Prostate lesions found, biopsy results, No symptoms

Posted by fredz @fredz, Oct 13, 2022

Hi everyone, I’ve no symptoms as frequent urinating or erection issue nor stop start urinating, my PSA is gone up for the last 6 years from 4 to 6 to 8 … and now @ 12 , did an MRI ( not coil/ sound type though ) it came out that I have two lesions one on inferior top part and one in the bottom of my prostate gland, hate to do biopsy, any idea ? Anyone have the same issue ?
Ps no blood in urine either

Thanks so much for all the feedback 🙏🏼

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@kujhawk1978

Seems like your medical team did some additional testing of the prostate tissue from your biopsy..

Immunohistochemical tumor markers are proteins that help doctors tell the difference between different types of cancer.

Here's a link to the three your medical team tested for in trying to determine your diagnosis given the GS 3+3 and low volume in the biopsy samples.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6753827/

Key note from this link - "In recent period, basal cell markers high molecular weight cytokeratin (HMWCK), P63 and prostate biomarker AMACR have been used as adjuvant to morphology in diagnostically challenging cases with a very high sensitivity and specificity."

Again, just my layman thoughts. It would seem another clinical data point leading to a discussion with your medical team about active surveillance vs treatment.

Kevin

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Thanks again, I’ll check that link but meanwhile what’s your take on that ? Anything that I should take very seriously and go for surgery procedure or ?? As I don’t know much about these at all .
Appreciate 🙏🏼

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@jb2buckwater

Fredz,

Read Dr. Walsh's Surviving Prostate Cancer:

https://www.publishersweekly.com/9780446526401

I also have Gleason 6 3+3. Found this book to be very reassuring, also helpful in calming my wife's legitimate concerns. Have decided on Protein Beam SBRT Radiation Therapy at Mayo Clinic Rochester.

Most important is to NOT panic and make decision without complete knowledge of your options.

Best wishes,

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Thanks , unfortunately I’m somewhere that I don’t have access to purchase the book.
Appreciate a lot 🙏🏼😎

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@fredz

Thanks , unfortunately I’m somewhere that I don’t have access to purchase the book.
Appreciate a lot 🙏🏼😎

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Fredz,
Much of the literature would suggest you have time to make a decision to treat or monitor. There are some who are pushing to reclassify Gleason 6 3+3 as a neoplasm as opposed to cancer. This is due to the panic which jumps into all of our minds when we hear the C word. First reaction is, "Cut it out, NOW". Very often this is a panic decision and may not be necessary at all.
Read as much as you can on-line and also check out the videos on YouTube, many are medical presentations outlining the many alternative treatment approaches as well as guidelines for active surveillance.

Good luck and take your time to become informed.

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@fredz

Thanks again, I’ll check that link but meanwhile what’s your take on that ? Anything that I should take very seriously and go for surgery procedure or ?? As I don’t know much about these at all .
Appreciate 🙏🏼

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The biopsy results you posted would indicate that those immunohistochemical tumor markers were "negative" and thus adding to the clinical data which supports continued active surveillance.

Here's a link to the use of MRIs vs TRUS biopsies if you and your medical team decide on active surveillance - https://www.urotoday.com/video-lectures/localized-prostate-cancer/video/mediaitem/2925-using-mri-to-safely-prevent-unnecessary-protocol-advised-repeat-biopsy-during-active-surveillance-journal-club-christopher-wallis-zachary-klaassen.html?utm_source=newsletter_11193&utm_medium=email&utm_campaign=expert-review-journal-clubs-in-the-management-of-localized-prostate-cancer

Again, discuss with your medical team.

Kevin

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@jb2buckwater

Fredz,
Much of the literature would suggest you have time to make a decision to treat or monitor. There are some who are pushing to reclassify Gleason 6 3+3 as a neoplasm as opposed to cancer. This is due to the panic which jumps into all of our minds when we hear the C word. First reaction is, "Cut it out, NOW". Very often this is a panic decision and may not be necessary at all.
Read as much as you can on-line and also check out the videos on YouTube, many are medical presentations outlining the many alternative treatment approaches as well as guidelines for active surveillance.

Good luck and take your time to become informed.

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Thank you soo so much , you are very correct as everybody suggested to go and remove it !!!
Thanks for your advice and patience truly appreciate.
🙏🏼🙏🏼

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@kujhawk1978

The biopsy results you posted would indicate that those immunohistochemical tumor markers were "negative" and thus adding to the clinical data which supports continued active surveillance.

Here's a link to the use of MRIs vs TRUS biopsies if you and your medical team decide on active surveillance - https://www.urotoday.com/video-lectures/localized-prostate-cancer/video/mediaitem/2925-using-mri-to-safely-prevent-unnecessary-protocol-advised-repeat-biopsy-during-active-surveillance-journal-club-christopher-wallis-zachary-klaassen.html?utm_source=newsletter_11193&utm_medium=email&utm_campaign=expert-review-journal-clubs-in-the-management-of-localized-prostate-cancer

Again, discuss with your medical team.

Kevin

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Thanks a lot for all your help I really appreciate .
🙏🏼🙏🏼

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fredz: my psa went from 6 to 8.5 and 10.0. Had the prosate mri, did the biopsy and all showed confined to prostate. Did the decipher test for aggressiveness and spoke with 6 radiation oncologists (2 from centers of excellence) all with slightly different opinions including 2 that said nccn.org recommends adt if PSA over 10. All suggested radiation or removal. Doing the radiation using Viewrays MRIdian machine. Tight margins with auto turn off. The radiation oncologist said she was not inclined to do Adt. Your in the right place to get a feel for live experiences.

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@bens1

fredz: my psa went from 6 to 8.5 and 10.0. Had the prosate mri, did the biopsy and all showed confined to prostate. Did the decipher test for aggressiveness and spoke with 6 radiation oncologists (2 from centers of excellence) all with slightly different opinions including 2 that said nccn.org recommends adt if PSA over 10. All suggested radiation or removal. Doing the radiation using Viewrays MRIdian machine. Tight margins with auto turn off. The radiation oncologist said she was not inclined to do Adt. Your in the right place to get a feel for live experiences.

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Than you Ben, my urologist suggested to wait another three months and do another PSA test , he also send me to an oncologist for his opinion too the oncologist suggestion was do radiotherapy instead of removal , I mentioned to him that I read an article online in which it was explaining IF you do radiations then later on you can’t do the surgery to remove the prostate!!, he disagreed to that and told me to go on live your life and don’t worry much but just keep checking and go back to him and my urologist every three months to see how’s it going .

I’m 64 and in pretty good shape other than diabetes which I’m taking pills for it .
Thanks again for your time .
🙏🏼

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Fred: Your welcome. I went down that road too regarding radiation and removal later on. I was told that there are a smaller number of surgeons who will do the removal but I was assuming, because of the liability issues, that surgeons shy away from it but then we have seen that with all doctors/surgeons who are asked to repair work from another doctor later on. One thing that stood out for me (and there were more than a few), was, to quote the Cornell Weill radiation oncologist, " if you can see it, you can treat it." I will keep my research up on imaging and the radioactive contrasts after my treatments. By the way, I have children so I also had the myrisk test by Myriad, a genetic test for problem genes. Maybe you knew but I did not, that my daughter (and obviously my sons) could be at breast cancer risk if I showed a problem with my brca or other genes. I had no gene issues but it was a surprise to me. I was told by Myriad that biopsy samples are good for up to a year for testing.

Feel free to prvate message me if you want to bounce something off me. I am just a guy who has spent a good deal of time researching many sources as I was really afraid of making the wrong decision so I think I gathered some insight.

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@bens1

Fred: Your welcome. I went down that road too regarding radiation and removal later on. I was told that there are a smaller number of surgeons who will do the removal but I was assuming, because of the liability issues, that surgeons shy away from it but then we have seen that with all doctors/surgeons who are asked to repair work from another doctor later on. One thing that stood out for me (and there were more than a few), was, to quote the Cornell Weill radiation oncologist, " if you can see it, you can treat it." I will keep my research up on imaging and the radioactive contrasts after my treatments. By the way, I have children so I also had the myrisk test by Myriad, a genetic test for problem genes. Maybe you knew but I did not, that my daughter (and obviously my sons) could be at breast cancer risk if I showed a problem with my brca or other genes. I had no gene issues but it was a surprise to me. I was told by Myriad that biopsy samples are good for up to a year for testing.

Feel free to prvate message me if you want to bounce something off me. I am just a guy who has spent a good deal of time researching many sources as I was really afraid of making the wrong decision so I think I gathered some insight.

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Hi again , same here I don’t have anyone in the family with prostate cancer issues, I’m father of one daughter and of course I didn’t tell her nothing about this as she will start to worry.
I’m out of the states at the moment and won’t be back for probably another year .
Thanks for everything.
🙏🏼

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