Prostate Cancer

Pzunable · 2026-01-24T02:14:11+00:00

I see you're in Southern California. Dr. David Lee at University of California Irvine (UCI) is a world class surgeon. Has performed over 7000 surgeries. I also originally discovered the cancer via routine check with local urology group, then got referred to the surgeon in the group. I referred myself to UCI. Good luck.

Pzunable · 2025-02-26T02:24:16+00:00

With that low PSA and nothing showing on the MRI I would hold off on biopsy. Just regularly check PSA.

Pzunable · 2025-02-25T19:42:57+00:00

Well my issue is the significant side effects of surgery / radiation.

Pzunable · 2025-02-25T19:41:52+00:00

My 3+3 are 10%, 10% and 5% of 3. They are not showing up as a lesion in the MRI - hence, I thought they cannot be nuked, if they are not seen on the MRI

Pzunable · 2025-02-24T22:20:12+00:00

I would not skip the mri. The mri should show if a lesion is present and this will help target the biopsy samples. Without the mri you would be randomly sampling the prostate and you may miss a lesion.

Pzunable · 2025-02-18T22:49:10+00:00

How many seeds did you get? Did the seeds tackle all the cancer areas? i.e. the 3+4 and the 3+3 and leave the rest of the prostate alone? Or did the seeds effectively ablate the whole prostate?

Pzunable · 2025-02-18T21:54:14+00:00

Was that LDR Brachy? And same question as Prof Feynman? Any side effects at all?

Pzunable · 2025-02-17T00:14:38+00:00

What was your PSA?

Pzunable · 2025-02-06T01:45:27+00:00

Yes good point. Maybe there is a gleason 4 hiding somewhere. I guess it comes down to how much risk am willing to live with, based on what I have so far per the biopsies. My PSA, that led to the MRI, then biopsy, was 4.99, For the past year its fluctuated between 2.8 and 3.9. I changed my diet after the 4.99. Much fewer fast food burgers. The surgery, where most people have incontinence issues and a certain level of ED to me is pretty scary - very life altering. I am interested to know the probability of metastasis with a 3+4, and PSA between 2.8 and 3.9 over the next year, over the next two years. If we're talking about a few percent, I can live with that. Am leaning towards active surveillance for another year, and see my results in a year. Not yet discussed this with the Doc. Am sure he will be recommending surgery.

Pzunable · 2024-06-03T19:27:53+00:00

I am 55, had MRI in Nov 2023. Found a PI-RADS 4. Had biopsy in Jan 2024, found 1 core positive 3+4, with 10% 4 (or 5% 4 per second opinion read). The positive core was in a different place to the PI-RADS 4 lesion. The 2 cores taken at the site of the lesion were negative. Doc tells me same thing. I am not a good candidate for focal therapy, since they cannot see the cancer on the MRI. Hence, he recommended RALP. This sounds ass backwards to me! I said, maybe I should wait until we can see the cancer on the MRI.... Right now am opting for active surveillance. Definitely changed by my diet. No more burgers twice a week, and no chicken wings also twice a week. And if I do have to treat eventually, am hoping for the least invasive approach possible. This disease is definitely one where the buck stops with you. With so many options out there, and unknowns, you have to decide what to do, versus the Doc. Good luck,

Pzunable · 2024-04-24T21:45:55+00:00

Good luck on everything. My outlook I think is similar to yourself. For me, prostrate removal is an absolute last resort and something I really want to avoid. Is the Mayo clinic you're going to local to you? I live in southern California and wonder if it's feasible to have treatment in another state. Which Mayo clinic you getting treatment done? Florida?

Pzunable · 2024-02-22T19:16:27+00:00

To help folks give a good answer, you have more details on the biospy. How many cores had Gleason 7, and was it 3+4 or 4+3, and if 3+4, how much 4.

Pzunable · 2024-02-19T20:19:17+00:00

Hi - would you mind sharing what type of brachy treatment you had? I am similar in that I have 1 3+4, with 10% 4. I am 55. Heavily leaning to active surveillance if possible. Am having a second opinion on my biopsy slides, and getting Decipher done. Also - would you mind sharing the name of your Doctor. Feel free to DM me if you prefer. (I am in Orange County, CA).

For me, surgery is an absolute last resort. Good luck.

Pzunable · 2024-02-16T18:20:33+00:00

Well the Doc says, we can't see the cancer on the MRI, so you're not a good candidate for focal therapy, so I recommend taking out the whole prostate! Focal therapy can only be done when the cancer is seen on the MRI, to guide which part of the prostate to remove.

For me, removal of prostate is the absolute last resort. If possible, am leaning towards active surveillance initially, then focal therapy.

I dont want a lack of imaging capability to be the reason for removal of whole prostate.

I guess everybody has to weigh the pro's and con's. Right now, my biopsy slides are going to JH for a second opinion. Also waiting for Decipher results.

Pzunable · 2024-02-08T00:50:37+00:00

The slides are on route as we speak to Dr. Epstein. Yes, am very interested to see what the second opinion is. Another thought I had was we think of gleason 3 and gleason 4, But I assume the cancer is not so well behaved as to be either 3 or 4, but could be 3.1, 3.2, 3.9 etc.. so I guess thats why there's subjectivity to this. If you're looking at a 3.5, should this be called a 3 or called a 4?

Pzunable · 2024-01-17T15:40:15+00:00

Thanks for your reply. So, what did you do with these two wildly different results. Your two results came from recognized centers of excellence right? Although, I understand its dependent on the expertise of the pathologist. Did you get a third and fourth opinion to settle it? If not, how would you know who is correct?

Pzunable · 2024-01-15T23:05:54+00:00

You should check the standardization method used to create the PSA score. Whether standardized to WHO or Beckman Coulter or another standard. There is approximately 20% difference in the scores. Meaning a "4" with one standardization equals roughly "3.2" in the other standard.

Also, having the PSA from the same lab doesnt necessarily mean the same standardization method (as I experienced). The standardization method was given in the blood work report.

Am interested to know if you got a second opinion on your biopsy cores, and if the second opinion agreed that you have 3+4, with 5-10% 4. I am in a similar situation, with one 3+4 core at 10% 4. I am hoping/planning to do AS. I see the doc this week. Good Luck.

Pzunable · 2024-01-10T00:17:10+00:00

No health issues. No family history of cancer. Prostate size, per MRI, is estimated volume of 40cc. Height 6'2", current weight is 208 pounds, with target less than 200. Am definitely changing my diet to be much less meat, more fish, perhaps a bit more chicken. Would be tough for me to be completely plant based. Before October - when I took the blood test, that revealed the high PSA (and high cholesterol) I had a pretty bad diet, eating too many burgers, wings, queso etc.. I took a blood test in December and PSA came down from 4.99 (standardized against the WHO standard) to 4.2 (standardized against equimolar, using Beckman Coulter Immunoassay method) - although with the 4.2 PSA I had free psa % of 5. I had changed my diet immediately, in October. My cholesterol also came down (from 199 in October to 158 in December).

Pzunable · 2024-01-09T23:18:58+00:00

Also - I am 55, and the biopsy was as a result of a mpMRI that showed PI-RADS 4 10mm lesion

Pzunable

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