), my urologist laid out the options. We eventually settled to watch and wait with a PSA test in six months and another biopsy next June. I think that’s the right decision, but after going on the net, the amount of information is overwhelming. Do I stick with the urologist? Do I go to Mass General where they have more resources? The supplements, the nutrition, exercise. It’s just so much. Help! Someone help me sort this out.
First of all, stop worrying. Gleason 6 cancer is hardly a cancer at all. Many docs don’t even call it cancer. Your PSA is low, you only have 2 cores positive (you don’t say what percentage of each has cancer), so those are good. The fact that the cancer was feelable during the rectal is a negative and that I guess is why you are deemed a T2a. Nevertheless, I’d say watchful waiting is right for you. If you want a second opinion, go to my doc, Glen Bubley at Beth Israel. He is the best. He is an oncologist who specializes in PC, so he does not have a horse in the race, so to speak. Won’t be biased in favor of surgery or radiation or watchful waiting. Best of luck. I’ve been doing this 12 years with him watching. So far so good.
Its rare but sometimes you can track down news stories and put together some semblance of the whole story even with the limited medical facts they provide.
This guy was a believer in the “for profit” medical industrial complex and apparently is still a believer. Diagnosed in 2011 at age 54 with minimal PSA elevation and a one of 12 minimal positive biopsy. He was probably scared into surgery because his dad died of pc at 80 (it would be interesting to know but there are no details on his dad’s treatment). He chose “state of the art” robotic surgery (all of my research says its worse). Afterwards he was told he was cured. Now this guy will probably be lucky to reach 70 whereas left alone I believe there’s no reason to believe he wouldn’t have outlived his dad’s old age.
The advertising says this guy’s surgeon performed more than 3000 robotic prostate removals but nothing at all about how many times recurrence like this happens. Good luck with trying to get that information out of the medical industrial complex or even any kind of a real data on whether the actual number of people saved by treatment is higher than the number who eventually die earlier because of it.
WKYT’s Sam Dick recovering from prostate cancer surgery: http://www.wkyt.com/cancer/headlines/WKYTs_Sam_Dick_recovering_today_from_prostate_cancer_surgery_111603349.html
Sam Dick: Robotic Surgery: http://www.vicc.org/news.php?page=2011/06/sam-dick-robotic-surgery/
WKYT’s Sam Dick faces setback in battle with cancer: http://www.wkyt.com/home/headlines/WKYTs-Sam-Dick-faces-setback-in-cancer-battle-266664811.html
My husband was diagnosed with prostate cancer in November. His PSA was 4.2 and cancer in 4 of the 12. Two involved 10% and 2 involved 5 10% in areas biopsied. He is 61 years old. A subsequent PSA six months later was 2.9. He had a second opinion from a urologist at KU Med Centet and also sent his biopsy to Johns Hopkins who confirmed 3+3(6). He has not rushed into anything but now his urologist is pressuring him to “do something”. He is active and healthy. Of course our concerns are the possible side effects and risks with radiation or surgery. Why is it so difficult to “know what to do”?? This Dr owns a radiation operation…
Get a second opinion from a doc who doesn’t have skin in the game. A medical oncologist who specializes in prostate cancer and who can help you in the decision making process objectively.
I am 64 years old. I first found out that I had a high psa in March 2013. I had a PSA of 4.33 in January 2009 but that doctor saw no problem with it. Since then, my PSA has been 6.45 (Jan 2013) and they sent me to a urologist., My biopsy showed “benign prostatic tissue on 5 of them. On the sixth sample I had 3+3 on two of three cores (2mm, 15%, and 1mm 10%). He didn’t see any cancer in the ultrasound, nor through the DRE. I started eating brocolli, taking green tea capsules, and changing my diet a little. Then I found this site and decided to do Active Surveillance. I’ve also taken the other tests and was told I have degeneration of the spine. So I started taking vitamin D3. Since that time, my results have been 6.18 (August 2013), 5.78 with the free PSA showing I had a low probability of getting prostate cancer (December 2013), I had sex within 24 hours of taking the PSA on March 2014 and my PSA jumped to 9.36. In April 2014, my PSA fell down to 7.69. Months ago I asked for the Oncotype DX test. At my next visit, he had sent the results to another doctor. A couple weeks ago I asked for the results and was told they are inconclusive. Today, he told me that my Oncotype DX test has me at a 25% chance of getting a more aggressive tumor and a 75% chance of not getting a more aggressive tumor. He told me I’d need to make a decision on what I wanted to do. Then he performed the painful biopsy. He usually tells me if he sees a tumor, but said nothing. At first he did the DRE and said nothing. Then he took 16 core samples. I’ll get the results next Tuesday. I am African American and I wanted to see what diet would do. To be honest, I haven’t gone strictly with not eating sweets and I love macaroni and cheese. I might have a meat loaf every now and then. Now, I eat mostly chicken and fish. And I’ve added cauliflower to my diet. I’ll see how things go next week.
You already know you have a trace of low grade cancer based on your first biopsy. Lets see what the 16-stick biopsy has to say. Then I will give you my thoughts.
I got my results today and I guess I’m out of the club. Of the eight, my prostate right base has a Gleason score of 4+3 = 7. Of the three cores, two are 25%, 4mm; and < 5%, <1 mm. Perineural invasion was also identified. So I have to schedule for tests over the next two weeks, and then we talk in two weeks about what kind of procedure I'll have. The other seven are benign.
The gleason 7 is a concern.
I recently had a biopsy with a Gleason score of 6 and was told it was low grade and small in relation to the core. I asked my urologist about the individual scoring the T scores of the biopsies and he said they consider all of the low grade patterns the same and don’t bother to distinguish between a 1,2,3. Is that your understanding of the current thinking. He recommends (I am 62) watch and wait
Low grade is a 3. To my knowledge, there are no 1′s or 2′s.
I would like to share my experience. I am 53 years old , I was diagnose with Gleason 6 ( 3+3) last January. My total PSA was 4.3 and the relation between total and free PSA was almost on the limit but ok. My health condition was very good, all blood tests results were ok, except total PSA. Then I stared to discuss with doctors and try to learn more in order to take the decision regarding surgery or watch. All urologist I have the opportunity to talk strongly recommended to surgery procedure. Fortunately I have decided and I had the surgery about 30 days ago. The surgery was a success and I am very well now and without any side effects. After the surgery the doctors examined the prostate and the cancer was contained on the prostate, but the Gleason was not 6, as showed on the biopsy I made in January but 7. The doctor told me I made the surgery on the right time. It is not clear if the change in the Gleason from 6 to 7 was really a change or the biopsy procedure showed a false result, anyway that is the reason I would like to share my experience.
Sometimes a Gleason score of 6 on biopsy actually is a 7 when more tissue is able to be examined following surgery.
Can PC be cured, or contained, using watchful waiting? My stats indicate maybe. I am 71 and have had 3 biopsies over 6 years. My first biopsy (6 cores) indicated 5%, Gleason 3+3=6. My 2nd and 3rd biopsies (12 cores ea) indicated no tumors present. Three cores indicated rare atypical glands present but technically acceptable and no tumors found. Urologist suggests continued PSA every 6 months, and another biopsy in 3 years. Current PSA 4.3. Eating mostly vegetarian, exercise, and taking prostate support supplements.
it is possible your second and third biopsies just missed the tumors that are still there. However, depending on how strict your diet and exercise program is, you may have shrunk your tumors. Dean Ornish has proven this can be done following his diet.
Welcome to the new version of my web site. The site crashed a few months ago and some of the most recent posts were lost forever. Now, it is up and running and can accept new posts. Welcome back!
Good site. I would suggest along with PSA, do a PSA% free and PAP. My PSA varies, due to different labs, but probably more so because of BPH. The other two have remained more constant. I believe in doing PSAs (and others mentioned), but the trick is to not panic. In 15 years my highest and lowest came within 6 months of each other. I have been AS for 10 years now. Am little concerned that psa average is slowly rising, but still around 7. Good luck guys.
I have had three MRIS tests. After the last, Dr. Wheeler in Sarasota suggested I get HIFU by him. It would cost $32,000 since I would have to go outside the country because it’s not approved here. I’m trying to get another opinion and contacted Dr. Chen at Fox-Case Philadelphia. I’m skeptical about seeing him in May since I ‘m told he is a surgeon and that HIFU isn’t the first choice. I am looking for a prostate oncologist to help me with AS and used the list in the book “Invasion of the Prostate Snatchers” to help find one. I’d like to hear opinions on the situations I’m describing.
I am closed with yours Adam, I am 42. I have Gleason 6 too. My urologist accidentally found it when he did biospy since I have OAB and bladder neck obstruction. He told me not too worry about it and asked me to do psa again in Jun 2013. So please consult your urologist carefully before taking surgery action which may not be necessary. By the way, what was your main reason to take the bladder incision? Is there any improvement after this? Please share more details. Thanks
My husband has just been told he has been detected with prostate cancer – Gleeson score of < 6 —- you say you also are a score of 6 but you do not mention anything regarding staging which is more important that gleeson score – as staging gives you a more detailed idea of how bad the cancer is & whether it has spread to other parts of the body – I am very interested to know what your staging has been – please ?
First of all, I am 44. Last week I had a neck bladder incision and TURP performed. My surgeon called today and said they found I have Gleason 6. Up until today I hadn’t even heard of Gleason 6 (or any of his relations, 1-10). Hi is suggesting a biopsy and then if it is confirmed – surgery. Having done just a little reading – that scares the heck outa me. Problem as I understand it is my age. Should someone my age be a wait and watch candidate? By the way my PSA is somewhere between 11 and 13 depending on whether I’m fasting or not. Comments welcomed. Thank you, Adam
I stopped in to see my urologist and asked for his opinion about my reduced PSA and the jump to near normal of my “free PSA.” Did he believe it was the year-long course of antibiotics following two UTIs or the 6 months of tumeric mixed with black pepper. He answered that it was most likely the tumeric (specifically the compound, “curcumin”);
. I am continuing the twice daily teaspoon of tumeric mixed with black pepper and tomato juice. I was a bit surprised by the doctor’s somewhat ambivalent reaction to the new numbers. A 3.8 PSA is high, but it’s not unusual for a 60-yr-old man with an enlarged prostate. My free PSAS went from the low teens to 21%, close to the ideal of 25%. Bruce Paul, my uncle has experienced his own problems following any number of biopsies. He is 82, in a wonderful relationship with a great woman, and has been impotent for a few years. Doctors could not explain any reason for his impotence and it’s been suggested that a major nerve on his prostate was nicked during a biopsy. Overall, PSA testing seems to create more problems than it resolves.