RE: Re: See the doctor next week and need help!

[Guest guest]

Doug, What you said makes sense. The smaller the prostate, the great the chance the biospy needle will hit a tumor. I am leaning toward surgery to remove the tumor. All the data shows the tumor is small, moderately agressive (Gleason 7) and in a good location to spare the nerves. I found the following: The 10-year prostate cancer-specific survival rate categorized by Gleason score is:

Gleason score 6 or less — 98.4 percent

Gleason score 3 + 4 = 7 — 92.1 percent

Gleason score 4 + 3 = 7 — 76.5 percentBig difference between a 3+4 and a 4+3. Chuck To: ProstateCancerSupport Sent: Tuesday, May 15, 2012 11:51 AM Subject: Re: See the doctor next week and need

help!

Chuck,

It doesn't.

Reduced prostate volume on its own might favor the detection of more

cancer, both low and high grade (less area to sample).

For some unexplained reason. 5-ARIs seem to result in less overall

cancer, but more high grade cancer. This has been shown in several studies.

More high grade is the reason the FDA gave for rejecting the use of

5-ARIs for chemoprevention.

Doug

My journey (nightmare) with PC continues. I have an appointment to talk

with the doctor next week about treatment for my PC. I had one positive

sample and 11 negative from the biopsy. Gleason score of 7. I am

guessing the doctor is going to recommmend removing the prostate. PSA

was 4 and DRE is normal. I took propecia (finasteride) for 10 years

for my hair loss. From the National Institute of Health:

The Prostate Cancer Prevention Trial (PCPT) demonstrated a 24.8%

reduction in the 7-year prevalence of prostate cancer among patients

treated with finasteride (5 mg daily) compared with that among

patients treated with placebo; however, a 25.5% increase in the

prevalence of high-Gleason grade tumors was observed, the clinical

significance of which is unknown. One hypothesized explanation for

this increase is thatfinasteride reduced prostate volume, leading to

detection of more high-grade tumors due to increased sampling

density. This possibility was investigated in an observational

reanalysis of the PCPT data, with adjustment for sampling density.

Median prostate volume was 25% lower in the finasteride group (median

= 25.1 cm3) than in the placebo group (median = 33.5 cm3).

Later studies showed finasteride does not cause increases in high grade

PC and actually reduces the risk of developing PC!!! The orginal studies

that showed more high grade PC was caused by the reduced size of the

prostate in mem taking finasteride.

I called the doctors office and ask for a copy of the pathology report.

I will read it and try to make some sense of it. I am worried the use of

finasteride has changed my Gleason score and made it higher. I sent a

letter to the doctor requesting the samples be sent to a Dr Epstein at

Hopkins for a second opinion.

My question is: Why does the reduced volume of my prostate make my

Gleason score higher?

Thanks to anyone who can help.

Chuck

[Guest guest]

Hello Doug, I know I’m not the Chuck you are referring to, but since there are now several of we “Chucks” who monitor this support list, best to identify which Chuck to whom you are referring, particularly when you are replying to a post and not including that post in your reply. Chuck (Maack) Always as close as the other end of your computer to help address any prostate cancer concerns. " What you leave behind is not what is engraved in stone monuments, but what is woven into the lives of others. " (Chuck) Maack - CMCPO/Ret, Rmd, PCaA, PCaM Email: maack1@... PCa Help: " Observations " http://www.theprostateadvocate.com From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of dtcSent: Wednesday, May 16, 2012 2:37 PMTo: ProstateCancerSupport Subject: Re: See the doctor next week and need help! Chuck,A friend of mine had a situation almost identical to yours.He was operated on by Pete Carrol at UCSF, and 3 mothsafter surgery he has undetectable PSA and almost no sideeffects. They do a Color Doppler prior to surgery, whichhelps them know what they are dealing with pre-surgery.DougNo virus found in this message.Checked by AVG - www.avg.comVersion: 2012.0.2176 / Virus Database: 2425/5002 - Release Date: 05/16/12