Prostate size/measurement confusion

Posted by oldoz @oldoz, Dec 6 4:18pm

Diagnosed with Prostate Cancer following a Biopsy in June 2023, done by local Urologist.
Was under Active Surveillance prior because of rising PSA. Urologist recommended continuing Surveillance.

Looking for information to help me understand prostate size, because I’m confused?
11/16/20 - 10 grams heavily calcified prostate - local Urologist based on an Ultrasound
06/05/23 - 20 grams normal sized prostate - local Urologist based on Ultrasound
11/16/23 - 20 gram prostate - report by local Urologist following a Ultrasound Needle Biopsy (Gleason 3+4 in 4 of the 12 samples)
08/13/24 - small prostate 16cc - measures 3.7 x 2.8 x 3.1 cm Radiology Report following local hospital MRI
11/27-24 - volume 15.3cc - Mayo Radiologist Summary report based on the MRI CD done at my local hospital
I don’t understand the different types of size measurements grams, centimeters, cc’s, volume?
I read somewhere online that a Prostatectomy can sometimes be a problem if a patient has a smaller prostate, because margins are small?
Mayo/Phoenix Urologist I saw last month ordered a new Biopsy and other tests to be done at Mayo, then a follow-up video appointment in January.
My confidence level on evaluation and treatment has gone up since some of you previously recommended Mayo to me.
Should probably have done it a couple years ago. Thanks.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

Mayo is very very good you are lucky that they are an option for you Good luck k

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Grams are the weight and cc the volume (size). With water they are identical. With a prostate, the average weight is 15 to 20 g and the volume around 20 to 25 cc.

The 10g number doesn’t match with the other 2 20 g numbers for the weight, Sounds like an error. 20g is normal for weight

The volume/size is a little low, smaller than normal. About 75% of normal. Probably not a major problem.

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@oldoz
Good decision on going to Mayo for testing and treatments. They are outstanding.

Your Gleason score was the same as mine. Asked for a Decipher test if not offered along with PSMA.

You did not list your age. Are you considering surgery as only option. I think your urologist will give you several options to consider.

I was 76 when I got cancer. I chose 30 rounds of proton radiation. My Decipher test showed low risk versus intermediate risk so no hormone treatment was needed. My PSMA was negative along with a bone scan that was also negative.

I am not familiar with prostate sizes. I was told my prostate was not enlarged. If you are considering surgery really do some research on the pros and cons and become familiar with side affects and complications. You can reach out to MCC again on feedback on those who had surgery and those of us that had radiation.

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@jc76

@oldoz
Good decision on going to Mayo for testing and treatments. They are outstanding.

Your Gleason score was the same as mine. Asked for a Decipher test if not offered along with PSMA.

You did not list your age. Are you considering surgery as only option. I think your urologist will give you several options to consider.

I was 76 when I got cancer. I chose 30 rounds of proton radiation. My Decipher test showed low risk versus intermediate risk so no hormone treatment was needed. My PSMA was negative along with a bone scan that was also negative.

I am not familiar with prostate sizes. I was told my prostate was not enlarged. If you are considering surgery really do some research on the pros and cons and become familiar with side affects and complications. You can reach out to MCC again on feedback on those who had surgery and those of us that had radiation.

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this has confused me at times as well since neither with MRI or ultrasound can they actually weigh the prostate. I've decided for myself based upon the water volume example that they are the same...........and I look at it as a volume measure. Also that measure is an estimate based upon a radiologist's interpretation of the size of the prostate. It is only as exact as the competence and the experience of the person estimating it. I've also heard that MRI is a more accurate image than ultrasound from image from which to make the volume/size estimate of the prostate.

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@jeffmarc

Grams are the weight and cc the volume (size). With water they are identical. With a prostate, the average weight is 15 to 20 g and the volume around 20 to 25 cc.

The 10g number doesn’t match with the other 2 20 g numbers for the weight, Sounds like an error. 20g is normal for weight

The volume/size is a little low, smaller than normal. About 75% of normal. Probably not a major problem.

Jump to this post

Thanks for the specific information!
I'm making a list of questions for my next appointments. I think the doctors tend to tell me what they think I need to know moving forward, and skip over the stuff that they don't see as important.

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@jc76

@oldoz
Good decision on going to Mayo for testing and treatments. They are outstanding.

Your Gleason score was the same as mine. Asked for a Decipher test if not offered along with PSMA.

You did not list your age. Are you considering surgery as only option. I think your urologist will give you several options to consider.

I was 76 when I got cancer. I chose 30 rounds of proton radiation. My Decipher test showed low risk versus intermediate risk so no hormone treatment was needed. My PSMA was negative along with a bone scan that was also negative.

I am not familiar with prostate sizes. I was told my prostate was not enlarged. If you are considering surgery really do some research on the pros and cons and become familiar with side affects and complications. You can reach out to MCC again on feedback on those who had surgery and those of us that had radiation.

Jump to this post

I'm 72. After my initial diagnose (18 months ago) I've gone from wanting it removed, to calming down and doing Active Surveillance. My thought is that my local urologist told me after a biopsy and testing that it doesn't appear to be real aggressive, but although I didn't need treatment right away, it would likely spread in the next ten years. I figured proven advancements in treatment will be coming in the near future, or I might die of something else first. Then I started looking at life expectancy Actuarial Studies. Basically they said a 72 year old average man will live to be 87. Then I read Dr. Walsh's book and the Outlive book by Dr. Attia and started to understand that cancer becomes very difficult to control or cure once it starts spreading, multiplying and mutating. That has led me back to leaning heavily towards a Prostatectomy. I expect I will be making my decision in January once the Mayo doctor gets additional test results. Travel becomes a bit of an issue with extended radiation treatment.

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@oldoz

I'm 72. After my initial diagnose (18 months ago) I've gone from wanting it removed, to calming down and doing Active Surveillance. My thought is that my local urologist told me after a biopsy and testing that it doesn't appear to be real aggressive, but although I didn't need treatment right away, it would likely spread in the next ten years. I figured proven advancements in treatment will be coming in the near future, or I might die of something else first. Then I started looking at life expectancy Actuarial Studies. Basically they said a 72 year old average man will live to be 87. Then I read Dr. Walsh's book and the Outlive book by Dr. Attia and started to understand that cancer becomes very difficult to control or cure once it starts spreading, multiplying and mutating. That has led me back to leaning heavily towards a Prostatectomy. I expect I will be making my decision in January once the Mayo doctor gets additional test results. Travel becomes a bit of an issue with extended radiation treatment.

Jump to this post

What is your Gleason score? That is what makes the first treatment decision. Did you get A decipher score? Have you had a recent biopsy?

Whether or not you stay on active for surveillance depends on those answers and a PSMA pet scan? What’s your latest PSA?

All Important factors in making a decision about what to do.

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@jeffmarc

What is your Gleason score? That is what makes the first treatment decision. Did you get A decipher score? Have you had a recent biopsy?

Whether or not you stay on active for surveillance depends on those answers and a PSMA pet scan? What’s your latest PSA?

All Important factors in making a decision about what to do.

Jump to this post

Did have a decipher test which I believe was at the higher end of the low risk, will have to sort thru my paperwork for the exact score.
Never had a PSMA pet scan.
Did have a Biopsy, MRI, and Bone Scan.
They said Gleason Group 2.
3+4=7 in 4 cores, 3+3=6 in one core, indeterminate in one core.
Bone scan didn't show spreading.
The Mayo Doctor said he needed more info/tests done at Mayo. He ordered an MRI Biopsy and some other tests to get more info on the prostate cancer and my difficulty urinating/bladder not emptying cause.

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@oldoz

Did have a decipher test which I believe was at the higher end of the low risk, will have to sort thru my paperwork for the exact score.
Never had a PSMA pet scan.
Did have a Biopsy, MRI, and Bone Scan.
They said Gleason Group 2.
3+4=7 in 4 cores, 3+3=6 in one core, indeterminate in one core.
Bone scan didn't show spreading.
The Mayo Doctor said he needed more info/tests done at Mayo. He ordered an MRI Biopsy and some other tests to get more info on the prostate cancer and my difficulty urinating/bladder not emptying cause.

Jump to this post

@oldoz, just checking in. How are you doing? When will you be having more testing at Mayo?

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@oldoz

I'm 72. After my initial diagnose (18 months ago) I've gone from wanting it removed, to calming down and doing Active Surveillance. My thought is that my local urologist told me after a biopsy and testing that it doesn't appear to be real aggressive, but although I didn't need treatment right away, it would likely spread in the next ten years. I figured proven advancements in treatment will be coming in the near future, or I might die of something else first. Then I started looking at life expectancy Actuarial Studies. Basically they said a 72 year old average man will live to be 87. Then I read Dr. Walsh's book and the Outlive book by Dr. Attia and started to understand that cancer becomes very difficult to control or cure once it starts spreading, multiplying and mutating. That has led me back to leaning heavily towards a Prostatectomy. I expect I will be making my decision in January once the Mayo doctor gets additional test results. Travel becomes a bit of an issue with extended radiation treatment.

Jump to this post

I'm 71 and had proton therapy at Jacksonville's UFHPTI in March/April of this year. I had 29 sessions over 6 weeks. My PSA is dropping steadily and is below 1 now. I'm confident the therapy is ending the cancer in my prostate and I have little to no side effects. Certainly nothing serious as I'm reading about by those having the prostate removed or other therapies that radiate more healthy tissue than does proton therapy. If you haven't sent for their free info package from UFHPTI by filling out their contact form, you should. Everyone reading this should. What can it hurt? You don't have to choose that therapy, but you should know your options. My brother had his prostate removed at 47 and was dead at 65 when cancer had developed in his urethra and bladder. I don't know if he had radiation on top of the surgery, but a lot of men posting here end up having that as well. When I was having the therapy a few men dropped by at UFHPTI for their 10 year checkups and were still ecstatic about having chosen proton therapy over the alternatives. Some here on the forum are saying there is no difference in the outcome between photon therapy and proton therapy, but they are mistaken. The outcome includes, in my opinion, how much healthy tissue has been radiated. Simply said, less healthy tissue is radiated during proton therapy. Protons release their energy differently from photons too. And I might add that a lot of men are choosing SBRT or fewer sessions at a higher dose of radiation per session because of the convenience of the fewer sessions. My thinking is that the lower dose per session gives your healthy tissue more time to recover in between sessions and thus, fewer side effects. But that's what I think. Time will tell and advances are being made in these different therapies almost daily. One other thought - my brother's wife always had the feeling that the surgery may have caused the cancer to spread outside the prostate. I Googled, "Can prostate removal therapy spread microscopic cancer cells?" You might want to do that too.

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