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Advice sorted based on the attached Biopsy & PSA reports

User
Posted 06 November 2017 10:38:48(UTC)

Hello,

My father has been diagnosed with Prostate Cancer. Life has been rather overwhelming for me in the sense that when my father was younger and healthy, my relationship with him was non-existence (there a was good 10 years gap since we spoke just recently). We have both realized that "Life can only be understood backwards; but it must be lived forwards!"

1. If you have experienced a similar diagnosis then sharing the treatments that worked for you would be very helpful!

2. If your a qualified doctor then your opinion would also be very helpful! What do the reports suggest?

3. I would also like to know if a robotic surgery to remove the prostate would be recommended?

4. If there anyone who is in the same situation as me and would like to just talk please feel to reach out to me:

Regards,

Saurabh

My Father's age is around 73 and he has no other major health issues. He was complaining about a back pain for over a year now.

Total PSA Levels over the last year:

18.90 on 01/07/16

30.12 on 19/09/17

 2.468 on 29/10/17 (after Orchiectomy on 06/10/17)      

 

BIOPSY NO.:B/8294/2017

SPECIMEN SUBMITTED: TRUS GUIDED PROSTATE BIOPSY --------------------------------------------------------------------------------------------
GROSS EXAMINATION:
LEFT LATERAL BASE
: SINGLE LINEAR GREY WHITE SOFT TISSUE CORE MEASURING 0.6 cm IN LENGTH (001) (NTL) LEFT LATERAL MID: SINGLE LINEAR GREY WHITE SOFT TISSUE CORE MEASURING 1.2 cm IN LENGTH (002) (NTL) LEFT LATERAL APEX: SINGLE LINEAR GREY WHITE SOFT TISSUE CORE MEASURING 1.0 cm IN LENGTH (003)
(NTL)
LEFT MEDIAL BASE: SINGLE LINEAR GREY WHITE SOFT TISSUE CORE MEASURING 0.6 cm IN LENGTH(004) (NTL) LEFT MEDIAL MID: SINGLE LINEAR GREY WHITE SOFT TISSUE CORE MEASURING 1.3 cm IN LENGTH (005) (NTL) LEFT MEDIAL APEX: SINGLE LINEAR GREY WHITE SOFT TISSUE CORE MEASURING 0.9 cm IN LENGTH (006)
(NTL)
RIGHT MEDIAL BASE: SINGLE LINEAR GREY WHITE SOFT TISSUE CORE MEASURING 1.2 cm IN LENGTH (007) (NTL) RIGHT MEDIAL MID: SINGLE LINEAR GREY WHITE SOFT TISSUE CORE MEASURING 1.5 cm IN LENGTH (008) (NTL) RIGHT MEDIAL APEX: SINGLE LINEAR GREY WHITE SOFT TISSUE CORE MEASURING 1.5 cm IN LENGTH (009)
(NTL)
RIGHT LATERAL BASE: SINGLE LINEAR GREY WHITE SOFT TISSUE CORE MEASURING 1.5 cm IN LENGTH(010) (NTL).
RIGHT LATERAL MID: SINGLE LINEAR GREY WHITE SOFT TISSUE CORE MEASURING 1.0 cm IN LENGTH (011)
(NTL)

RIGHT LATERAL APEX: SINGLE LINEAR GREY WHITE SOFT TISSUE CORE MEASURING 1.6 cm IN LENGTH (012) (NTL) SINGLE LINEAR GREY WHITE SOFT TISSUE CORE MEASURING 1.2 cm IN LENGTH (013) (NTL)
SINGLE LINEAR GREY WHITE SOFT TISSUE CORE MEASURING 1.0 cm IN LENGTH (014) (NTL)
SINGLE LINEAR GREY WHITE SOFT TISSUE CORE MEASURING 1.0 cm IN LENGTH (015) (NTL)

SINGLE LINEAR GREY WHITE SOFT TISSUE CORE MEASURING 0.8 cm IN LENGTH (016) (NTL) SINGLE LINEAR GREY WHITE SOFT TISSUE CORE MEASURING 1.2 cm IN LENGTH (017) (NTL)

MICROSCOPIC EXAMINATION:

001. 10% OF THE CORE SHOWS ADENOCARCINOMA, GLEASONS GRADE: 3+3=6 002. 80% OF THE CORE SHOWS ADENOCARCINOMA, GLEASONS GRADE: 4+3=7 003. 70% OF THE CORE SHOWS ADENOCARCINOMA, GLEASONS GRADE: 4+3=7 004. ..% OF THE CORE SHOWS ADENOCARCINOMA, GLEASONS GRADE: 4+4=8 005. 80% OF THE CORE SHOWS ADENOCARCINOMA, GLEASONS GRADE: 4+4=8 006. 40% OF THE CORE SHOWS ADENOCARCINOMA, GLEASONS GRADE: 4+4=8

 

006. 40% OF THE CORE SHOWS ADENOCARCINOMA, 007. 80% OF THE CORE SHOWS ADENOCARCINOMA, 008. 90% OF THE CORE SHOWS ADENOCARCINOMA,

PRESENT. EXTRAPROSTATIC EXTENSION SEEN. 009. 90% OF THE CORE SHOWS ADENOCARCINOMA, 010. 80% OF THE CORE SHOWS ADENOCARCINOMA, 011. 50% OF THE CORE SHOWS ADENOCARCINOMA, 012. 70% OF THE CORE SHOWS ADENOCARCINOMA, 013. 80% OF THE CORE SHOWS ADENOCARCINOMA, 014. 70% OF THE CORE SHOWS ADENOCARCINOMA, 015. 80% OF THE CORE SHOWS ADENOCARCINOMA, 016. 70% OF THE CORE SHOWS ADENOCARCINOMA, 017. 90% OF THE CORE SHOWS ADENOCARCINOMA,

GLEASONS GRADE: 4+4=8
GLEASONS GRADE: 4+4=8
GLEASONS GRADE: 4+5=9, PERINEURAL INVASION

GLEASONS GRADE: 4+5=9 GLEASONS GRADE: 4+5=9 GLEASONS GRADE: 4+4=8 GLEASONS GRADE: 4+5=9 GLEASONS GRADE: 5+4=9 GLEASONS GRADE: 4+5=9 GLEASONS GRADE: 4+5=9 GLEASONS GRADE: 4+5=9 GLEASONS GRADE: 4+5=9

OPINION: ACINAR ADENOCARCINOMA, GLEASON SCORE: 4+5=9, GRADE GROUP-5 WITH PERINEURAL INVASION AND EXTRAPROSTATIC EXTENSION.

User
Posted 06 November 2017 14:57:21(UTC)

Hi Saurabh,

I have removed your personal contact details from your post to protect your privacy.

Best wishes,

Carol

Digital Manager
Prostate Cancer UK

User
Posted 06 November 2017 18:56:14(UTC)

Hi Saurabh,
I think that you are not in the UK as men in the UK would be very unlikely to have an orchiectomy in these circumstances.

It may be that there is some information missing (for example, was there any suggestion that your dad's cancer has spread to his bones?) but if he has had an orchiectomy it is very unlikely that there is any benefit in having his prostate removed as well.

There are no qualified doctors on here to comment on your post - we are all just people like you, with prostate cancer or with a family member / friend that has it.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard


User
Posted 07 November 2017 17:59:01(UTC)

Hello Carol,

I am very new to all this, sorry if I have not followed the rules. Can you please let me know to edit my post as I would like to add some more reports.

 

Regards,

Saurabh

User
Posted 08 November 2017 00:19:45(UTC)

It's not that you have broken rules but for reasons of privacy that personal details may be deleted as people with intrusive intend may take note. You can always amend your own post by clicking on the top sign on the right with a green background. Sometimes it is just better to add to your thread by using the 'Quick Reply' as not everybody is going back to a post that has been amended. Over time detailed information provided in threads becomes history, so it is always a good idea to show at least basic diagnostic details and general progress under Profile/Bio, a place members can use for easy reference when replying to you. You can source information a member has given about themselves or who they are here because of, by clicking on a members avatar with their username.

Prostate Cancer (PCa) varies in many ways, so is specific to an individual and  best advice is from Dad's consultant(s) who are familiar with his scans and histology. If his PSA now climbs significantly after his orchiectomy, further treatments will be considered but I doubt a prostatectomy, radical or robotic will be one of them. It rather looks like that would be tantamount shutting the stable door after the horse had bolted.

Hope Dad's orchiectomy works for a long time but only time will tell.

This is how it is shown when you amend a post

 

 

Barry
User
Posted 08 November 2017 11:09:06(UTC)

Like almost everyone here, I cannot comment on your lab reports - the last line is important, the details are for pathologists and consultants.

The key missing report (though a doctor would need to see many more reports), it's probably the last line that is all we need here - is the "Staging Report"

This takes the form of TNM - Tumour, Nodes, Metastases: staging is a vital part of treatment planning.

You described a tumour that appears to be  T4 (probably)

We don't know if any lymph nodes are affected

We don't know if there has been distant spread - metastases.

So it is clear your father has at least 'locally advanced prostate cancer', but it is not clear whether it's Advanced Prostate Cancer or not. 

In either case, there are options, but different options.

Your father needs to to discuss the pros and cons of these options with an oncologist and a surgeon. No website can substitute for that, alas, though personal experience often helps with the finer points of decision-making.

 

Good Luck.

 

-- Andrew --

"I intend to live forever, or die trying" - Groucho Marx
 
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