Recently diagnosed stage 1 prostate cancer

@kyndats
if your biopsy truly shows you are a T3 then it means your cancer has grown outside the prostate. This doesn’t seem to correlate with a Gleason 6.

You need to discuss this with your doctors? You don’t want to go on active surveillance if you’re truly a T3.

@jeffmarc
No, sorry for the confusion. My reply to @jopocop was regarding the type of MRI scanner that was used. It was a T3 scanner.

Call Veracyte Labs to have them e-mail you your Decipher Test report. Veracyte Labs: 888-792-1601
They'll just need name, D.O.B., date of specimen collection, and perhaps your doctor's name. Good Luck.

@kyndats What I learned is prostate cancer is a disease that has many different twists and turns because we are all different, different specialists, different opinions, and different goals and needs individually as the patient.

In my case, I placed my trust in a “centers of excellence” urological dept at an American medical school. My urologist was a professor of urology and prostate cancer. He was the director of all the residents desiring to become one day a urologist certified by their Board. Everyone of my exams had a residence involved. The professor was teaching his resident about my case. Therefore, I concluded logically I was getting best exams and advice.

Subsequently I learned my first biopsy by the professor was a failed cultivation of pattern 7 cancer. He didn’t get the needle into the core of the tumor, even though it was a MRI Fusion biopsy. The MRI he used was PI-RADS 4. When the biopsy returned G6, there was this discordance with the PI-RADS 4.
I subsequently learned in my case I needed a new biopsy like in 3-4 months later for a redo and the professor to try again to get the needle into the core where pattern 4 cells linger.

In my case it was a 2nd biopsy 2 1/2 years later that returned G3+4=7 because the professor got the needle into the core that time.

I learned therefore I was really at the time of the first biopsy G7 grade two, stage T2a. I had a misdiagnosis, but exercisable as there was no proof the professor committed any negligence. There is a percentage of times urologist just don’t collect the cancer cells. It can be hit and miss.

Another thing is G6 alleged benign cancer findings as to the tumor isn’t the end of the story. G6 can grow bigger and bigger overtime. They grow bigger and bust through the thin capsule. That is called extra prostatic extension EPE.

That alone is a threat because possible pattern 4 cancer cells are potentially exiting the gland and are outside the gland.

So that situation might warrant RRP, or radiation. Some American doctors will do focal therapy in that case, but many will not. Urologists disagree on that problem.

Both standard treatments RRP and radiation have risks and complications so choosing one over the other is very individualized as the patient’s choice. There are many factors to consider both kinds of intervention.

I would say make many appointments for second, third opinions and make a choice. Of course, costs for services can be important to those having deductibles and co-pays. So some patients just can’t get all the extra consults and diagnostics over money issues and insurance policy benefits.

Good luck, and the good news is everything is early in this case, so that you can count on heavily as living a very long life.

@rlpostrp
Ok. Thanks for the contact

@jopocop
Thanks a lot. I appreciate all the information. In light of all the feedback I’m getting from the MCC community I will be pushing for more detail and diagnostics review at my next consult. My urologist was very open to and encouraged me to seek a second opinion. I will definitely raise that issue with him again.

@rlpostrp
Upon further review of my on line chart I found the full Decipher report by Veracyte labs.
Clinical Stage: T1c, Gleason 3+3, NCCN Risk Category: Very Low/ Low, Decipher Genomic Risk Group: High 0.78

Thanks for giving me the nudge to look further. I had already called the lab but got no answer. Nonetheless, I’m more prepared for my next consult.

@kyndats
Glad to see that Gleason of 3+3=6. I would explore what gene(s) you have that cause the higher Risk category and Decipher Test score of 0.78. Like many people, you may have an inherited genetic marker(s) that predispose you to greater challenges in acquiring and/or treating one or more types of cancer. The Decipher Test again, is prostate specific: 22 prostate-specific gene identifiers that stratify your risk against others. Once you find out which gene(s) you have, you can search on them to learn more about them, and thus be more informed when you discuss it with your urologist to set a plan. I am curious...
How did this diagnosis come about? It seems that it might have been a random thing...like an annual physical that included a PSA. The 4.87 ng/ml PSA prompted your physician to refer you to a urologist who did the biopsy, etc. That is actually the way most men "find out"...a PSA and digital rectal exam (DRE). It is up to your physician and you, but active surveillance seems like it would be the route that you go. If the gene(s) involved in the higher-than-expected Decipher test are such that they cause an aggressive or difficult to treat form of prostate cancer, then your urologist will know what to do. My only additional recommendation and wish for you, is to find THE BEST urologist you can find. Determine the travel radius or distance your are willing to go to find the best, university medical center-based urologist you can find...a place where lots of men are seen and where cutting edge treatment and surgery occurs. If you are in a small town, perhaps rural America, I would hope that you find it in yourself to make the trek to a bigger city to find that university-based physician and medical center. Even in the middle of sprawling suburbia like I live in, and going to the biggest, local medical center you can, doesn't always guarantee that you are seeing the best urologist around.

@kyndats
Have you discussed all the options for treating PC? There are many beyond just having RP.

A lot of individuals have radiation. And the treatment options for radiation are extensive with all having very excllent success rates.

Discuss your options if your final diagnosis is PC. If you are seeing an experienced urologist and you respect them seek their medical advice. If you are in doubt seek a second opinion. I sought second opinion even though I completely trusted and was seeing an experienced urologist and R/O at Mayo Clinic. I wanted second opinion on diagnosis and treatment recommendations.

@jc76
Will be discussing all my treatment options with my urologist next week. Trying to consume as much info as I can on my own before that consult. Thank you for the encouragement.