Another Tumor: Met with the oncologist... - Advanced Prostate...

Advanced Prostate Cancer

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Another Tumor

tom67inMA profile image
tom67inMA
โ€ข29 Replies

Met with the oncologist today to go over the CT scan from my trip to the ER a couple days ago. It turns out the radiologist at the hospital wasn't as inept as I'd hoped, and I really do have a growth on the outside my bladder. Most likely this is a return of my bladder cancer, but a biopsy will confirm. I'm also being tested for Chromogranin A to check for neuroendocrine prostate cancer.

If this is bladder cancer, it should be curable with chemotherapy followed by surgery. Surgery would remove both the bladder and the prostate. The chemo would also theoretically attack the prostate cancer and beat it back a little further. So as much as I'm upset at the thought of losing my bladder, there is the bright side that it may get more prostate cancer out of my body which is a good thing in the long run.

My body refuses to follow any rules. My PSA screening tests didn't detect any cancer until I was metastatic. Now my bladder cancer grows on the outside where it can't be seen in a routine cystoscopy. At this rate, someday I'll find out that I actually died back in 1993 and some cancer has been animating my corpse ever since :-)

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tom67inMA profile image
tom67inMA
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29 Replies
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Steveo3312 profile image
Steveo3312

Sorry for the bad news Tom.

๐Ÿ™

Danielgreer profile image
Danielgreer

Hi tom67, Iโ€™m really in envy of your positive outlook. Hoping for the best for you. I also had normal PSAs until I found out I had mPC. Iโ€™m wondering how common that is ? I did everything I was supposed to do with preventive care and I still got nailed! ๐Ÿ˜€

tom67inMA profile image
tom67inMAโ€ข in reply toDanielgreer

I do try to be positive. Sometimes it works, other times the post gets deleted. Which is it say I'd be envious of me too if all I knew about me was my posts :-)

Screening is important but far from perfect. I thought the quarterly checks would give me a warning, but here I am again where symptoms were the first warning. Welcome to the club!

Danielgreer profile image
Danielgreerโ€ข in reply totom67inMA

Three years ago I had lower back pain while my PSA was normal and went to my PCP who did a digital exam of my prostate and X-ray of my lower spine and he didnโ€™t alert me to cancer. I think I may have had it at that point. No way to know for sure though but I do have suspicions. Anyway doesnโ€™t help to dwell on it must push ahead!

tom67inMA profile image
tom67inMAโ€ข in reply toDanielgreer

Yep, though sharing your story can help if it helps others avoid the same fate. It's difficult though, my wife has more back pain than me and obviously she doesn't have prostate cancer.

Muffin2019 profile image
Muffin2019โ€ข in reply toDanielgreer

10 years ago my psa jumped from 2.5 to 5.4 then 3 years jumped to 7.9 then to 156 with symptoms 2 years ago. I should have been proactive but was told by my mom that there was no cancer in the family history. She passed in 2013 and did not know that my brother had bladder cancer 6 years ago which came back last year along with colon cancer. His diet stinks and did not give up alchol, I think he is an alcholic so there is nothing they can do, he had had 3 minor strokes with vision loss in one eye. Lesson learned so I am very proactive with this , have had chemo in 2018, scans good and not ready to give in, still working part time.

Danielgreer profile image
Danielgreerโ€ข in reply toMuffin2019

So the chemo knocked your PSA down (hopefully)? I stopped drinking 20 years ago when I had a liver issue and so glad I quit since it would be a challenge to deal with PC and drinking. Hope you brother can navigate through.

Muffin2019 profile image
Muffin2019โ€ข in reply toDanielgreer

It knocked it down to .6 but now 3.6 no progression and no new Mets from recent scans.

timotur profile image
timotur

Tom, as a fellow runner, I wish you a good treatment. Keep running and hope for the best. Rgds, Tim

LearnAll profile image
LearnAll

Tom...You are a courageous man with such a wonderful sense of humor. In face of difficulties, you are able to see the silver lining...I truly wish you great success in getting your health back. Best of luck !

j5000 profile image
j5000

Tom, your attitude will carry you through. Please keep us posted.

Tall_Allen profile image
Tall_Allen

Take it one step at a time. They have to determine just what the growth is. Some bladder cancers are treated with innoculation of BCG. I assume they will be doing a biopsy. Chromogranin A alone is not a test for neuroendocrine cancer.

tom67inMA profile image
tom67inMAโ€ข in reply toTall_Allen

Yes, biopsy is planned. Since it's on the outside can't use BCG. I expect chemo regardless of what the biopsy shows, but the drugs used will probably change depending on what they find. I also asked about genetically testing the tumor.

Tall_Allen profile image
Tall_Allenโ€ข in reply totom67inMA

The most important analyses are histological and IHC. Since you don't know if the site of origin is urothelial, prostate or lung, they have to stain for them all. Ask for stains for TTF1, CK7, CK20, P63, HMW keratin, EGFR, synaptophysin, chromogranin, PSMA, DLL-3, NKX3.1,

tom67inMA profile image
tom67inMAโ€ข in reply toTall_Allen

Why would the origin be the lung? Also, are these stains for genetic defects? Or types of cancer?

Tall_Allen profile image
Tall_Allenโ€ข in reply totom67inMA

Sorry - I take that back. I thought you had mentioned a lung lesion, but that was a different patient. No, this is for IHC analysis- much more important than genomic analysis. It stains for proteins expressed by different tumor types. It can distinguish bladder cancer from prostate cancer. Scratch TTF1, HMW keratin, and EGFR. Keep the rest.

Tall_Allen profile image
Tall_Allenโ€ข in reply toTall_Allen

FWIW - Several top MOs have recommended to me that Dr. Wong at Duke is the top guy to do morphology and IHC.

pathology.duke.edu/research...

You may want to request a second opinion on the biopsy from him.

Apparently, he's the go-to pathologist for this sort of thing (similar to Dr Epstein's reputation for prostate biopsies).

JamesAtlanta profile image
JamesAtlanta

Wow, quite a sorry! You do have the most positive attitude Iโ€™ve ever seen! Keep it up - an inspiration to us all!

Please keep us posted - we will be praying for you!

James

๐Ÿ˜‚๐Ÿ˜‚๐Ÿ˜‚

Haniff profile image
Haniff

Stay strong and cheer up Tom. Trust me, your positivism will help you overcome this hurdle too.

My very best to you.

Haniff

snoraste profile image
snoraste

Sorry about the news. But keep your positive attitude (I know it's hard at times). Another bump on the road. But you can manage.

Jimhoy profile image
Jimhoy

Damm it!

Currumpaw profile image
Currumpaw

Hey tom67inMA--

I am so sorry to read this. Dr. Gary Larson who is at the Integris Cancer Institute in Oklahoma City is a proponent of proton therapy which is done at the Institute. He had bladder cancer. He wrote that he chose to have his bladder cancer treated with proton therapy at Mass General rather than the Institute because at that time there was a doctor there that was perhaps the best at treating bladder cancer with proton therapy.

I don't know if this info about Mass General would possibly be helpful but know that you will be in my thoughts.

Perhaps Dr. Gary Larson would have a conversation with you--if you wished to--that would be your call of course. Just a suggestion. Explore options if you wish. Do what you feel is right for you.

What a positive attitude you have! A Smiley Face to close your post!

Currumpaw

tom67inMA profile image
tom67inMAโ€ข in reply toCurrumpaw

At this point my MO would say radiation therapy would be plan B, but if we choose not to go the surgical route that may be a very useful reference, thanks!

RonnyBaby profile image
RonnyBaby

When all else fails, a good sense of humour can't hurt.

You've been racked over the coals somewhat but I'll bet something good will come out of this.

Your body is trying to tell you something - now if the right people are listening ....

Hang in there - there's lots of fight left in you !

bellyhappy58 profile image
bellyhappy58

What a great positive attitude approach to your situation. Will pray for your recovery.

Jbooml profile image
Jbooml

God your heroic Tom.....I to sometime look at my body as a marriage of convenience for my Rotty old cancer.

tom67inMA profile image
tom67inMAโ€ข in reply toJbooml

Thanks for the kind words but I wish the "heroic" came with better results in remaining cancer free. :-P

Jbooml profile image
Jboomlโ€ข in reply totom67inMA

I hope...as I'm sure many here...that yours is the case that busts cancers grip on us all.

Peace love and health brother.

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