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Biopsy vs pathology results
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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.
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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!
 
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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. http://vets.yuku.com/forums/74

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.
 
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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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