Active Surveillance, Ductal Carcinoma, and Staging | Answering YouTube Comments #2 | Mark Scholz, MD
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- čas přidán 5. 08. 2024
- Medical oncologist Mark Scholz, MD, answers CZcamsr's "staging-themed" questions. Prostate cancer is a heterogeneous disease (meaning it behaves differently in different people) and staging refers to the process of characterizing an individual's cancer to determine the appropriate intensity of treatment-one that preserves as much quality of life as possible without risking morbidity and mortality from metastatic spread. In ambiguous cases, this balance will oftentimes require patient input about his own personal goals and wishes.
0:22 "I'm a 41-year-old with a Gleason score of 3+3 on the right side and 3+4 on the left side. Would radiation be a good treatment? I'm really scared of doing an operation. And what is the chance of the cancer coming back?"
2:08 "Do you have any suggestions on therapy for ductal carcinoma of the prostate?"
3:16 "Which patients should do a PET scan before deciding on a focal treatment like TULSA-PRO?"
5:08 "If prostate cancer is found in only 1 core out of 12, is that 5% or less? Would that qualify one for active surveillance?"
5:50 Can you reiterate the importance of getting a second opinion on the pathology report if there is a chance that it could affect the intensity of treatment?
6:59 How much do pathology second opinions on cost?
7:11 "I'm always confused why long term health is not considered for men who are in their 70s and 80s, like those in their 40s. Can you explain that deeper?..."
Don’t know your stage? Take the quiz: Visit www.prostatecancerstaging.org
To learn more about prostate cancer visit www.pcri.org
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The Prostate Cancer Research Institute (PCRI) is a 501(c)(3) not-for-profit organization that is dedicated to helping you research your treatment options. We understand that you have many questions, and we can help you find the answers that are specific to your case. All of our resources are designed by a multidisciplinary team of advocates and expert physicians, for patients. We believe that by educating yourself about the disease, you will have more productive interactions with your medical professionals and receive better-individualized care. Feel free to explore our website or call our free helpline at 1 (800) 641-7274 with any questions that you have. Our Federal Tax ID # is 95-4617875 and qualifies for maximum charitable gift deductions by individual donors.
The information on the Prostate Cancer Research Institute's CZcams channel is provided with the understanding that the Institute is not engaged in rendering medical advice or recommendation. The information provided in these videos should not replace consultations with qualified health care professionals to meet your individual medical needs.
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Kaiser rated at Gleason 3-4 and surgery was recommended. Per your advice, Dr. Epstein rated at 3-3 but with additional finding of ductal carcinoma - cost was $730. Also per your recommendation, opted for brachytherapy from an excellent and highly experienced Kaiser Dr. Your CZcams’s led me to a better path. Am very grateful !!
55 and just diagnosed today with Gleason 6 Adenocarcinoma in two left edge spots of biopsy. Doctor recommended to re-biopsy and MRI in 6 months. Needless to say today is not a good day.
Thank you. Like the question/answer format. These videos have helped me enormously.
Interesting that you state ductal type just means it’s a slightly higher grade cancer than indicated with current staffing systems.
I’m researching this morning my own ductal type diagnosis and see in pubmed that ductal generates lower PSA numbers than other cancers, and that ADT isn’t as effective in ductal as it is in non-ductal.
Also that a study comparing ductal to other aggressive cancers showed that ductal patients had worse outcomes regardless of treatment types.
Love your channel, it’s a great resource for patients trying to understand their cancers.
Thank you! If you have any questions about your case, feel free to call our free helpline at pcri.org/helpline. We have patient advocates who are trained to provide people with information relevant to their case.
Have worries down the road about the invasive nature of ductal carcinoma. Having Lynch Syndrome, am also concerned about adequate screenings (blood and urine tests and imaging) to detect reoccurrences, around prostate and especially in the renal ductal tracts ? Appreciate any ideas or guidance.
I’m 74 years old with stage 4 metastatic (lungs) prostrate cancer diagnosed 3.5 years ago. Initial treatment was chemo,Eligard and zytiga. I’ve been on quarterly Eligard injections and zytiga as needed basis when PSA rises above ~2. Tried taking a hormone holiday and PSA went from ~2 to 3.5 in a month. Now back on Eligard for a month and PSA is still climbing and at 4.5. My testosterone was
Are u alive??
Dr. Scholz, I'm 55y/o and just Dx w/prostate cancer from UCI and GS is 3+4. Started w/PSA 27, 22, 20 & 18.4 (9/2020), and mpMRI shown two abnomalities (PI-RAD 3 & 4 lesion), no pelvic lymphadenopathy and no suspicious bone lessions. My biopsy resulted with 7 our of 18 cores found cancer with 80% in 1 core. My T-stage is approximately T2b. My next procedures are CT scan and Bone scan in two weeks. What steps should I take before making decision on surgery or radiation? Thanks so much for making these videos. I'm learning so much from them.
Hello, our prostate cancer helpline may be able to help with your question. Please feel free to contact us here: pcri.org/helpline
There are a lot many cases with prostatectomy who need to be on various treatments like hormone therapy, radiation and other kinds. You would do well to discuss such cases and advise such patients. Thank you.
I was diagnosed with prostate Cancer, through a Targeted MRI biopsy with A Gleason score of 4 and 3 I was offered 2 choices surgery or chemotherapy We talked about the quality of life and Side effects That I can live with From listening to you guys I learned about spaces Zar and I mentioned it to they said yeah yeah we do that too This is my life I'm not trying to give you ratings it's just the truth Thank you for that I wasn't comfortable with either one of those choices I understood the seriousness of it but I walked out of there disappointed and 3 years later I hadn't done anything my wife dragged me back in there I wasn't having issues By that time I had learned a little something on my own ¿1st thing the doctors wanted to do is a PMSA scan Immediately I agree It came back negative The tumor In the beginning, was 2.2 cc The doctor told me befor he discussed everything he wants To order a MRI We did and it came back identical to the 3 years ago something called a comparison? in fact the tumor had went down 1.5 the only difference my question is do I qualify for seed inplant There was only one spot on 1 side the right sibetween 9 and 6 o'clock whatever that mean Thank you for reading these few words I will think with you again down the road at God speed
Maurice
Can Thyroid-T3 substitute enzymes couter the growth of prostate cancer cells ?
Most times, the discussion is on cases who have not undergone prostatectomy
What risk is involved in a prostate biopsy? Can the prostate once poked with the instrument (14 X) cause cancer cells to metastasize?? When my husband had it done, And subsequently was diagnosed with prostate cancer, he bled for a month and blood clots came out in his semen. Since he had that experience, he has declined another biopsy after his PSA has climbed from his initial one that initiated the biopsy (from 6.0 in 07/2017 to 14.0 02/2022). It has been since August 2017, and he had a Gleason score of 3+3 and was graded Stage 1a in his cancer and accepted the course of Active Surveillance. He is 52 years old. Thank you & appreciate finding this channel.
Hello,
I will add this to our list of questions for future videos. There is no evidence in prostate cancer of biopsies spreading viable metastases, and studies with other cancers have shown that patients who get appropriate biopsies do better than those who do not. There is a small risk of infection, especially when a 12-core biopsy is used (as opposed to a targeted biopsy with 2-4 cores). If you would like to learn more from one of our patient advocates, feel free to call our free helpline at pcri.org/helpline.
I'm 66 and recently dianosed with Gleason 4+4 and 5+3 in 5 of 12 cores. The doctor is recommending HDR and EBRT with ADT. I had open heart surgery 7 months ago and am concerned about cardiac issues. The doctor is recommending degarelix. Should I also ask about casodex in addition to degarelix - to cover mores areas of testosterone production? Any other thoughts?
Forgot to add that I have ductal carcinoma in two cores and perineural involvement in one core.
Hello, our prostate cancer helpline may be able to help with your question. Please feel free to contact us here: pcri.org/helpline