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Received the news on Halloween. I have prostate cancer. Need advice.
Prostate Cancer | Last Active: Dec 25, 2025 | Replies (56)Comment receiving replies
@brianjarvis
Regarding 2nd opinion of biopsies. Since UCLA facility is one of the center of excellence, I am not sure if other facilities will disagree with their findings? But I will certainly ask the doctor who did the biopsy on me, next week.
As to the words cribriform pattern, extracapsular extension, seminal vesicle invasion, perineural invasion or intraductal carcinoma ---> On their pathology report, total 18 cores were extracted. There is a table for each core. There are 3 columns: Crib4, IDC, PNI. I looked it up, they refer to Cribriform, Intraductal Carcinoma, and Perineural Invasion. None are checked.
For PSA numbers. It is 5.4 and Prostate size is 59cc, so density is 0.09. No free PSA number this time. For PSA doubling time, I asked chat gpt. Since last PSA was 4.5. So, doubling time is 3.5 years?
Than you for your thoughts
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@frank1956 A few years ago, I was in a webinar with Dr. Jonathan Epstein (Johns Hopkins) as the speaker. He made a comment regarding 2nd opinions that was something like “If two pathologists agree 2/3rds of the time, that’s considered good.”
(Prior to starting my proton radiation treatments, a 2nd opinion upgraded my Gleason from 7(3+4) to 7(4+3). Not knowing which was “right” - the 3+4 or the 4+3 (since they were both educated, experienced opinions) - I chose to be treated per the higher Gleason. So we simply added 6 months (two 3-month injections) of Eligard to my treatment regimen.)
That’s good that none of those terms are mentioned in the MRI or biopsy reports. Some of those terms are indicators of more advanced disease.
Regarding Free PSA. That’s not a standard PSA test, but they’ll do it if you ask. PSA circulates in the blood in two forms – either attached to certain blood proteins or unattached (“free”). If the PSA is between 4.0-10.0, but the % of Free PSA is low (< 25%), it may indicate a higher disease risk. (Another datapoint in the decision-making process.)
PSA Doubling Time (PSADT) –> The number of months it takes for PSA to double. If the PSADT was < 10 months, patients tend to do worse. (Again, just another datapoint in the decision-making process.)