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    Decision Point: I have an initial diagnosis of prostate cancer.

    My friend has gotten a lot of insights from this forum. His advice was to post as much information as possible, so that others would be able to give insights on a disease that seems to vary a lot by person. I don't know how to interpret all the data. Books and ACS material gives levels, but I fit in some as low level and some as high risk. With talks scheduled with a variety of doctors in the next could of weeks, some experience of others with this ranking system would be helpful. Thanks in advance.

    If this is improper, I apologize.

    Bellingham Tom

    I’ve just been diagnosed with prostate cancer. The information I’m receiving makes me a little puzzled, since on some measures, I am low risk, and other measures I am quite high risk. Books seems to suggest that prostate cancer is different, but that makes deciding which is which factor is important when I have conversations with my doctors. My doctor says that the high PSA and the jump in the last year is all that matters in the determination. Does anyone have any insights from their experiences?

    First high PSA in in 2001.

    PSA has ranged from 10 to 14 for the last ten years.

    Biopsies in 2001, 2002 and 2003 showed no cancer.

    Disease was not palpable, even in 2012.

    Decision was made not to do further biopsies until the PSA rose.

    PSA in 2012 was 31. Biopsy showed cancer.

    Pathology report showed the following:

    Right Lobe
    Acinar Type Adenocarcinoma
    Histologic Grade: Gleason Major Pattern 3; Minor pattern 4 Pattern Score 7
    3 of 9 cores positive
    Greatest length of carcinoma in a single core: 2.5 mm
    6 of 135 mm positive (4% involved)
    Negative for perineural invasion

    Left Lobe
    Acinar type adenocarcinoma
    Hostologic Grade: Gleason major pattern 3; minor pattern 3; pattern score 6
    2 of 7 cores positive
    Greatest length of carcinoma in a single core: 2 mm
    2.5 of 120 mm positive (2% involved)
    Negative for perineural invasion

    Some things like non palpable and small involvement indicate low, while other like Gleason and PSA change indicate high.

    Bone Scan: No indication of cancer outside prostate
    MRI: No indication of cancer outside prostate
    CT Scan: No indication of cancer outside prostate
    X-ray: No indication of cancer outside prostate

    Size of prostate has increased by 50%
    BHP symptoms have been present for several years.

    This seems pretty complicated for me to judge. Thanks for any experience to help me understand what besides the doubled high PSA matters from others’ experience.

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