Uptick in my Gleason Score-Would appreciate feedback

[Guest guest]

Here is my 

" CV "

I was originally diagnosed with Prostate Cancer in August 2007 (at the age of

59) and the following tests as well as test results ensued:

Age-59

PSA 3.17 as of August, 2007

PSA had doubled in 22 months (in retrospect, my Internist now says that I

probably had localized prostatitis which raised my PSA level).  Nevertheless I

do have Prostate Cancer.

Clinical Stage-T1c 

Gleason score 6 (3+3)

Bone Scan-Negative

CAT Scan-Negative

DRE-Negative

Strategy-Active Surveillance, PSA every 3 months.

Had PSA test on January 9, 2008, PSA test result was 2.13

Had PSA test on April 9, 2008, PSA test result was 2.33

Had PSA test on July  8, 2008, PSA test result was 2.55

Had PSA test on October 15, 2008 PSA test result was 2.95

I think a big mistake was made from the outset in my case and I wish I had known

more about this topic at the time.  My PSA of 2 years ago was about 1.75.  The

one taken last August (2008) was 3.17 which is almost " doubling " so my Internist

advised I see  a Urologist who took biopsies and confirmed that I had PCA.

 However, subsequent PSAs have been in the low 2 range and my Internist admits

that I may have had a prostatitis infection when the " 3.17 " result came in but

which is ultimately a moot point inasmuch as I did and do have Prostate Cancer.

Anyway, fast forward to December 2008:

In the Interim I had been on Active Surveillance and getting a PSA test every 3

months as enumerated above. In December 2008 my Urologist put me on Flomax and

Avodart. Because Avodart can shrink the Prostate and cause other changes the

PSA reading will reduce by about 50% so my last reading was about 1.25 which is

" actually " 2.50 because of the effects of the Avodart. So far so good.

Last week I underwent a second biopsy (most of the adenocarcinoma was originally

found in the right lobe) because my Doctor wanted to check the left lobe ,this

time taking 10 samples. I spoke to him briefly this afternoon and he said the

results came back " positive " and my Gleason score is now " 7 " . I don't know if

it's " 4+3 " or " 3+4 " , the first number indicating the cancer's degree of

aggressiveness but this and other things will be discussed when I see him on

Wednesday morning.

We will discuss treatment options but a Radical Prostatectomy is out of the

question. Overlook Hospital in Summit, New Jersey has the " CyberKnife " System

but as of about 20 months ago my Insurance r, Oxford Health Plans (a

United HealthCare company) would not pay for CyberKnife treatments for Prostate

Cancer citing their belief that it is " investigational " or " experimental " for

Prostate treatment. That is my first choice. Would appreciate hearing from

anyone who has dealt with Oxford (or any other Insurance carrier for that

matter) re: their policy on CyberKnife treatments for Prostate Cancer.

The CyberKnife is a type of " stereotaxic radiosurgery " which delivers high

dosages of radiation and with maximal accuracy to minimize (hopefully)

collateral damage to adjoining structures and organs. Other treatment options I

believe are appropriate for my situation are IMRT Radiotherapy, EBRT

Radiotherapy and Brachytherapy (low-does) where radioactive seeds are implanted

into the prostate. Other therapies are Cryotherapy and Radiofrequency Ablation

among others but these won't be " on the table " as Overlook Hospital does not

offer them nor have I read that they offer any benefits that the other available

therapies don't..

I am absolutely convinced that there is an enormous amount of over-treatment not

to mention completely unnecessary treatment in this field. In fact two large

scale studies which were recently completed in the USA & Europe corroborate

this. The findings of both studies basically assert that to " save " 1 man, about

47-50 men need to undergo needless procedures. Anyway we also know that a very

large percentage (50-65%) of men

who die in their late '70s and early '80s " due to other causes " are found on

autopsy to have Prostate Cancer. It would be very interesting to know what

stage and grade those cancers are. I'm sure it's been studied and if anyone

knows of any links to that type of data I'd love to see it. Would appreciate

any link(s) to such study results.

Back to me:

I had had several second and third opinions after first being diagnosed and have

confidence in my Urologist overall.

Would like to get some feedback on the above history of my PCA as well as

opinions about what to do next. Sorry for the long spiel but I wanted to get my

information across as clearly and as comprehensively as possible.

Thanks in advance.

Sy