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2 weeks before my prostotecomy

airwood58
Posts: 5
Joined: May 2012

I was just diagnosed about 3 weeks ago after having a biopsy. My PSA was 9.8. 4 years ago I had a biopsy and I waqs told there were suspicous cells. I never followed up because after doing some research on prostate cancer, I read that it grows very slowly. I had another biopsy and i was told that I had prostate cancer. My Gleason score was a 3+3(6) and I had a 12 core with a T2C rating. I was told that my prostate was oblong instead of round and was hard as a rock. The center has 80% cancer, the upper lobe has 20%, the right lobe has 10% the upper left has 10% and the left lobe has 5%. I have a family history of prostate cancer. My grandfather died of colon rectal cancer that was caused by prostate cancer. My dad and my uncle also had prostate cancer and now I have it. I am going to be 59 and I am scared to death. I was told that a Radical Prostotectomy would be my best bet to get rid of the cancer. I also have an autoimmuine disease that affects my lungs. The meds to stop it Immuran causes lymphoma and skin cancer but I can't stop it or it will get worse. My other fear is that the cancer has spread and when they do the surgery, how do I know they got it all and it won't come back again. PLEASE HELP ME ANSWER THESE QUESTIONS.
Airwood58

Samsungtech1
Posts: 350
Joined: Jan 2011

The decisions you make, once you get the results back, will determine what is going to happen. There are many individuals on this site with so much information it is amazing. You need to read through the posts here and see what advice is given. Most of it is what you need to focus on is here.
Unfortunately, i can not speak for others, but what your condition is, what treatment you have, your diet and exercise all play a part in survival.

Focus on the present, and read what these extremely gifted individuals are sharing with all of us. Survival is often a matteroflearning what the pros tell you. Take a deep breath, and relax. The calmer youare thebetter your body will respond. Not everyoneon here has severe issues but a lot of us do. They can help you make an informed decision.
Read everything you canon this site, and follow their references. Diet is the key along with exercise. Read!!

laserlight's picture
laserlight
Posts: 165
Joined: May 2012

Greetings and welcome to the group. At this point in time you are going thru a lot of confusion. Stop and take time to research all of the treatment options, but donot let this go. I was dignosed with stage t2c and was informed that I had very agressive cancer in Jan of 2011. After talking to my urologist I opted for the surgery. I was informed that this cancer in a young male tends to be more agressive. I was 61 when diagnosed. it also tends to spread more quickly. My dad has prostate cancer but he is in his late 80's. The main focus here is to get treated, donot let this go it will cause problems. Surgery is one way of treating this cancer, but there are other treatments. Now keep in mind that there will be side effects and these vary from person to person. This is going to be one of the most important decisions of your life so far. Over the last year I modified my diet to about a 90 percent vegetarian. I eat some fish and chicken, I have cut out refined sugar, transfats,junkfoods. It has been hard but I feel better. My red meat intake has been cut to almost nothing. The cancer diet is a heart healthy diet. You have started down a new road in your life, the main point is now to take care of yourself and keep up on this. This is bad cancer and if left untreated will cause many problems. In an older male this cancer tends to remain in the prostate and not spread as quickly. Talk to your doctor and ask questions. I have a very good urologist and he took time to explain all of the current treatments and the side effects. This past year has been hard but it also has been a wake up call. At your age there is a chance that this cancer can be treated and contained. But keep in mind that you have cancer and it needs to be taken care of. There are many good books on cancer diets on the internet, do reasearch. These diets are for the most part not bad. I have come to like these diets and donot miss the normal diet that I was used to. The western diet is not a heart healthy cancer diet. Above all start doing as much reasearch as possible on this cancer. Sorry for going on about this, you have already started down the road. My gleason score was the bad 7 my biopsy had cancer is all 18 samples taken, there were between 40 to 60 percent cancer, it was spread thru my prostate. There were no symptoms on my part, the DRE and biopsy picked this up along with the PSA test.

VascodaGama's picture
VascodaGama
Posts: 1526
Joined: Nov 2010

Airwood

Welcome to the board. Many here will be eager to help you with their layman’s opinions and real experiences, acquired along their journeys. Prostate cancer treatment, however, is not a definite science with straight answers to each case. There is lot of guessing by the part of the doctors because they do not know.
The tendency is therefore to recommend something that has given higher rates of success in previous successful experiences.

In saying that, no one can give you an acceptable assurance that after a treatment you are cured and that cancer never comes back again. Once diagnosed with PCa one must constantly monitor symptoms and be active with a series of tests, periodically and coordinately.
You got already some good advice from the above survivors. My recommendation is that you do researches and read books and prepare a list on your doubts and subject them to your team of doctors.

Surgery has high rates of survival in the treatment of guys in your situation, with voluminous cancer (high PSA) and low grade Gleason pattern (3) and score (6), and the comment of “The centre has 80% of the cancer”.
A bad “aspect” in your diagnosis is the positive DRE (digital rectum examination). Your doctor’s comment on an “…oblong prostate instead of round and was hard as a rock…” indicates high involvement of cancer, but it lacks evidence (no bumps) of extra capsular extensions.
Low grade voluminous cancer is in most of the cases related to micrometastases.
This was my diagnosis in 2000 after a failed surgery. Before RP I had a PSA of 22.4, Gs 5 (6 by the new standards) and negative DRE and negative image studies. But after surgery I was diagnosed with positive margins.

I wonder if you have done any image study like a MRI, CT or Bone Scan. These tests if done with the latest equipments and techniques (contrast agents C11 and F18 and Feraheme) are able of finding metastases of cancer at the places where PCa usually spreads; that is to say, at close lymph nodes and at bone in the iliac. One test very useful to check for extra capsular extensions is a colour Doppler (must be done by an expert in interpreting the image), which finds the activity of blood vessels (BV) surrounding the prostate. The presence of unusual BV, is regarded as blood feeding extra capsular cancer as micrometastases.
Any of the above tests should be done before surgery, if you want to get a closer (more precise) answer to your queries now.

You have not shared the type of surgery you are going to get. Nevertheless, I am a “fan” for open radical prostatectomy when done by experienced surgeons. It is said that they can feel by the tact when touching the surrounded mucosal tissues (micro-metastatic cancer cannot be seen), and proceed with a total cleaning dissecting lymph nodes and vacuuming the area.
Robotic surgeries have been in performance for many years and can also present similar results in contained cases if done by experienced “mechano-surgeons” with loads of executions in their “belts” (as reported by many survivors). The difference seems to be at the possibility in reaching and dissecting far lymph nodes and in some of the more influencial side effects. Robot gives more incidences to incontinence and Open assures proper dissection but will require longer terms of recovery. In any case, some surgeons operating with a robot also dissect lymph nodes stopping the robot arm at middle of surgery and inserting their hands in the tiny surgery holes. You should request for that to get more assurances.

Once the prostate gland is out together with the lymph nodes and seminal vesicles, at the laboratory, the pathologist will slice it into pieces and will examine them through out in the microscopic, using a series of stains to verify the type of cells, malignancy, any margin invasion and extra capsular, etc. Overall the pathologist will report on your real status and attribute you a path stage, which could become different from your present clinical stage of T2c and Gs 6. If extra capsular extensions or invasion of the Seminal Vesicles are found, then your stage would become more advanced to a T3a or b.

T3 guys will require latter a continuous look out. Many just wait until recurrence is declared (PSA=>0.2 or a continuous increase after a nadir) to follow with a salvage treatment, and many prefer to attack the soonest with an adjuvant treatment usually Radiation therapy or a combination of Hormonal with Radiation therapies.

Here is a link to discussions on the Surgical Pathology Report after RRP, which may be of interest to you. Nevertheless, no two cases can be considered equal but similar;
https://www.inspire.com/groups/us-too-prostate-cancer/discussion/surgical-pathology-report-after-rrp/

Here you got additional links to help you in understanding the perils of our disease;
http://www.oncolink.org/types/article.cfm?c=16&s=57&ss=452&id=9597
http://undernoillusions.blogspot.pt/2006/02/prostate-surgery-post-surgery-status.html
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1426879/
A compendium on Prostate cancer and care; http://www.lef.org/protocols/prtcl-138.shtml
Side effects from Radicals; http://www.pcf.org/site/c.leJRIROrEpH/b.5822789/k.9652/Side_Effects.htm

I wish you an eventless surgery and success in a remission.
Be positive. Hope for the best.

VGama

Swingshiftworker
Posts: 623
Joined: Mar 2010

If the PCa is still contained w/in the prostate, surgery may or may not be the best choice to make in treating your cancer. However, if the cancer has already spread beyond the cancer, surgery will NOT solve the problem and may actually make things worse. In this case, IMRT and hormone therapy would probably be the better treatment choice.

As Vasco mentioned, the question is whether you've done any testing -- MRI, CAT and/or bone scans -- to determine if the cancer has already spread or not. For a discussion of the types of tests that need to be done in order to assess the best treatment approach for higher grade cancers, see:

http://www.ustoowichita.org/pdf/Advanced%20Prostate%20Cancer%20at%20Diagnosis.pdf.

If this information gives you pause (or generates more questions as it should), I suggest that you postpone your surgery until you can do the tests necessary to determine if the cancer has spread or not and then make the appropriate treatment decision based on the test results.

But, if you decide to proceed with the surgery w/o further testing, I wish you the best of luck BUT don't be surprised if you will still require follow up radiation and hormone treatment, which is all that might have been required at the outset, if the surgery fails.

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