Since Jerry's appointment last Wednesday, he has been doing fairly well, better than usual, after his treatment. However, Jerry is still taking the medication (Vancomycin) for the C-Diff Colitis and while he's on the medication he doesn't have too many problems with diarrhea. But, he is still having some problems... just not as bad. The Gastro and Oncologist both agree that they cannot do a colonoscopy or take more aggressive cancer treatments until the C-Diff Colitis has cleared up and the stool tests come back negative. Once the infection is cleared a colonoscopy and a more aggressive cancer treatment will begin. Jerry's tumor inside the prostate has grown since the last color Doppler in Oct.07. Here is what the report says and comments from Dr. Duke Bahn of the Prostate Institute of America...
Power Doppler and Tissue Harmonic Transrectal Ultrasound of the Prostate
Clinical History: This is a follow-up to the previous study of October,2007. The patient is still on Leukine, Revlimid and Intron. However there has been a significantly elevating trend of his PSA since his last visit. It is now up to 11.3.
Digital Rectal Examination: Nodular prostate, more in the right lobe than the left.
Gland volumn is 25cc, unchanged
The predicted PSA is between 1.9 and 3.0.
The recent serum PSA level is 11.3.
The post-void residual urine volume is 88cc.
The International Prostate Symptom Score is 5.
The urinary continence score is 5.
The SHIM score is 1.
Ultrasound: Careful gray scale and color Doppler ultrasound study again reveals an extensive infiltrating-type lesion involving almost the entire prostate with more tumor volume in the right lobe than the left. At the base level, it measures 40 x 12 mm. It was 36 x 12. At the mid level, the lesion measures 40 x 12. It was 37 x 7 mm. At the apex level, especially on the right side, it measures 17 x 6 mm. It was 15. 6 mm. There is a variable degree of neovascularity, in the 1 to 2+ range. There is evidence of extracapsular penetration as before.
Conclusion: There is evidence of the tumor progression by measurement. There is also an elevating trend of his PSA. Therefore, I recommended that he return to Dr. Leibowitz for discussion of treatment changes or further treatment.
Power Doppler and Tissue Harmonic Transrectal Ultrasound of the Prostate
Clinical History: This is a follow-up to the previous study of October,2007. The patient is still on Leukine, Revlimid and Intron. However there has been a significantly elevating trend of his PSA since his last visit. It is now up to 11.3.
Digital Rectal Examination: Nodular prostate, more in the right lobe than the left.
Gland volumn is 25cc, unchanged
The predicted PSA is between 1.9 and 3.0.
The recent serum PSA level is 11.3.
The post-void residual urine volume is 88cc.
The International Prostate Symptom Score is 5.
The urinary continence score is 5.
The SHIM score is 1.
Ultrasound: Careful gray scale and color Doppler ultrasound study again reveals an extensive infiltrating-type lesion involving almost the entire prostate with more tumor volume in the right lobe than the left. At the base level, it measures 40 x 12 mm. It was 36 x 12. At the mid level, the lesion measures 40 x 12. It was 37 x 7 mm. At the apex level, especially on the right side, it measures 17 x 6 mm. It was 15. 6 mm. There is a variable degree of neovascularity, in the 1 to 2+ range. There is evidence of extracapsular penetration as before.
Conclusion: There is evidence of the tumor progression by measurement. There is also an elevating trend of his PSA. Therefore, I recommended that he return to Dr. Leibowitz for discussion of treatment changes or further treatment.
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