I'm 67 yr old and perineural invasion was mentioned on my biopsy report , 12 out of 12 cores positive, aggressive cancer . I'm 2yr out of radiation and 24 months of hormone treatments with 12 months to go, this is the first time anyone has explained the perineural invasion. God Bless you.
68 years old and elevated PSA led to mri then biopsy- have been confirmed pc and aggressive 5+4. I’m due for a petscan this Friday then back to urology team before Xmas- a bit anxious but keeping my cool great view deo
I'm a 70 year old with 12 out of 13 cores positive with an aggressive cancer. Gleason 4+5 with mets to 2 distant lymph node. I'm 2 years out of RARP, Chemo and radiation and 10 months free from ADT with PSA
My dad just recently got diagnosed gleason 9 high risk cancer invaded just to the seminal vesicles, surgery wasnt recommended but i feel deep down inside he should get it i dont know what to do
I recently had a diagnosis of elevated PSA and a lesion in the prostate as seen on MRI with contrast. Biopsy confirmed a diseased prostate but no malignancy. This site has been invaluable in letting me know what to expect every step of the way regarding diagnosis and possible treatments. Thank you for the information I needed to make decisions regarding getting the proper tests.
Timestamps: 0:33 How concerning is seminal vesicle invasion? 5:16 What is seminal vesicle invasion? 7:01 What is extracapsular extension? 8:28 What is perineural invasion? 10:41 Is perineural invasion painful? 11:59 Does treatment for seminal vesicle invasion affect fertility? 13:36 How is seminal vesicle invasion detected? 14:36 Should a biopsy of the seminal vesicles follow signs of invasion on an MRI? 16:10 How do PET scans detect seminal vesicle invasion? 17:10 Do other PET scans have the same clarity? 17:51 Can Gleason 6 cancer invade the seminal vesicles? 18:55 How often do PET scans and MRIs miss Gleason 6 cancer 19:00 Does Gleason 6 cancer need to be treated if it invades the seminal vesicles? 20:20 Are higher Gleason grades more prone to SVI than lower grades? 21:41 Is there an optimal radiation treatment for seminal vesicle invasion? 22:23 Is focal therapy possible if seminal vesicle invasion is present? 23:34 Does cribriform cancer require more intensive treatment? 24:34 Alex's conclusions
Great info. addressing a lot of my concerns. Thanks for all the many educational videos posted that I followed from Gleason 6 to now a Gleason 8. My next step is to find a good interventional radiologist who has done 1000's of HDR Focal Brachytherapy Treatments. Any recommendations? Preferably UCLA.. Any suggestions.
È un grande dottore, seguo quasi tutti i suoi video. Finalmente un professionista che dice le cose con chiarezza senza mai incutere terrore nei pazienti a differenza di moltissimi suoi colleghi che sembrano essere divertiti nel farlo. Di fronte ad un team multidisciplinare i cui dottori, oncologo, radioterapista e urologo, volevano convincermi a fare radioterapia di salvataggio io ho opposto un convinto "no" spiegando loro il perché. Il loro tentativo di terrorizzarmi non ha funzionato sicché ho scelto di fare terapia blocco recettore androgeni con erleada. È vero che avevo una recidiva biochimica con doubling time inferiore a 9 mesi ma il mio gleason sul pezzo operatorio era 3+3, non avevo vescicole seminali e linfonodi coinvolti, né margini positivi, quindi sono abbastanza tranquillo. Dopo il colloquio con il team multidisciplinare sono tornato in ospedale per farmi assegnare il piano terapeutico e l'oncologo in camera caritatis mi ha detto: tu hai dato prova di grande preparazione medico-scientifica, dove attingi tante notizie? Gli ho risposto: senza voler svalutare la tua preparazione io faccio bottino di molti video di alcuni luminari italiani e soprattutto statunitensi 😊. Quello che mi sento di dire ai malati di cancro alla prostata è quanto segue: non prendete per oro colato le parole che escono di bocca del primo medico che sentite ma informatevi, informatevi, informatevi! Ricordatevi che non è il cancro alla prostata che uccide ma l'ansia che vi accompagna. La scienza ha fatto passi da gigante per cui l' unica cosa di cui dobbiamo preoccuparci è quella di contrastare energicamente tutti gli effetti collaterali derivanti dagli interventi chirurgici e dalle terapie radianti e farmacologiche. Comunque torno a ripetere: grande dottore!
La pet psma gallio talvolta è in grado di individuare la recidiva anche con un PSA 0,20. La comunità scientifica è un po' divisa sul quando sottoporre il paziente alla psma. Molti medici preferiscono che il PSA salga almeno a 0,50 per avere più possibilità di individuare qualcosa. Personalmente ho fatto tre psma con i seguenti valori di PSA, 0,22 0,54 1,06 ma il referto è risultato sempre negativo proprio a conferma di quanto ha detto il dr. Scholz, che quando ci troviamo di fronte ad un gleason 3 + 3 in oltre il 50% dei casi la psma non individua niente perché le cellule del gleason 3 +3 sono molto simili a quelle sane. Nel mio caso sospetto che la recidiva si trovi sui nervi dell' erezione che mi hanno salvato a seguito della prostatectomia. Viceversa ad un mio amico che aveva un gleason 4+4 la psma ha individuato una metastasi linfonodale in area parasacrale con PSA 0,42. Ha finito di fare radioterapia di salvataggio un anno fa' e da allora il suo PSA è oscillante tra 0,03 e 0,05.
How common is climatura after a turp.? Having had a turp 18 months ago I have this experience which was not occurring prior to to turp. Thanks again to you both for your empathy and the best source of information about prostate cancer.
Post op biopsy they told me svi...but no additional treatment recommended. Psa no more than .04 for 8 yrs finally bumped to .08 so got a psma it was negative...now what?
I am a 73 year old man, physically active who works out hard . I have a Gleason 7 (4+3). Will start SRBT next month. My main fear is ADT. I would like to know what percentage of men who undergo ADT have serious long term side effects.
From what I have read (and i have read easily hundreds of comments on scores of videos by doctors AND men w/ cancer), the SIDE-EFFECTS of ADT are horrendously hellish, but the LONG-TERM DAMAGE includes permanent penis atrophy and shrinksge and deep depression. The side-effects also seem to linger for a long time after discontinuing the drugs
had 4+3 and prostatectomy ,radiation , and everything you just talked about , i was 57 yr old slow PSA just doubled still low number 63 yr old now. now blood in urine everyday for one month, Dr. said its from radiation (bladder) . but sounds like nothing to worry about here , i guess its the big words that sound bad.
Same 4+3 here prostatectomy svi 8.5 yrs ago...no radiation...9 yrs ago.but low psa .04 for 8 yrs now .07. Did psma in July it was negative....radiate or wait for another bump..no blood no side effects very healthy and normal.
Just had a PSMA PET today (12/26): it involves being shot up with radioactive isotopes in a mixture that looks for, targets prostate cancer that may have metastisized (spread) to bones, organs. . . In other words, to see if the cancer has escaped the "capsule," the prostate proper, so to speak. Many insurance companies wont cover it. Mine (CIGNA) did--possibly because I have already paid out so much out of pocket for the 2024 year. . .
Most prostate cancers produce something called PSMA. The PSMA scan involves injecting an isotope into you that can find PSMA anywhere in the body and "light it up" for the doctors to see. The scan is quick and painless. The isotope decays over the course of 18 hours or so and is no longer in your body.
One aspect of radiotherapy versus surgery is the massive x-ray loading with RT. In my case 57 gray. (Tooth x-ray 0.02 gray). Surely that has to be counted as a negative when comparing RT with surgery?
Many thanks for the tips, until recently I hadn't realized that Mario updated his favorite way to tackle ED and it's a relief! Although what he previously suggested was pretty good, it was a real pain to follow... I just go'ogled Mario Volpstein , it's so much simpler and potent now!
You may not actually be ejaculating urine rather leaking urine as I do. What happens when you sneeze or cough do you leak then? I was 57 diagnosed now 62
@@TERRY-cb2ku 78 years old. I asked the oncologist if i was having retrograde ejaculation, and she laughed and said that I wasn't ejaculating at all. I have the feeling of having an orgasm, but no ejaculate. At my age, it's not a major concern. If i was in my sixties or younger, I'd be very upset. Any thoughts? Thanks.
Support Groups Resources:
pcri.org/supportgroups
ancan.org/prostate-cancer/
zerocancer.org/help-and-support
malecare.org/support-groups/
Thank you so much for the education...I worry a lot less these days.
I'm 67 yr old and perineural invasion was mentioned on my biopsy report , 12 out of 12 cores positive, aggressive cancer . I'm 2yr out of radiation and 24 months of hormone treatments with 12 months to go, this is the first time anyone has explained the perineural invasion. God Bless you.
68 years old and elevated PSA led to mri then biopsy- have been confirmed pc and aggressive 5+4. I’m due for a petscan this Friday then back to urology team before Xmas- a bit anxious but keeping my cool great view deo
I'm a 70 year old with 12 out of 13 cores positive with an aggressive cancer. Gleason 4+5 with mets to 2 distant lymph node. I'm 2 years out of RARP, Chemo and radiation and 10 months free from ADT with PSA
My dad just recently got diagnosed gleason 9 high risk cancer invaded just to the seminal vesicles, surgery wasnt recommended but i feel deep down inside he should get it i dont know what to do
I recently had a diagnosis of elevated PSA and a lesion in the prostate as seen on MRI with contrast. Biopsy confirmed a diseased prostate but no malignancy. This site has been invaluable in letting me know what to expect every step of the way regarding diagnosis and possible treatments. Thank you for the information I needed to make decisions regarding getting the proper tests.
Timestamps:
0:33 How concerning is seminal vesicle invasion?
5:16 What is seminal vesicle invasion?
7:01 What is extracapsular extension?
8:28 What is perineural invasion?
10:41 Is perineural invasion painful?
11:59 Does treatment for seminal vesicle invasion affect fertility?
13:36 How is seminal vesicle invasion detected?
14:36 Should a biopsy of the seminal vesicles follow signs of invasion on an MRI?
16:10 How do PET scans detect seminal vesicle invasion?
17:10 Do other PET scans have the same clarity?
17:51 Can Gleason 6 cancer invade the seminal vesicles?
18:55 How often do PET scans and MRIs miss Gleason 6 cancer
19:00 Does Gleason 6 cancer need to be treated if it invades the seminal vesicles?
20:20 Are higher Gleason grades more prone to SVI than lower grades?
21:41 Is there an optimal radiation treatment for seminal vesicle invasion?
22:23 Is focal therapy possible if seminal vesicle invasion is present?
23:34 Does cribriform cancer require more intensive treatment?
24:34 Alex's conclusions
Great info. addressing a lot of my concerns.
Thanks for all the many educational videos posted that I followed from Gleason 6 to now a Gleason 8.
My next step is to find a good interventional radiologist who has done 1000's of HDR Focal Brachytherapy Treatments.
Any recommendations?
Preferably UCLA..
Any suggestions.
One of your top three presentations. I have not heard or read these topics discussed anywhere else. Excellent presentation.
Intelligence and a great sense of style.
È un grande dottore, seguo quasi tutti i suoi video. Finalmente un professionista che dice le cose con chiarezza senza mai incutere terrore nei pazienti a differenza di moltissimi suoi colleghi che sembrano essere divertiti nel farlo. Di fronte ad un team multidisciplinare i cui dottori, oncologo, radioterapista e urologo, volevano convincermi a fare radioterapia di salvataggio io ho opposto un convinto "no" spiegando loro il perché. Il loro tentativo di terrorizzarmi non ha funzionato sicché ho scelto di fare terapia blocco recettore androgeni con erleada. È vero che avevo una recidiva biochimica con doubling time inferiore a 9 mesi ma il mio gleason sul pezzo operatorio era 3+3, non avevo vescicole seminali e linfonodi coinvolti, né margini positivi, quindi sono abbastanza tranquillo.
Dopo il colloquio con il team multidisciplinare sono tornato in ospedale per farmi assegnare il piano terapeutico e l'oncologo in camera caritatis mi ha detto: tu hai dato prova di grande preparazione medico-scientifica, dove attingi tante notizie? Gli ho risposto: senza voler svalutare la tua preparazione io faccio bottino di molti video di alcuni luminari italiani e soprattutto statunitensi 😊.
Quello che mi sento di dire ai malati di cancro alla prostata è quanto segue: non prendete per oro colato le parole che escono di bocca del primo medico che sentite ma informatevi, informatevi, informatevi! Ricordatevi che non è il cancro alla prostata che uccide ma l'ansia che vi accompagna.
La scienza ha fatto passi da gigante per cui l' unica cosa di cui dobbiamo preoccuparci è quella di contrastare energicamente tutti gli effetti collaterali derivanti dagli interventi chirurgici e dalle terapie radianti e farmacologiche.
Comunque torno a ripetere: grande dottore!
Thank you for a fantastic presentation. As usual extremely informative and very thorough. Dr. Sholz is a Godsend and so are you Alex. Cheers
If you have a relapse of prostate cancer what level does your PSA have to be at before a PSMA can detect where the cancer is located
Your insurance may have a designated level. Mine is above 1.0
La pet psma gallio talvolta è in grado di individuare la recidiva anche con un PSA 0,20. La comunità scientifica è un po' divisa sul quando sottoporre il paziente alla psma. Molti medici preferiscono che il PSA salga almeno a 0,50 per avere più possibilità di individuare qualcosa. Personalmente ho fatto tre psma con i seguenti valori di PSA, 0,22 0,54 1,06 ma il referto è risultato sempre negativo proprio a conferma di quanto ha detto il dr. Scholz, che quando ci troviamo di fronte ad un gleason 3 + 3 in oltre il 50% dei casi la psma non individua niente perché le cellule del gleason 3 +3 sono molto simili a quelle sane. Nel mio caso sospetto che la recidiva si trovi sui nervi dell' erezione che mi hanno salvato a seguito della prostatectomia. Viceversa ad un mio amico che aveva un gleason 4+4 la psma ha individuato una metastasi linfonodale in area parasacrale con PSA 0,42.
Ha finito di fare radioterapia di salvataggio un anno fa' e da allora il suo PSA è oscillante tra 0,03 e 0,05.
Heavily informative presentation that answered may of my questions that I have had but unable to articulate. Salute to Dr. Shultz and Alex!
Thankyou for explaining fully unlike my NHS oncologist!
How common is climatura after a turp.? Having had a turp 18 months ago I have this experience which was not occurring prior to to turp. Thanks again to you both for your empathy and the best source of information about prostate cancer.
Post op biopsy they told me svi...but no additional treatment recommended. Psa no more than .04 for 8 yrs finally bumped to .08 so got a psma it was negative...now what?
Have a beer and wait for the next test.
I am a 73 year old man, physically active who works out hard . I have a Gleason 7 (4+3). Will start SRBT next month. My main fear is ADT. I would like to know what percentage of men who undergo ADT have serious long term side effects.
From what I have read (and i have read easily hundreds of comments on scores of videos by doctors AND men w/ cancer), the SIDE-EFFECTS of ADT are horrendously hellish, but the LONG-TERM DAMAGE includes permanent penis atrophy and shrinksge and deep depression. The side-effects also seem to linger for a long time after discontinuing the drugs
But to answer your question regarding percentages, that i do not know for sure, but if I had to guess, i would say 90% at least. At least.
Can you have radiation on the Seminole vessels if you’ve had a seed plant?
I have been informed my Prostate Cancer is categorised as T2. Please can you explain what this means. Thank You.
had 4+3 and prostatectomy ,radiation , and everything you just talked about , i was 57 yr old slow PSA just doubled still low number 63 yr old now. now blood in urine everyday for one month, Dr. said its from radiation (bladder) . but sounds like nothing to worry about here , i guess its the big words that sound bad.
Same 4+3 here prostatectomy svi 8.5 yrs ago...no radiation...9 yrs ago.but low psa .04 for 8 yrs now .07. Did psma in July it was negative....radiate or wait for another bump..no blood no side effects very healthy and normal.
can someone explain what exactly is a PSMA PET SCAN, vs all the other types of scans their is MRI and CT etc etc scans ??
Just had a PSMA PET today (12/26): it involves being shot up with radioactive isotopes in a mixture that looks for, targets prostate cancer that may have metastisized (spread) to bones, organs. . . In other words, to see if the cancer has escaped the "capsule," the prostate proper, so to speak. Many insurance companies wont cover it. Mine (CIGNA) did--possibly because I have already paid out so much out of pocket for the 2024 year. . .
Most prostate cancers produce something called PSMA. The PSMA scan involves injecting an isotope into you that can find PSMA anywhere in the body and "light it up" for the doctors to see. The scan is quick and painless. The isotope decays over the course of 18 hours or so and is no longer in your body.
One aspect of radiotherapy versus surgery is the massive x-ray loading with RT. In my case 57 gray. (Tooth x-ray 0.02 gray). Surely that has to be counted as a negative when comparing RT with surgery?
I do not see any references to support groups in the notes. Can you post them?
Support Groups Resources:
pcri.org/supportgroups
ancan.org/prostate-cancer/
zerocancer.org/help-and-support
malecare.org/support-groups/
Many thanks for the tips, until recently I hadn't realized that Mario updated his favorite way to tackle ED and it's a relief! Although what he previously suggested was pretty good, it was a real pain to follow... I just go'ogled Mario Volpstein , it's so much simpler and potent now!
I had radiation therapy and I ejaculate urine.
I can't ejaculate at all after radiation therapy. The female oncologist made light of it. smh.
I haven’t even tried to ejaculate after knowing I’m dry so at 69 and single I just have to be happy I’m still here.
@@BeDoHave-so8nr That is concerning. May I ask your age ?
You may not actually be ejaculating urine rather leaking urine as I do. What happens when you sneeze or cough do you leak then? I was 57 diagnosed now 62
@@TERRY-cb2ku 78 years old. I asked the oncologist if i was having retrograde ejaculation, and she laughed and said that I wasn't ejaculating at all. I have the feeling of having an orgasm, but no ejaculate. At my age, it's not a major concern. If i was in my sixties or younger, I'd be very upset. Any thoughts? Thanks.