Question: Dr. XXXXXXX C. See,
Good morning! How are you? I hope you are doing well! I am not sure if your remember me, but you have been quite helpful in answering my questions pertaining to my 74 year old father's rapid rise in PSA. Unfortunately, my dad had a
biopsy report with cancer findings. He had 18 cores, and 9 came back with cancer. Could you please review findings, and answer my accompanying questions? Thanks!
Final Diagnosis:
1.) Prostate-left apex-biopsy
-Prostate tissue with a small focus of atypical glands.
2.) Prostate-left mid-biopsy
-benign prostate tissue
3.) Prostate, left base, biopsy
-Adenocarcinoma of the prostate. XXXXXXX score 4 +3= 7 involving 20% (1.5 mm in length) 1 of 2 core(s)
4.) Prostate, right apex, biopsy.
-Adenocarcinoma of the prostate. XXXXXXX score 4 +5=9 involving 95%, 95%, and 60%).
(5.5 mm, .5mm, and 4 mm in length) of 3 of 3 core(s).
-
Perineural invasion is identified.
5.) Prostate, right, mid, biopsy
-Adenocarcinoma of the prostate. XXXXXXX score of 4+5=9 involving 95% (7 mm in length) of 1 of 2 core(s)
-Adenocarcinoma of the prostate. XXXXXXX score of 4 +3=7 involving 80% (8.5 mm in length) of 1
of 2 core(s)
- A total of 2 of 2 cores involved in carcinoma.
6.) Prostate, right base, biopsy
-Adenocarcinoma of the prostate. XXXXXXX score of 4 +4=8 involving 85 and 70% (10 mm and 7 mm in length) of 2 of 3 core(s).
1.)Do you think, with this aggressive spiking, that my dad could have had this cancer spread to the spine, bones, and/or
lymph nodes?
2.) If spread, what is the probability, and also how is it treated (i.e.
hormonal therapy)?
3.) Have aggressive, or various other levels of
prostate cancer not been effectively treated with
radiation and chemotherapy?
4.) Is it possible to treat a spread to bone and/or lymph node with hormonal therapy? Would this hormonal therapy decrease the tumor cells?
5.) Can
cancer staging, and also the possibility of cancer spread be determined by biopsy?
6.) Can regional or distal spread take place within a short time frame?
7.) I am concerned about time of being of the essence here. Should I worry about a week or two making a difference?
8.) Would you recommend a complete removal of the prostate gland in aggressive cancers, or is radiation and hormonal treatment enough and equal to prostate removal? I have been reading that by removing the prostate gland, one can more readily and fully detect the full pathology of the prostate.
9.) What is the survival rate?
10.) How long should I wait before starting these radiation treatments?
11.) How does hormonal treatment work on possible spread to bone and lymph nodes? Does it completely eradicate, or rather just slow down the cancer?
12.) Have you ever seen such high XXXXXXX numbers, with such high PSA spikes, and if so, what has been your understanding of how this treatment will work with such a challenging combination/aggressiveness?
13.) When you say the two tumors were found on the sides of the prostate, does this mean it has a poorer prognosis, and more of a chance of spreading?
14.)If half of the biopsies were negative, is this a good sign?
15.)
1.)Do you think, with this aggressive spiking, that my dad could have had this cancer spread to the spine, bones, and/or lymph nodes?
2.) If spread, what is the probability, and also how is it treated (i.e. hormonal therapy)?
3.) Have aggressive, or various other levels of prostate cancer not been effectively treated with radiation and chemotherapy?
4.) Is it possible to treat a spread to bone and/or lymph node with hormonal therapy? Would this hormonal therapy decrease the tumor cells?
5.) Can cancer staging, and also the possibility of cancer spread be determined by biopsy?
6.) Can regional or distal spread take place within a short time frame?
7.) I am concerned about time of being of the essence here. Should I worry about a week or two making a difference?
8.) Would you recommend a complete removal of the prostate gland in aggressive cancers, or is radiation and hormonal treatment enough and equal to prostate removal? I have been reading that by removing the prostate gland, one can more readily and fully detect the full pathology of the prostate.
9.) What is the survival rate?
10.) How long should I wait before starting these radiation treatments?
11.) How does hormonal treatment work on possible spread to bone and lymph nodes? Does it completely eradicate, or rather just slow down the cancer?
12.) Have you ever seen such high XXXXXXX numbers, with such high PSA spikes, and if so, what has been your understanding of how this treatment will work with such a challenging combination/aggressiveness?
13.) When you say the two tumors were found on the sides of the prostate, does this mean it has a poorer prognosis, and more of a chance of spreading?
14.)If half of the biopsies were negative, is this a good sign?
15.) Was this cancer caught early enough to obtain a successful eradication of this cancer?
16.) Can the disease become independent from hormone manipulation?
17.) What is meant by perineural invasion?