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    Biopsy vs pathology results
    dab60 posted:
    Hi. A question has been nagging me for the last year.
    PSA 3.5 Jan. 2009 at age 59 and had been rising for a year or two. Biopsy March 2009. Left side 3 of 6 cores with 5% cancer, Gleason 3+3, right side 6 cores and no cancer. Stage T1C.
    I went into see my urologist after getting that news and decided on the open prostate surgery. Surgery April 2009. Pathology Stage pT2C NX, MX, Gleason 3+4 and the tumor occupied 25% of the prostate. The tumor was confined to the prostate and my PSA has been less than 0.1 at 3 and 6 months.
    The question is did the biopsy just totally miss a lot of the cancer or did I have a fast growing, aggressive cancer that grew that rapidly in one month? Wouldn't most people with a Gleason 6 and 5% involvement on one side of the prostate be taking their time making a decision on treatment or going for watchful waiting?
    I've seen some research on Vietnam vets and their prostate cancer often being more aggressive. Thank you for any input on this.
    Galileo1962 responded:
    Surgical pathology often differs from biopsy results. The biopsy takes a very small amount of tissue.
    That is a "pro" to surgery--having the removed prostate examined by a pathologist. That gives you a much better picture of stage and aggressiveness.
    You're right--some men with Gleason 6 will watch and wait, or take a more leisurely approach to decision making. There is a risk inherent in those approaches - the risk that the cancer isn't really Gleason 6. My own uncle is taking that course, but it is his informed choice, and he is monitored by a urologist.

    That's good news on your PSA!
    H555 replied to Galileo1962's response:
    Dab- I'm also a Vietnam vet and have been battling prostate cancer for 5 years now. here's a link to a web board that deals with Agent Orange related cancers.

    I've gotten better and more informed information here but the other site is useful. I hope you know that prostate cancer is one of several that the VA considers to be caused by Agent Orange is you were boots on the ground.
    dab60 replied to H555's response:
    Thank you for your reply Galileo1962. This has to be the only cancer with so many treatment options. I wonder if there's a survey comparing the biopsy and the pathology.

    H555: Both my diabetes type II and the prostate cancer are Agent Orange related since I was in Vietnam. That Veterans Benefit Network is sure a good source of information. Thanks.

    Although I've been a diabetic for almost thirty years I accidently found out about the Agent Orange connection at a party and got started with the VA two years ago. Then a year later the prostate cancer shows up. I think there are still many in-country Vietnam veterans that aren't aware of the prostate cancer and diabetes connection so I mention that often when I run into a veteran.

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