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What are the chances of aggressive cancer of prostate being encapsulated?

DOCTOR OF THE MONTH - Jul 2016
Jul 2016
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Practicing since : 1971
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Dr. XXXXXXX Hi! You had been so gracious to answer my numerous questions before regarding my dad with the spiking PSA numbers. Here is where I stand now, and I was wondering if you could assist me. I wanted to share with you the shocking biopsy results, and ask your opinion on all of this. I am quite upset. Out of the 18 core biopsies, half came back positive for cancer. In particular, the MD stated two tumors were discovered; one with a XXXXXXX score of 7 and the other a 9. These tumors were found on the sides of the prostrate. I am very concerned. The MD said the next step is a CT scan and also a bone scan. My dad has a pacemaker, and I am not sure if the bone scan involves Magnetic Resonance Imaging. Do you think, with this aggressive spiking, that my dad could have had this cancer spread to the spine, bones, and/or lymph nodes? I asked the MD if this, God forbid were the case, he stated the spread could be treated with hormonal therapy? Is it possible to treat a spread to bone and/or lymph node with hormonal therapy? Would this hormonal therapy decrease the tumor cells? I am not sure if cancer staging can be provided from this biopsy, or do they wait until the CT and Bone scan are done? What are the chances of this aggressive cancer being encapsulated? Is it determined by the CT scan, or can the biopsy determine this? Can regional or distal spread take place within a short time frame? I am concerned about time of being of the essence here. Should I worry about a week or two making a difference? Would you recommend a complete removal of the prostate gland in aggressive cancers, or is radiation and hormonal treatment enough and equal to prostate removal? I know that this is an over abundance of questions for you. I am just so upset by all of this. Thanks again! Dr. XXXXXXX Good evening! Please review my dad's biopsy results, and let me know what you think. Also, what does it mean by a perienal nerve involvement, and is this dangerous? Final Diagnosis: 1.) Prostate-left apex-biopsy -Prostate tissue with a small focus of atypical glands. 2.) Prostate-left mid-biopsy -benign prostate tissue 3.) Prostate, left base, biopsy -Adenocarcinoma of the prostate. XXXXXXX score 4 +3= 7 involving 20% (1.5 mm in length) 1 of 2 core(s) 4.) Prostate, right apex, biopsy. -Adenocarcinoma of the prostate. XXXXXXX score 4 +5=9 involving 95%, 95%, and 60%). (5.5 mm, .5mm, and 4 mm in length) of 3 of 3 core(s). -Perineural invasion is identified. 5.) Prostate, right, mid, biopsy -Adenocarcinoma of the prostate. XXXXXXX score of 4+5=9 involving 95% (7 mm in length) of 1 of 2 core(s) -Adenocarcinoma of the prostate. XXXXXXX score of 4 +3=7 involving 80% (8.5 mm in length) of 1 of 2 core(s) - A total of 2 of 2 cores involved in carcinoma. 6.) Prostate, right base, biopsy -Adenocarcinoma of the prostate. XXXXXXX score of 4 +4=8 involving 85 and 70% (10 mm and 7 mm in length) of 2 of 3 core(s).
Posted Sat, 8 Feb 2014 in Urinary and Bladder Problems
 
 
Answered by Dr. P. T. Patil 6 days later
Brief Answer: It is an agressive Cancer of Prostate. Detailed Answer: Thanks for faith you have shown in me and writing again.There is no doubt that your father has aggressive cancer of the prostate with Gleason's score of 7 to 9.I would like to answer your queries point to point 1)Pace maker will not interfere with results of the C.T Scan. 2) The spread of cancer to bones,spine,can not be ruled out unless proved otherwise by bone scan. 3)Hormonal treatment will prevent further spread of the disease and will help to have relief from symptoms like pain etc. 4)Hormonal treatment will not regress the tumour completely but will help to reduce the severity of symptoms. 5) C.T scan and Bone scan are necessary to determine the stage of the disease whether ir is advanced or organ confined (Limitred to prostate.) and will help to determine line of treatment and prognosis. 6)This can be confirmed only by CT and Bone scan 7)Prostate cancer is a slow growing cancer and takes long time to infiltrate to surrounding structures and distant spread.However in our country.it being non symptomatic it is detected when it is advanced 8) Complete removal of tumour along with prostate is possible and helpful only when it is organ confined ( Confined within capsule of the prostate.). 9) Radiation and Hormonal treatment help to alleviate the symptoms and improve quality of life but will nor regress the primary pathology. 10) Technicality it is not possible to remove advanced cancer . Please go ahead and get C.T scan and Bone scan done to decide further course of action. and mode of treatment.A period of one or two week will not make any difference at this stage of disease. Hope I have answered your query ,please feel free to ask if you have more questions ,I shall be happy to help you Thanks and Regards. Dr.Patil.
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Follow-up: What are the chances of aggressive cancer of prostate being encapsulated? 9 hours later
Dr. XXXXXXX Good morning! Thanks again for answering my questions. My dad's CT scan came back clear, but his Bone Scan showed some spots on his ribs, femur, pelvis, and spine. What do you think? Is it still possible to control this disease? When you say prostate cancer is a slow growing disease, is this still the case with my dad's type? Dad has no pain in his bones, and the MD stated that, with hormone treatment, my dad's bone spots may decrease, and eventually die off. Have you ever seen such an aggressive case, as my dad's? What do you think the prognosis would be (in terms of years)? Thanks! XXXXXXX
 
 
Answered by Dr. P. T. Patil 1 hour later
Brief Answer: Bone metstasis indicates advanced disease. Detailed Answer: Hello Thanks for updates. The disease has spread to bones .It suggests that it is cancer of the prostate is in advanced stage and the only option of the treatment is a palliation with hormonal treatment and chemotheraphy. It is difficult to predict obout the life span but he will have quality life for rest of his life We do come across such cases in our practice and this is the only option left at this advanced stage. Thanks and Regards. Dr.Patil...
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Follow-up: What are the chances of aggressive cancer of prostate being encapsulated? 16 hours later
Dr. XXXXXXX Hi! I heard of people with advanced disease doing very well for years with the correct hormonal treatments. Do you know of any such cases? Any new drugs coming out which may be beneficial? XXXXXXX
 
 
Answered by Dr. P. T. Patil 47 minutes later
Brief Answer: Yes people do well with hormonal treatment. Detailed Answer: Thanks for follow up. Patients with advanced cancer of the prostate with bone metastasis if monitored.properly do well for rest of their life. Please consult medical oncologist for further treatment. Thanks and Regards. Dr.Patil.
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Follow-up: What are the chances of aggressive cancer of prostate being encapsulated? 8 hours later
Dr. XXXXXXX Good morning! 1.) Any special diet, or foods, which may help regress this cancer? 2.) Do you know of people who are on a specific hormone for years, without developing a prostate cancer resistance? Thanks! XXXXXXX
 
 
Answered by Dr. P. T. Patil 50 minutes later
Brief Answer: There are no food items that can regress cancer. Detailed Answer: Hello Thanks for follow up. There are no specific diet or food items that can regress cancer of prostate. Patients do well with hormonal treatment but some patients develop resistance to hormonal treatment . Thanks and Regards. Dr.Patil.
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Follow-up: What are the chances of aggressive cancer of prostate being encapsulated? 5 hours later
Dr. XXXXXXX Hi! What happens when patients develop a resistance to hormonal treatment? Do Chemotherapy drugs then become the 2nd option? Do these drugs also show success in keeping people alive and healthy for years? Thanks! XXXXXXX
 
 
Answered by Dr. P. T. Patil 3 hours later
Brief Answer: Hormonal resistant patient succunb ealry. Detailed Answer: Hello Thanks for follow up. Once the patient becomes resistant to hormones the disease spreads further very fast and succumb early within few months. Thanks and Regards. Dr.Patil.
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