introduction

[Guest guest]

Patti,

Thanks for the update on your Aunt. I am glad she managed to get in. I will continue to keep her in my prayers.

Hugs

nne

Breast Cancer Patients Soul Mates for Lifehttp://www.geocities.com/chucky5741/breastcancerpatients.html

Check out my breast cancer ornaments at:http://www.geocities.com/chucky5741/bcornament.htmlalso check out my other ornaments and lots of nice gifts at:http://www.cancerclub.com

introduction> Hi my name is Patti. Yesterday my aunt found out that she has> infiltrating duct carcinoma. I don't know that much about breast> cancer, so I was wondering if someone could please send me some> information on it. One thing that I am curious about is, she found> out yesterday and they can't get her into see a surgeon until May> 6th. Doesn't that seem like a long time to wait? Or am I just> emotional, would not be the first for me re: over re-acting. What> kinds of things should we expect.>> Thank you in advance for any help you can give.>> Patti>>>>>>>

[Guest guest]

Patti,

Thanks for the update on your Aunt. I am glad she managed to get in. I will continue to keep her in my prayers.

Hugs

nne

Breast Cancer Patients Soul Mates for Lifehttp://www.geocities.com/chucky5741/breastcancerpatients.html

Check out my breast cancer ornaments at:http://www.geocities.com/chucky5741/bcornament.htmlalso check out my other ornaments and lots of nice gifts at:http://www.cancerclub.com

introduction> Hi my name is Patti. Yesterday my aunt found out that she has> infiltrating duct carcinoma. I don't know that much about breast> cancer, so I was wondering if someone could please send me some> information on it. One thing that I am curious about is, she found> out yesterday and they can't get her into see a surgeon until May> 6th. Doesn't that seem like a long time to wait? Or am I just> emotional, would not be the first for me re: over re-acting. What> kinds of things should we expect.>> Thank you in advance for any help you can give.>> Patti>>>>>>>

[Guest guest]

Alan

>> I'm especially confused about your sentence that reads " 3+5 and

4+4 " . I'm having trouble understanding what the pathologist meant by

that. <<

Me too. I thought you got one Gleason score per biopsy. My TN

urologist is on vacation and his staff has pretty much ignored me. I'm

beginning to feel like Rodney Dangerfield (I don't get no respect).

Thanks for all the information. My plan is to have Bostwick Lab give a

second opinion on the biopsy ASAP. I am considering Mayo Clinic in

ville, FL for consultation and possibly treatment.

I have decided to delay the bone scan until the consultation.

Thanks again for your help.

Ken Bradshaw

---------------------------------------------------------------------

>

> > I am 64 and was informed Wed. that I have " aggressive "

> > prostate cancer. I was given two Gleason scores, 3+5 and 4+4,

> > both from the left side. My most recent PSA, Nov. '08, was

> > 6.3. Previous PSA's were 4.5 in Jan. '08, 5.9 in Nov. '07 and

> > 4.8 in June '07. The 5.9 was considered inaccurate because I

> > had ridden a bicycle the day before the test.

> ...

> > My urologist is recommending a full body bone scan ASAP. I am

> > considering getting a second opinion on the biopsy first. Is

> > this a good idea? I would appreciate a recommendation for a

> > pathology group that specializes in prostate biopsy.

> ...

>

> Hello Ken,

>

> Sorry to hear of your diagnosis.

>

> On the question about biopsies, I think Steve Jordan has already

> given you his standard and very cogent advice. Yes, get a

> second opinion. I'm especially confused about your sentence

> that reads " 3+5 and 4+4 " . I'm having trouble understanding what

> the pathologist meant by that. He seems to be saying that

> either the predominant pathology was Gleason 3 with secondary

> Gleason 5, or else Gleason 3 and 5 were both insignficant and

> both the primary and secondary pathology were Gleason 4.

>

> Huh? Did the urologist provide any interpretation of that?

> Does it mean that there were two cancerous samples on the left

> side, one of which was 3+5 and one 4+4?

>

> While a second opinion on the biopsy is always a good idea, it

> seems to me to be particularly important in your case where the

> report is somewhat ambiguous.

>

> [bear in mind though that I am not a doctor and no kind of

> expert in any of this. Perhaps the " 3+5 and 4+4 " report is very

> common and I just don't happen to have heard of one before.]

>

>

> On the specific issue of the bone scan, Dr. Gerald Chodak has

> produced a little video giving his opinion of it. I think it's

> worth watching:

>

>

http://www.prostatevideos.com/prostate-cancer/grading-and-staging-of-prostate-ca\

ncer/bone-scan-for-assessing-cancer-spreading-to-the-bones/

>

> or:

>

> http://tinyurl.com/8rlmoa

>

> Dr. Chodak claims that, for men with a PSA under 20, a bone scan

> will produce, on average, 3 true positives and 130 false

> positives out of every 1,000 patients. He doesn't think bone

> scans are a good idea for men who are facing prostate cancer for

> the first time (i.e., not a recurrence) with low PSA scores.

>

> I suggest asking your doctor:

>

> 1. Does he know the statistics on true and false positives for

> men with your PSA?

>

> 2. If the scan is positive, and given that the vast majority of

> positives on men with low PSA are false, how will he determine

> whether the suspect area in the scan is actually cancer or not?

> Will he then have to do a bone biopsy? Is there another way?

>

>

> Finally, here is some general advice from a non-specialist (me)

> whose opinions are probably worth what you're paying for them.

>

> If your combined Gleason score is 8, then your cancer is

> potentially aggressive and should be treated. I believe that a

> Gleason 8 cancer is likely to kill you sometime in the next

> 8-20 years if left untreated. At age 64, you might reasonably

> expect to live long enough for that to happen.

>

> With the current treatment options, the best chance at defeating

> cancer is always the first chance. A patient will typically get

> surgery or radiation. If it fully succeeds, he will be free of

> PCa for the rest of his life. If it fails, he cannot do the

> surgery or radiation again, though with surgery he can try

> radiation if the surgery fails [there is a dispute about whether

> that is an advantage for surgery, or whether a patient who fails

> surgery and then succeeds with radiation should have had

> radiation the first time.]

>

> I won't claim to know what the best treatment is. In my

> inexpert opinion, there is no best treatment. Surgery and a

> number of different forms of radiation have comparable outcomes

> - but with different side effects. However I do know that

> different doctors have different success rates.

>

> Therefore, since you only get one first shot at the cancer, you

> want that to be the very best shot you can take, i.e., with the

> best surgeon or radiation oncologist you can find. If you

> choose surgery, get a guy who does 50, 100, or more

> prostatectomies every year, not a guy who mainly treats

> incontinence and urinary infections and does a prostatectomy

> every two or three months. If you choose radiation, get a

> radiation oncologist who does lots of prostates, not one who

> does breasts, hips, ankles, elbows, brains, and oh yes,

> prostates.

>

> So, shop around. Seek advice from other patients (as you are

> doing here) and from other docs and nurses that you might know.

> Find out who has a good reputation. Get a consultation with

> that doctor. Form your own opinion of how good a doctor he or

> she is. Be sure to consult with at least one surgeon and one

> radiation oncologist.

>

> Best of luck.

>

> Alan

>

[Guest guest]

Steve

Thanks for all the information. My plan is to have Bostwick Lab give a

second opinion on the biopsy ASAP. I am considering Mayo Clinic in

ville, FL for consultation and possibly treatment.

I have decided to delay the bone scan until the consultation.

Thanks again for your help.

Ken Bradshaw

---------------------------------------------------------------------

>

> Ken,

>

> This is an old cliche', but you definitely need a second opinion.

However you pursue, weigh all of the options. I reviewed all for me

(age:56, PSA had risen from 1.3 in Feb '07 to 2.5 in Feb '08 with

blood in urine to 3.78 in May '08). My Gleason was 6 (3+3) and stage

T1c. After Dad having PCa and 2 others in that generation as well, I

decided NOT to wait and opted for Da Vinci RP. Dad had been

overradiated and the others had open surgery. Brachytherapy was ruled

out. My actual option would have been proton therapy had the locations

not been so far away. Of all treatment plans, it has the fewest side

effects. My HMO would not approve it. I had surgery in August and

still am experiencing some side effects (minor leakage and erectile

dysfunction). Anyone having surgey should begin doing Kegel exercises

long before they have the surgery in order to overcome the leakage

faster. My problem arose when the catheter lost enough pressure to

slide in the urethra

> and cause major irritation and an infection which did not respond

to the antibiotics very well.

>

> Best wishes in your quest. Check out the yananow.net for people who

have been there, done that.

>

> Steve S in Arkansas

>

>

>

>

> ________________________________

>

> To: ProstateCancerSupport

> Sent: Sunday, January 4, 2009 6:47:47 AM

> Subject: Introduction

>

>

> Hello.

>

> Just joined and would like to introduce myself.

>

> I am 64 and was informed Wed. that I have " aggressive " prostate

> cancer. I was given two Gleason scores, 3+5 and 4+4, both from the

> left side. My most recent PSA, Nov. '08, was 6.3 . Previous PSA's

> were 4.5 in Jan. '08, 5.9 in Nov. '07 and 4.8 in June '07. The 5.9 was

> considered inaccurate because I had ridden a bicycle the day before

> the test.

>

> My urologist is recommending a full body bone scan ASAP. I am

> considering getting a second opinion on the biopsy first. Is this a

> good idea? I would appreciate a recommendation for a pathology group

> that specializes in prostate biopsy.

>

> I retired to NE TN but am spending the winter in S. FL. If I opt for

> surgery, I would prefer to have it done in S. FL . I would also

> appreciate any information on an experienced surgeon in the area.

>

> Thanks for any help.

>

> Ken Bradshaw

>

[Guest guest]

I agree that the basics are the same.  But most lay people don't realize how

quickly treatment protocols can change.  Especially for a condition like

prostate cancer which has advocates for all the different modalities.  the fact

is, that most treatments work well for early stages.  And some patients may be

better off doing nothing (of course, the problem with that is we really don't

know who those patients are in advance).  Larry