Prostate biopsy

[TainoWarrior]

I pray that you find recovery brother. I’ve had the biopsy (psa 10) but no cancer. My prostate is enlarged so that’s always an issue for me. I’d stay away from the surgery unless I was past my late 60s. Just me. I would explore the options already posted. Seek the Lord for some direction and healing.

IronInsanity , and all you other brothers , its an honor to have you bros comment and share your wisdom with me. No cap. You bros know that this takes alot from me to share this type of issue with anyone . Its a big thing for me for I have never had anything quite like this to bare. :Yes I am taking heed to all the advice and all thats been shared . I will keep everyone up to date in this and once I truly make a decision I will post and share with my TID fam. I for one dont think that my gear use had anything to do with this . That being said it does run in my family tree starting from my granddad and my dad , they all had problems with theirs. To keep it real my Grandfather had all his male reproductive organs , ALL , taken from him by age 75. But he never went to a doctor cuz he was scared of doctors. He had prostate cancer stage 3. Im glad they caught it early. Thats for sure. Im reading and researching and of course asking questions. I have a list of questions for my next appointment which is Radiation. Thank you all for sharing your thoughts and your knowledge and wisdom with me ..


Taino ,

God bless you all

 

[2ez]

Very promising results. do your due diligence, but dont wait 1yr to pull the trigger.

Good replies here.

Good Luck my Brother.... you will be fine.

 

[TainoWarrior]

What grade is the cancer? What is the Gleason score? What is the TNM staging? What type of biopsy was it? Standard US or fusion (US/MRI)? Did you have an mp (multiparametric)-MRI before they did the biopsy? Did they do genomic testing on the biopsied sample to determine how aggressive the cancer may be going forward? The most important part of this is making sure you have a doctor and clinic that knows their shit and is up to date on cutting edge treatments. Testosterone doesn't cause prostate cancer nor does it cause it to grow exponentially. Once you have a testosterone level of 250 ish, further increases have minimal effects, only ADT will cause regression, often temporarily. In fact there are biopolar treatments (one 400 mg shot of TC a month that can control metastatic PCa in a number of men). There are also laser treatments that depending on the lesion size, grade/score, etc. where they can simply ablate the cancer and do no further damage. https://www.uchicagomedicine.org/cancer/types-treatments/prostate-cancer/treatment/focal-therapy I believe there is a doc at the Cleveland Clinic that is doing this as well. Do your homework, your future quality of life depends on it, this isn't the 1970's, make sure your doc isn't still living there or they are simply a cancer treatment factory where they do what is best for them.

CC: prostate cancer
HPI: TainoXXXXXX is a 52 year old male with new diagnosis of prostate cancer. His recovery from the biopsy is uncomplicated. He did not tolerate the biopsy well with much pain.
His path is one core + left base gl 3+3 30% of core with - PNI
He had one core HGPIN.
This is ggg 1 and stage 1 ct1c
ROS- no fevers/chills/nausea/emesis/chest pain/shortness of breath/change in bowel habits/weakness

A/P Stage 1 early prostate cancer
We reviewed the long natural history of this cancer
Options are active surveillance
Radiation
surgical removal of prostate
He will consider each then decide on plan
Referrals sent

Thats what I have right now Wilson, I can get more info , Gleason Score was a 6. I did not have an MRI before the Biopsy though. They did the biopsy and sent it to their labs . Im new to this so I dont know too much , Im learning as I go .

 

[Wilson6]

CC: prostate cancer
HPI: TainoXXXXXX is a 52 year old male with new diagnosis of prostate cancer. His recovery from the biopsy is uncomplicated. He did not tolerate the biopsy well with much pain.
His path is one core + left base gl 3+3 30% of core with - PNI
He had one core HGPIN.
This is ggg 1 and stage 1 ct1c
ROS- no fevers/chills/nausea/emesis/chest pain/shortness of breath/change in bowel habits/weakness

A/P Stage 1 early prostate cancer
We reviewed the long natural history of this cancer
Options are active surveillance
Radiation
surgical removal of prostate
He will consider each then decide on plan
Referrals sent

Thats what I have right now Wilson, I can get more info , Gleason Score was a 6. I did not have an MRI before the Biopsy though. They did the biopsy and sent it to their labs . Im new to this so I dont know too much , Im learning as I go .

If you have PCa, this doesn't look like a bad place to be. GS of 6, T1c and GGG1. Probably more guys on this board walking around with just that and don't know it. PIN is where some of the prostate cells look/behave abnormally. High Grade is more likely to progress to PCa but not always. What you don't know is what is going on in the rest of the prostate that was not biopsied. If the PCa is localized, targeted ablation may be the best option. Seems to me (my non-medical opinion) that either radiation or surgical removal of the prostate is a bit extreme given this path report. I would get a second opinion by a doc/hospital that specializes in what is best FOR YOU, not them. I would also ask about an mp-MRI to image the rest of the prostate. I sent the path findings to my urologist to get his opinion. He worked at one of the top hospitals in Cleveland for decades, seen it all and accomplished surgeon.

 

[rawdeal]

Taino, thank you for this thread. With TID's membership trending toward somewhere over 40yo, it could, maybe should, attract some replies for you, and some food-for-thought for many of us ........................ Maybe you, I, and others can all learn from this thread ... thanks again.

A few days ago I hoped this thread might prove valuable to an audience that needs to consider this stuff, and we all got lucky. Taino, your openness about what's going on with you got us started ... thank you. Wilson6, your insight here and on other subjects is always must-read material ... glad you're here in this thread.

 

[Wilson6]

Something else I was thinking about, aside from Fred Hatfield, how many bodybuilders have died from metastatic prostate cancer? Heart disease yes, PCa it's just not common at least that I've heard. Has anyone else known of any of the guys from the 70's and going forward dying from PCa? You'd think PCa would be epidemic in BBs and PLs from the 60's - 90's if androgens were indeed initiators or growth promoters, even GH. Aside from what Bob Goldman speculated in "Death and the Locker Room" back in the 80's, it's just not mentioned.

 

[Wilson6]

CC: prostate cancer
HPI: TainoXXXXXX is a 52 year old male with new diagnosis of prostate cancer. His recovery from the biopsy is uncomplicated. He did not tolerate the biopsy well with much pain.
His path is one core + left base gl 3+3 30% of core with - PNI
He had one core HGPIN.
This is ggg 1 and stage 1 ct1c
ROS- no fevers/chills/nausea/emesis/chest pain/shortness of breath/change in bowel habits/weakness

A/P Stage 1 early prostate cancer
We reviewed the long natural history of this cancer
Options are active surveillance
Radiation
surgical removal of prostate
He will consider each then decide on plan
Referrals sent

Thats what I have right now Wilson, I can get more info , Gleason Score was a 6. I did not have an MRI before the Biopsy though. They did the biopsy and sent it to their labs . Im new to this so I dont know too much , Im learning as I go .

His reply relative to the PSA and age. "Now that truly surprises me, no inflammation on the biopsy report. How many cores? Would definitely see in 4 - 6 mo and repeat PSA w/percent free. Suggest an MRI even though lesions less than 5 mm are missed. 52 is too young for a PSA that high. A fusion biopsy would will likely be best for any suspicious areas on MRI. If positive, a genetic test would be helpful to get a prostate specific score for high grade disease possibly not detected on the biopsy. PCa is multi-focal and can have different grades in the same gland." His concern with a PSA of 11 at age 52 and standard biopsy that only samples a very small area of the prostate is that there is a high grade cancer that was not detected with the biopsy. Thus the recommendation for the MRI and a guided (fusion US + MRI biopsy) to get a better picture of the entire gland. You need to follow up and get more clinical data from a specialist and clinic that is state of the art. A lower PSA with the above path report would be an easy call for active surveillance, but a PSA of 11, rule out something more aggressive that is being missed. If it were me, I would want more data before and the entire prostate imaged before making any decisions.

 

[IronInsanity]

His reply relative to the PSA and age. "Now that truly surprises me, no inflammation on the biopsy report. How many cores? Would definitely see in 4 - 6 mo and repeat PSA w/percent free. Suggest an MRI even though lesions less than 5 mm are missed. 52 is too young for a PSA that high. A fusion biopsy would will likely be best for any suspicious areas on MRI. If positive, a genetic test would be helpful to get a prostate specific score for high grade disease possibly not detected on the biopsy. PCa is multi-focal and can have different grades in the same gland." His concern with a PSA of 11 at age 52 and standard biopsy that only samples a very small area of the prostate is that there is a high grade cancer that was not detected with the biopsy. Thus the recommendation for the MRI and a guided (fusion US + MRI biopsy) to get a better picture of the entire gland. You need to follow up and get more clinical data from a specialist and clinic that is state of the art. A lower PSA with the above path report would be an easy call for active surveillance, but a PSA of 11, rule out something more aggressive that is being missed. If it were me, I would want more data before and the entire prostate imaged before making any decisions.

I've had a high PSA for 7-8 years, near his, and in his age range. No cancer. I think different docs have different opinions on PSA. One doc was ready to prescribe my cancer treatment just from seeing my PSA, before my biopsy.

You sound like you know a lot, but I also don't have a whole lot of confidence in medical opinions from one doctor to another.

 

[searay]

A few yrs. ago my primary, internal med. doc, told me that a study had been done using thousands of men who had some form at various stages of prostate cancer. The men who did nothing ended up having a less painful, more productive, longer life than those who did one or more of the available procedures.

 

[Wilson6]

I've had a high PSA for 7-8 years, near his, and in his age range. No cancer. I think different docs have different opinions on PSA. One doc was ready to prescribe my cancer treatment just from seeing my PSA, before my biopsy.

You sound like you know a lot, but I also don't have a whole lot of confidence in medical opinions from one doctor to another.

I think he would be more comfortable with a PSA of 7 - 8 vs 11. In Taino's situation, given he has PCa and high PIN, the higher than expected PSA could represent a higher grade PCa in an area that wasn't biopsied or it may not. He was just surprised given a Gleason6 the PSA was 11 without evidence of inflammation that can drive PSA higher alone, BUT he is not Taino's doc just commenting on what I sent him. His point is, consider an MRI along with other diagnostics to assess the entire prostate and see if there is anything else that looks suspicious or concerning. If there is nothing else there, then active surveillance is probably the way to go and recheck in 6 mo. If one assumes all is well based on a biopsy that only looks at a small fraction of the prostate and there is a high grade PCa elsewhere that gets outside the capsule before it is caught, then he's fucked. Trust but verify as Reagan once said. I have a close friend that just turned 80, his path report looks very much like Taino's, he also had a positive DRE for the past 3 years. Same urologist as mine and we are all close friends. The CCF doc that sees him now told him active monitoring. He is also on HRT (mix of TC and ND about 200 mg/10 days), they told him to continue on the HRT. He's been on it for 40 years. The other issue with some treatments is, they limit other options going forward that might be necessary if the first treatment doesn't work. Know as much as you can before making a decision. If it were me and I thought based on a rising PSA that would be the course I'd have to take, I told the docs, before we do any biopsies, we do an mp-MRI and other testing, then if there is something to biopsy and other tests suggest PCa, we do a fusion biopsy and go from there. I'm just throwing out my non-medical two cents based on my research. The rest is between Taino and his docs.

 

[TainoWarrior]

Hello TID fam. I hope everyone is maintaining and doing well. A little update, I went and spoke with the the Dr who will be in charge if I decide to get radiation. He gave me the ins and outs of several options. He feels that because Ive been having problems urinating that I would be under what he called Favorable Intermediate Risk. So I went ahead and asked about the MP-MRI and he said that was his next step anyway. He got the MRI set up , they have to call me with a date . He wants me to talk with the surgeon and hear him out . He says that either way I will have some side effects. My main thing was that he didnt think that the radiation seeds were needed only because he feels that with External radiation I should be fine . I told him that I wont be making any decisions until after the MRI. I am going to mention the fusion biopsy in my next appointment with the Urologist/Surgeon . Bros, I will get as much knowledge and info before making any decision. Thank you all for being here where I can share my fears and concerns. I appreciate every one of the replies . Again , thank you .

 

[midevil]

Bro I had Prostate cancer 11 years ago and opted for the surgery.

There's so much information that I can offer but really don't wanna make a huge post jumping in the topic a couple weeks late. Based on what you've learned in the past 2 weeks from your medical staff what questions do you have?

I'd be happy to post or you can pm me.