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Gleason 8, PSA 26, Newly Diagn.

Pbentley
Posts: 4
Joined: Oct 2005

Husband 58, biopsy done 4 out of 8 positive (one side of prostate only). Bone scan came back negagive and waiting for results of CT scan.
Has anyone had similar Gleason grade who has had prostactomy. I've read the result of Mayo Clinic on T3 Prostate Cancer that says surgury best option even if lymph node involvement as only way to get the so called "cure". We still have to find out if cancer has progressed outside of capsule but we are still hopeful it has not.

Love to hear from similar cases and results.

Deb

rogermoore's picture
rogermoore
Posts: 265
Joined: Mar 2002

Deb,

I'm sorry to hear of your Husband's diagnosis. Although my PSA was not that high, I am a 4 yr survivor of a Prostatectomy.

I was also 58 at the time of my diagnosis and can sympathise (sp) with the shock factor you and your husband are going through. First and foremost, Keep a positive attitude! Although Cancer can be a deadly disease, that is not always true. There are a lot of us survivors out here still enjoying life.

I would strongly suggest you obtain a second opinion. Your physician would be a good place to start in locating another surgeon to consult. Its obvious you have already begun researching possible treatments. I am partial to the surgical avenue, although the other options have proved successful in some cases.

If you or your husband would like to communicate with me privately, you may do so by replying from my personal page on this site.

All our thoughts and prayers are with you both.

Roger

stuart
Posts: 88
Joined: Dec 2001

I had a Gleason score of 8 with a 20 PSA four years ago...Surgery is a viable option but so is radiation... It would be worth while to get a second opinion from a radiologist who specializes in prostate cancer...Your husband and you should make an effort to understand both approaches to treating this cancer so that you can ask appropriate questions to your docs...They should be able to respond to your concerns..

JimDSM
Posts: 8
Joined: Apr 2005

As others have said, research and understanding of courses of treatment are the best way to decide how to proceed. I too was 58 when diagnosed with PC a little over 1-1/2 years ago. I had PSA of 8.5 and Gleason of 8 (4+4). My local urologist recommended radical prostatectomy but continued that if it was in the lymphnodes he wouldn't remove the prostate and would send me for radiation and chemotherapy. I talked to my wife (a health care professional), my primary care provider and an oncologist. All were "troubled" by such a program. I was refered to Mayo in Rochester, MN and the surgeon there said that RP was the indicated treatment regardless of potential lymphnode involvement because it only made sense to remove the source. His response when I asked about the other plan was "you can use my name when you ask him why he is using such an outdated approach." Following surgery they concluded the CA hadn't spread and the final pathology report showed a Gleason of 7 (4+3) which confirmed that the original 8 was well justified. After 1-1/2 years my PSA remains below detectable limits and my bone scan is clear (I was "happy" to learn my back pain was due to disk problems!). While RP is drastic and the after effects are less than ideal (I have 95% bladder control but still essentially impotent) my wife and I have concluded that life is still good - I ain't dead and I don't have to wear a diaper. We're still debating the other issue but the alternatives are still not attractive enough to me/us.

Jim in Des Moines

Pbentley
Posts: 4
Joined: Oct 2005

Jim, thank you for your reply. We second your thoughts on "life is still good". Thats our goal as well.

Did you undergo preadjuvant harmone therapy prior to your RP. Also, from what I recall from 1st appmt with Urologist, preadjuvant harmone therapy, RP, and then harmone therapy or radiation and harmone therapy.

Was your overall treatment similar?

Deb

JimDSM
Posts: 8
Joined: Apr 2005

Deb,

Sorry for the long delay, we were out of town for some vacation time and so my wife could attend a conference. My only treatment has been the radical prostatectomy. Because my PSA was "only" 8.5 no one was in a real rush until I saw the surgeon at Mayo. Basically things sort of plodded along until the last few days so I didn't have any pre-treatment and didn't even a bone scan before I had surgery. The course of events and timing started with a physical Jan 8. I went back to my primary care provider on Jan 12 to discuss the lab report showing the elevated PSA. I saw the original urologist Jan 16 and was scheduled for a biopsy Jan 30. I saw the urologist again Feb 9 for his recommendation. I saw the oncologist Feb 16 and again on Feb 18 when he got me scheduled into Mayo on Feb 20 (Fri). The surgeon there recommended surgery Feb 23 (Mon) but setting up things at home and work pushed the surgery to Feb 26 (Thu). I took 2 weeks sick leave then went back to work 1/2 time for another 2 weeks. Recently I learned that a new "young" urologist here now also emphatically agrees with the Mayo practice of RP regardless of spread of the CA. He also says it only makes sense to get rid of the source. It may sound a bit strange but I hope things are moving along well for you in the decision and treatment process. We wish you the best in recovery as well.

Jim in Des Moines

AuthorUnknown
Posts: 1564
Joined: May 2006

I had Gleason 4+3 last year and had laparascopic removal in Florida, painless. Recommend you find an expereince (200 or more procedures) robotic surgeon. I am 64 only lingering problem is ED

william1
Posts: 35
Joined: Nov 2005

postlrp
Where in Florida did you have your surgery?
I'm probably going to have to make a committment soon and Florida would be as close to home as Atlanta. Who was your doctor and how do I get in touch with him? Post here or send me an e-mail. L/p sure sounds better than retro-pubic.
Thanks and good luck,
William1

Photon
Posts: 57
Joined: Jul 2005

Deb - Hi from the UK. I had a Gleason 8 in all 10 cores of the prostrate but only a psa of 6.4 and extension out of the prostrate. 18 months ago I had an RP following advice from many medical sources. My sister headed up the oncology planning for our national health service and had her people read all the research from Europe and the USA. Research now shows if the person is fit and can take the RP it is the best option for survival. There are the side effects that Jim from Des Moines desribes but in some cases there are no side effects much of it is down to the surgeon and the severity of the RP.

All the best to you and your husband.
David

2ndBase's picture
2ndBase
Posts: 220
Joined: Mar 2004

My case is very similar as my psa was 24 and Gleason of 9 and I was 52 when dx. My urologist took case to tumor board and he said the best option was to take a shot of Lupron and then start the 40 radiation treatments after that. That is what I did and now about 3 years later my psa is .54 which is up from .14 which was as low as it got. If it stays below 1.0 my urologist is optimistic and I will have my next test later this month. I took a leave of absense for two months due to fatigue and pain and was told I had been replaced when I asked to return to work. So for the last 2.5 years my wife and I have had no insurance and have lived off of retirement money. Today I filed for bankruptcy and we are trying to live off of a 276 dollar unemployment check which will run out in 8 weeks. But considering I was given a 50% chance of living 2 years and a 2% chance to live 10 years I really do not care about being poor. Life is good and I have lots of friends. Choosing one method of treatment over another is something only you can decide and if you would like to talk about it let me know. I wish you the best and will pray that you do well.

dakotarunner's picture
dakotarunner
Posts: 96
Joined: Feb 2004

Best to you and your husband,
I had higher than normal PSA for 4 years, biopsy always was negative. I jumped from PSA of 14 to 19.5 in 5 months, finally a 30 section biopsy showed cancer. My original DR. was worried it had spread to my bones, so gave me a hormone shot and said check back in 6 months. Went to Mayo as second consultation. it took them 2 days to nail things down. Had RP surgery (it was not bad at all, up and walking with very little pain in 20 hrs.) They also said they would remove prostate regardless. Yes, I have ED, but I am alive, when first call was 3 years tops. Yes, I am bothered by the ED, but what good would it have done for me to acheive an errection, but only for three years till I tipped over. I still have my wife of 33 years, my children, and the future. I still run 1/2 marathons, hike, etc. Modern medicine can take care of the ED. i am alive!!!! I preach to all my friends about getting PSA tested. Stand strong with your husband. It is not an easy time for him mentally. Just remember, both of you, there are a lot of us, both husbands and wives, who have gone through this. Lean on us, we are there for you.
DR

JoeDeb
Posts: 1
Joined: Nov 2005

Deb:

My husband, 48, was just diagnosed with PC less than 2 months ago after a bout with what we thought was a UTI, but the doctor believes it might have been prostatitis. He just yesterday had a prostatectomy, lymphectomy and repair of a hernia that was necessary to get to the right side lymph node. He began with a 7.2 PSA that climbed to a 9.4 in two weeks. The biopsy revealed a Gleason score of 10 and cancer was present in 5 of the 6 sites specimens were taken from. Bone scan revealed good results, which we were concerned about due to the discomfort he had been feeling for a few months. (He thought he was just getting old and had just been finishing up putting in a 10,000 gallon pond in out backyard!) Luckily we have a doctor that agreed with us that no mattter the condition of the nodes, he would and did remove the prostate. The nodes looked good, pathology will tell. The prostate did not show signs of cancer outside of the capsule, but again path will tell. They were able to save one side of the nerves removing the side where the cancer was found in biopsy. Dependant upon the path results and that first PSA, we will have to see if radiation may be a possibility. My husband has no brother, a father without this condition, and no uncles on either side with prostate cancer. We call this our newest adventure, because life is something that comes along when you are planning something else. Am going down in the next few months and reserving that cruise to Hawaii that we put off due to the pond and our son's wedding this last July. This is OUR time and am not going to miss a minute of it....no anymore and for whatever lays ahead!!

Our best to you and would like to let you know that we understand and support you!

Jodie & Deb, Washington State

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