Dougie Posted May 22, 2015 Share Posted May 22, 2015 Month and year of diagnosis. Example: June 2009.February 2012Age at diagnosis. Example 61 years60 Current treatment status. Examples: Continuing ADT OR Monitoring PSA each 6 weeks. Monitoring PSA - every 3 months Last few PSA scores with dates. Example: PSA 0.07 Feb 2012, PSA 0.11 Jul 2012. June 2014 PSA 0.068; September PSA 0.072 January 2015 PSA 0.094: April 2015 PSA 0.21 Gleason score at diagnosis. (from biopsy) Examples: 7 OR 3+4. 3+3 Bone scan result at diagnosis. Examples: Clear OR Metastases in pelvis and lower spine.No Scans performed Highest PSA before treatment. Example: 10.4 5.6Initial treatment - surgery. Examples: Robotic prostatectomy OR open prostatectomy:Robotic Prostatectomy Lowest PSA after initial treatment. Example: 0.2 0.02Month and year of recurrence. Example: June 2012February 2014PSA at recurrence. Example: 2.70.06 Recurrence treatment - radiation. Example: External beam to prostate bed OR External beam to 2 bone metastases. External Beam Radiation to Prostatic Bed Final paragraphs - anything else you wish to say I had regular visits to the Doctor from age 22 for high blood pressure. Commenced PSA tests at about age 50 and they were normal until November 2011. 8 November 2011 -PSA 5.6 up from 4.2 on 30 December 2010. Considered high velocity change. 21 November 2011 Total PSA 4.4 free PSA 0.68. % Free PSA 15.5%. Comments on collection "The median %Free PSA for men of all ages is 25%. Elevated total PSA less than 10ug/L and free/total PSA ratio is within the reference interval but at or below 25 % may be associated with an increased risk of prostatic neoplasia)."I was referred to Urologist. Had biopsy in February 20122 of 18 samples positive for carcinoma -Right Apex Medial Gleason 3+3=6, spanning length of<1mm and Left AnteromedialGleason 3=3=6 spanning a length of1mm. Both amounted to between 5% and 10% of the prostatic tissue in section.Diagnosed localised prostate cancer Gleason score 3+3= 6 -Stage T1c.No perineural InvasionNo Extraprostatic ExtensionRobotically Assisted Laparoscopic Radical Prostatectomy October 2012Post Surgery Pathology Tumor location :Dominant nodule; Direct posterior peripheral zone, toward the apexSmaller nodules: Right anterolateral peripheral zone toward the apex; left anterior transition zoneVolume /Size Multifocal; dominant nodule 0.5ccWhen the surgeon phoned and advised me of these results. He said "His gut churned" when he read the results.Gleason Score 4+5=9 Stage pT2c pNX. Post operative PSA as followsFebruary 2013 -0.02July 2013- 0.03February 2014 Established PSA recurrence-0.06ug/L"Discussed pros and cons of prostatic bed and pelvic radiation therapy. We don't have technology that will tell us exactly where the PSA is coming from but certainly is a body of literature that would support pelvic radiation in this setting rather than ADT."7 March 2014CT Abdomen and Pelvis Summary : "No convincing evidence of metastatic disease in abdomen and pelvis. There are small volume retroperitoneal lymph nodes which are not enlarged according to CT size criteria and are doubtful clinical significance. No osseous metastases."Bone Scan Summary: "There is no confirmation on today's study of osteoblastic skeletal metastases from carcinoma of the prostate."Radiation therapy to Prostatic bed 33 treatments at 2 Gy - 31 March to 19 May 2014Post Radiation PSAJune 2014 - 0.068September 2014 - 0.072January 2015 - 0.094PSMA Scan at Wesley Medical Imaging 13 February 2015Opinion:Small moderate PSMA focus in left pelvis laterally. this appears to correspond to a small or tiny 2mm short axis elongated distal iliac node. This is suspicious but not definite for malignant node due to the small size of the node and moderate PSMA uptake. In addition, the PSMA is 0.09. No other PSMA avid disease identified in the rest of the study. Depending on the clinical progress and PSA level, follow up PSMA PET CT in 3 months can be considered. February - March 2015. After discussion with Medical colleagues -Urologist-believes surgery is not a safe option.April 2015 PSA -0.21. Results delivered by Radiation Oncologist who had viewed images of PSMA and read report. Additional radiation not recommended as it may result in perforation of small bowel. Does not think Stereotactic radiation is an option either as it is possible that cancer cells may have already escaped to other areas.My case was to be considered by Multi Disciplinary Team on 12 May 2015.I see Urologist later this month.Date updated:14 May 2015 Link to comment Share on other sites More sharing options...
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