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User

Posted 19 Aug 2021 at 17:40

Hello all.

Well, I decided for nerve sparing RP. Quite nervous, but I feel the best for my situation. As you'll see on my Bio, big numbers reduced my options.

Have a lot of faith in my surgeon as he has preformed around 2K procedures. So here goes my giant leap!

Even though I'm in the US, this community site is awesome, you have helped me so much, THANK YOU!

User

Posted 19 Aug 2021 at 22:24

Nice to hear from you across the pond. Hope all goes well. Keep us informed.

Dave

User

Posted 20 Aug 2021 at 08:05

Good luck with the operation- when is it? I had RP March 2020 and have been really pleased so far with the outcome

User

Posted 20 Aug 2021 at 15:03

Thanks Dave. MikeW, your story gave me a lot of insight to make my decision, thank you. I'm scheduled for Oct. 19th. Plan to start pelvic floor exercises asap. Looks like lots of prep for this....

User

Posted 20 Aug 2021 at 17:05

A PSA of 18 isn't abnormally high for localised prostate cancer, by any means. Mine was 31 prior to treatment!

Best wishes for your surgery,

Chris

User

Posted 20 Aug 2021 at 17:24

I talked with with one of my urologists patients who did RP with PSA under 5, so 18 sounds almost terrifying. My brother, as I recall, got up to 33+. He never choose surgery and tried to go naturopath for a cure. Unfortunately he had a melanoma removed which got infected with septis that took him down. He was 79. My father had PC also, but diagnosed very late in life and they let him go on without treatment. He passed peacefully of old age at 94. Definitely will not follow brother, being proactive gives me confidence. (wish I had more dad genes in this case....)

Thanks for thoughts Chris,

Phil

User

Posted 20 Aug 2021 at 21:22

Hi Phil,

It can be worrying waiting for an op although I got used to thinking I was going to sleep and would awake with the cancer gone. Fingers crossed.

Your op in October is quite a long time away. Is that because you chose a busy surgeon, delays due to the pandemic or did they say it didn't need faster treatment?

Your psa went from 6 to 18 to 8 so I'd consider 8 your psa which isn't that high. It's unusual to fluctuate like that unless there's a condition or an error with the test reading. The 18 seems like an anomaly.

Also your prostate is quite large at 50cc, relative to most. That must be contributing something to the psa level. I once read psa rises by 1 for every 10cc over normal which is about 25ish. So at your age perhaps psa 2 is being contributed by the size.

If it's enlarged or agitated it can effect how often you go to the loo and how fast it flows. Did you have such symptoms?

My lesion was said to be 13mm which I thought fairly large to be in one side although I read 20mm is considered large. Yours might be less although they found two.

You might also consider that they say many older men have a low level prostate cancer that they live with until they die of something else. Perhaps your GL6 one is like that depending where it is. The 4+3 one is the one they need to work on, but they'll do both in the op.

I'm just a patient so the above is obviously an unqualified opinion.

All the best,
Peter

User

Posted 20 Aug 2021 at 23:25

Just to give you some context on your PSA - the highest reading we have had on here was 13,000 and there have been quite a few men with over 1000. At the other end of the scale, my husband had a PSA of 3.1 and it had already spread to his bladder. PSA doesn't tell you exactly what is happening inside; it just tells you that there is a problem that needs checking out (unless it is 13,000 in which case it is a certain problem).

You don't have big numbers that would suggest you need to act urgently.

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

User

Posted 21 Aug 2021 at 17:10

Best of luck with surgery. I had mine end of June and it was ok and now recovering. Im sure you are feeling better having made the decision.

User

Posted 23 Aug 2021 at 17:43

I'll answer all questions & comments as best I can with my test results, etc. (don't understand all, some of you will)

First, here is MRI results from two images:

4/30/21 MRI prostate - 53.8cc 14 x 7mm left mid to base PZ (enlarged from 8 x 6mm), PI-RADS 4

9/23/19 MRI prostate - 9 x 5 x 10mm anterior left mid PZ, PI-RADS 4

Biopsy results 9/23/2019:

Prostate: Focal 9 x 5 x 10 mm mass at the anterior lateral left mid peripheral zone seen on 14 of series 6 and 7 with high high B value DWI and low ADC signal with hyperenhancement and washout. The overlying capsule is bulge slightly, however, no discrete transition capsular spread (12 of series 8). No evidence of neurovascular bundle involvement. The peripheral zone of the prostate is otherwise diffusely heterogeneous on T2 signal, however, no other discrete areas of restricted diffusion.

Pasted this info from biopsy 05/24/2021:

B. PROSTATE, RIGHT MID, NEEDLE CORE BIOPSIES:
ADENOCARCINOMA OF THE PROSTATE, GLEASON GRADE 3+3 = 6 (GRADE GROUP 1).

G. PROSTATE, LESION #1, NEEDLE CORE BIOPSIES:
ADENOCARCINOMA OF THE PROSTATE, GLEASON GRADE 4+3 = 7 (GRADE GROUP 3).

PERCENT GLEASON PATTERN 4: 70%.

CRIBRIFORM GLEASON PATTERN 4: PRESENT.

NUMBER OF CORES INVOLVED: 3 OF 3.

PERCENT OF TISSUE INVOLVED: 90%.

LARGEST LINEAR DIMENSION OF TUMOR: 10 MM.

Notes from Dr. after 05/24/2021

67yo male with prostate cancer diagnosed 10/18/19: cT1c, PSA 7.53, Gl 3+4=7 (Group 2) in left apex and lesion #1 (all 3 cores). TRUS vol 63cc.

He had UroNav 5/24/21: cT1c, PSA 7.94, GL 4+3=7 lesion #1 left mid and GL 6 right mid. TRUS vol 58cc.

Looks like I'm all over the place!

There's the technical info above.

Current PSA 8.10 tested 08/17 I tried Rick Simpson Oil after the PSA of 18, it may have lowered it to 7, Dr. did ask how I lowered it!

My Dr. has to get at least 4 to 6 weeks lead time on scheduling as he preforms many RP's with robotic assist. They also want 5 weeks of pelvic exercises before procedure.

I do have a lousy stream, half of what it use to be. Sometimes I better be pretty close to a loo when the urge hits the bladder. Get up once to twice a night to urinate, also like to have a glass of water on bedside table as I'm a mouth breather and live in the West where humidity is 15% to 25% most of the time.

I really feel I don't have the time to wait, last thing I want hear is that it spread.

Sorry for all the pasting of info, but hope the test results can make a little more clarity on my decision to have the RP, I'll watch for thoughts...

User

Posted 23 Aug 2021 at 21:16

OK I can understand some of it. You have a large prostate 53.8cc is bigger than the average 30cc. But that is not unusal nothing to worry about. Gleason 4 is worrying and with 90% of the prostate at least on one side having 70% grade 4. I think treatment is a good idea.

It doesn't look like it has spread, which is good. So you are likely to be curable.

Dave

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