What Are The Chances Of Aggressive Cancer Of Prostate Being Encapsulated?

Question : 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).

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

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

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

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