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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") 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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The Gleason score of 10 after surgery means your cancer is very aggressive. Did they ever mention you had intraductal or cribriform? Those make it much more aggressive and pretty much guarantee metastasis will form with a Gleason 9 or 10.
Instead of Dr. Kwon guiding your treatment (he is a urologist not a GU Oncologist) you could go to Mayo and get help from their oncologists or get an appointment with Doctor Scholz in Marina Del Ray California, you can listen to some of his speeches on YouTube, he’s pretty knowledgeable to put it mildly.
You really do need some expert advice on treatment with a Gleason 10. I would recommend you connect up with Ancan.org. They have 2 hour online meetings every week for advanced prostate cancer patients. They send out a newsletter every week that has incredibly helpful information in it about new and existing treatments. They’ve had a number of people that have gone to Doctor Kwon and have not had the best treatments, even though Doctor Kwon gives some great speeches at the PCRI conferences. They can fill you in on the issues people have had with him. They’ve been working with cancer patients for 15 years and really know what’s going on. New people are given first priority and can usually find very up-to-date. New information on what to do with their treatment.
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2 ReactionsFirst of all, sorry to hear about your diagnosis. I felt numb when I got my biopsy results 3 years ago that I had a G8 prostate cancer.
I know you have not yet had your diagnostic tests to determine if the cancer is confined to the prostate, if there is direct contiguous spread, local (pelvic nodes) spread or more distant metastatic disease.
If your disease is confined to your prostate or a few pelvic nodes, it is treatable with a possibility of cure.
If you have oligo metastatic disease (distal spread to about 3 or fewer sited -bone or lymph nodes) there is also hope for long term remission or even cure (according to some reputable medical oncologists). Some cutting edge medical oncologists at Centers of Excellence are treating newly diagnosed oligo metastatic disease very aggressively . RP or radiation to primary (prostate), MDT ( radiation to the few distal metastases), and triple therapy consisting of ADT (Lupron or equivalent), chemotherapy with Docetaxel and androgen receptor blockade drug like Darolutamide. The very aggressive initial therapy is aimed at removing the primary tumor, killing the known few mets with radiation and treating the micro disease with the triple therapy. At some centers this approach has shown to kill the aggressive clones and if the cancer returns it is a more manageable, indolent variety.
Good luck in your journey.
Here’s my score card13/13 cores cancer Gleason 9/10 on Feb 2, 2022, with 2 pelvic lymph node involvement. Here I am today PSA < .01 taking ADT drugs. Gonna stop the ADT in Jan 2025 to see what happens to my PSA. Had 28 radiation treatments too. Side effects- fatigue. Age 76 now. Not dead yet. Hope this helps your mind. Lol
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3 ReactionsNot good news. But, as you mentioned, at least you know and the issue has been addressed. Now comes the treatment options.
I was diagnosed in 2010 with PC with Gleason 3+3; PSA" 6.47. Because I was in the military and prior to deployments a modest physical and blood work is normally done. As such, I was able to see my PSA "jump" several points in one year. Like you, a biopsy..not one but two to validate.
I went to Loma Linda for proton radiation therapy for 2.5 months. I can recall the doctor at Loma Linda saying to me the cancer was in one small location hence directed proton radiation would be the best option. He indicated many men come to Loma Linda, but because their cancer is more spread out, directed proton radiation cannot be an option. Proton radiation was initially designed for children with brain tumors.
This is just a matter of information/opinion from one who went through all the mental challenges of understanding the disease which effects one out seven men in the US. Good luck..RH/Florida