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651 Responses to “General Discussion”

  1. Bob

    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.

    Reply
    • Michael Lasalandra

      Bob,
      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.

  2. Susan

    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…

    Reply
    • Michael Lasalandra

      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.

  3. Francis A

    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.

    Reply
    • Michael Lasalandra

      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.

    • Francis A

      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.

  4. Bob

    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

    Reply
    • Michael Lasalandra

      Low grade is a 3. To my knowledge, there are no 1′s or 2′s.

  5. Hugo Chagas

    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.
    Best Regards
    Hugo

    Reply
    • Michael Lasalandra

      Sometimes a Gleason score of 6 on biopsy actually is a 7 when more tissue is able to be examined following surgery.

  6. Larry

    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.

    Reply
    • Michael

      Larry,
      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.

  7. Michael Lasalandra

    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!

    Reply
  8. bill smith

    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.

    Reply
  9. Richard

    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.

    Reply
  10. Brian

    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

    Reply
  11. Raquel Epstein

    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 ?

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  12. Adam

    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

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  13. Edward N.

    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.

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