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Biopsy confirms prostate cancer in 12 out of 12 cores
Hi, all. It appears my initial post ("Journey begins - age 51, PSA 72" https://connect.mayoclinic.org/discussion/journey-begins-age-51-psa-72/) was not premature after all. Based on my biopsy results, I am officially diagnosed with prostate cancer (prostatic acinar adenocarcinoma). I missed a call from my urologist to discuss my test results and interpretations, but I have the full pathology report. In case anyone is interested, I'll outline below. I don't have any specific questions, I'm just sharing at this point and feeling generally numb about the whole thing.
12 out of 12 cores (systematic biopsy) show prostatic adenocarcinoma; my six grade groupings are 2 at 8 (4+4), 2 at 7 (4+3), and 2 at 7 (3+4). Percentage of pattern 4 is 71-80%, with approximately 81% of the total combined core samples (137mm out of 169mm) identified as cancer. Intraductal carcinoma could not be determined, with at least one of the samples showing an IDC component that "cannot be excluded". Additional words listed were "invasive carcinoma", "cribriform pattern favored", and "cribriform glands present".
Without having discussed with my doctor yet (aside from Dr. Google), I'm guessing this is not exactly ideal. I already have an abdominal CT scheduled for tomorrow, and an urgent order in for a full body bone scan which I hope to get scheduled ASAP. I plan to ask my doctor about other scans as well. Based on these results and other symptoms, I fully expect that it has already metastasized, so it's a matter of determining where and how much.
Ironically, I feel calmer and less anxious now than I did before seeing the pathology report. I feel more concerned about how this will affect my family than how it will affect me. But regardless, we will share the journey and figure out next steps together.
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Since you have 2 Gleason 8 cores you are a Gleason 8. The other symptoms mentioned imply the cancer has gotten outside the prostate. You should ask your doctor if you can get a PSMA Pet scan ASAP. CT and bone scans are ok but the PSMA pet scan replaces both of them and produces much more useful information. If he doesn’t agree, go somewhere else.
You also want to get a PSMA pet scan so you can have a baseline from which other scans in the future can be based.
This is treatable and you could live MANY years. You just need to be proactive about getting optimal treatment.
Speak to your doctor ASAP but you are in need of a medical center of excellence, like Mayo, to make sure you got the best treatment, since you’ve got a complex case. If you are not near a Mayo Clinic, let us know where you live and we can give you some information about where to go.
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10 ReactionsThat's a lot of detail in the report. Much more than I had.
Now you know it's cancer, the discussion obviously moves to treatment options.
At 51, you'll hear a lot of "a good candidate for surgery", which may be a good idea. It depends on how the scans go.
Sounds like you're in great hands & can always come here to share updates & vent.
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3 ReactionsI'm sorry for your result, but glad that you can end the stress of wondering and focus on treatment now. A bone scan is valuable, but you might also want to ask about a PSMA PET scan before you start treatment -- it can spot smaller metastases, especially those not on your bones, but it's not that useful once you start on hormone treatment, from what I've heard.
I hope they don't find any metastases, but even if they do there are excellent options for managing the cancer so that you can continue living a good life for a long, long time. Our goal here is to keep living until we die of something else (preferably old age).
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8 ReactionsIn case anyone is interested?? On here everyone is interested, so many people on here whom will share their journey. You are in the right place. You are not alone no matter what your diagnosis. I wish you the best on your journey, please know you are not alone. This site has been a blessing to me with so many people to help us push on. Best to all.
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14 ReactionsI sought local treatment but transferred my care to Mayo Clinic Rochester MN. It is a 10 hour drive which I now do quarterly. In three years, I have made the trip 17 times. They are phenomenal and my life is worth the trip. I am now clear…but was stage 4, Gleason 10. The trip also gave me precious time with my wife. Mayo was incredibly with scheduling so I could get all my testing and scans done on Thursdays and have treatments/doc visits Fridays so I could return Saturday and miss the least work.
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6 ReactionsThis is a list of NCI cancer centers: https://www.cancer.gov/research/infrastructure/cancer-centers/find and hopefully one is near you
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5 ReactionsI'm sorry about your diagnosis as it's quite a shock to learn you have PCa, but I certainly wouldn't assume it's metastatic. A PSMA scan is the gold standard for determining that. Based on the results you may have several treatment options which include surgery and radiation. I chose surgery at 60 in August of 2022 and have had no post surgery issues. I'd try to schedule your biopsy consultation with your doctor as soon as possible and get the PSMA Scan. Good luck. You'll be okay.
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6 ReactionsThanks for the update. I'm sorry you have PC and hope your additional tests turn out well. You seem upbeat about your diagnosis. Please keep posting to this forum.
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2 ReactionsThanks for your support. I'm just trying to keep it together by focusing on the clinical aspects and cold facts and not on what this might mean for me as a person and for my family. Part of me is terrified, but I'm trying my best to suppress that for now until we know more facts and have a plan and a path forward. As many have pointed out, a PSMA-PET scan would be helpful (I plan to speak with my care team today about whether that is an option for me), and in the meantime I know I am possibly getting ahead of myself in assuming it has spread - which we can't know for certain yet.
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1 Reactionnear to mayo Rochester. Which Dr did you use and are you satisfied? Looking for a Dr this is on the cutting edge. Thank you.