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Newly diagnosed

Posted by ireland1964 @ireland1964, 3 days ago

First I want to thank anyone taking the time to reply.
So I'm at the beginning of my diagnosis and recent follow up to discuss biospy has only left me feeling less confident of what direction to go.
Psa 4.37
Prostrate volume 31.88ml
MRI shows lesion 1.6-1.9-2.5cm oval shaped w/irregular margin
located inloving R trans zone extending into anterior and posterior lateral peripheral zone at base & mid gland.
PI-RADS 5
Decreased ADC
Diffusion restriction

Biospy Results
Stage T1c
Gleason II (3+4)
No PNI
EPE- No tumor in adipose tissue identified
(6) Left all clear
All (6) on right adenocarcinoma with (4) 3+3 avg 30% involved area and (2) 3+4 with 10% pattern and 35% involved area
Lesion 3+4 10% pattern & 45% involved area
Lymph 1%
Seminal vesicle 2%
Extraprostatic Ext 23%
Organ confined 74%
Note states Prolaris Biospy Test ordered

Uroligist basically gave me info on ALL treatment options OR just active watching which seems very unspecific given we have some results. So now what?

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

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ireland1964 | @ireland1964 | 22 hours ago
In reply to @turtbean "@ireland1964 - with EPE, on my pathology report, I have one section that identifies “focal EPE,”..." + (show)
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@ireland1964 - with EPE, on my pathology report, I have one section that identifies “focal EPE,” meaning it was just beginning to break through the prostate cap, but hadn’t actually made it to any other neighboring tissue.

Further down, though, I have another section that plainly states “no EPE observed.”

Yes? No? Maybe?

During my most recent PSA follow-up, I asked about this, and I think the NP said it had something to do with EPE being found in one area of my prostate, but not in the other.

I’m not really a details person, so I don’t remember everything she said about it, but she did tell me not to get too worried about it, that since everything else came back negative and they actually downgraded my cancer from a 3+5=8 to a 3+4=7, and changed me from intermediate unfavorable to intermediate favorable, I had a lot to be happy about.

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@turtbean
Thank you and glad it is sounding like a good direction for you.
I only had those (2) EPE listed separate and didn't see a "focal EPE"
I guess the stage of T1c and 3+4 should be encouraging although cancer in 9 of 15 doesn't seem great

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ireland1964 | @ireland1964 | 22 hours ago
In reply to @jeffmarc "@ireland1964 You might wanna get a second opinion from a pathologist that it has looked at..." + (show)
Profile picture for Jeff Marchi @jeffmarc

@ireland1964
You might wanna get a second opinion from a pathologist that it has looked at hundreds of thousands of biopsies. I know a bunch of people that have gone to this guy and he is really good. You can call him before you sign up for a second opinion and discuss it, and you can then speak to him for quite a bit of time after to go over what he’s found. He does, however, charge $500 for a biopsy review. He will arrange to have whatever he needs sent to him for the review.

Dr. Jonathan Epstein biopsy
https://advanceduropathology.com

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@jeffmarc
I had left a message for a local Karamonos Cancer Institute about looking for another opinion and will definitely look into this Dr. Epstein you mentioned.

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