Jan 15, 2013 - 7:35 pm
My husband (52) and I were recently married in September and now are trying to understand the best treatment options for this most recent diagnosis. The information I found on this chat board has been helpful but a bit overwhelming, too, since it doesn't seem like we have a lot of time to work with. My husband's PSA was 14 as of a few weeks ago and after 12 biopsies, they found all but one section positive for cancer. His gleason score is 3 + 4 = 7 and so the doctors are suggesting surgery by robotic removal within 4 months. The doctor said that if he was his own brother he would not wait longer than this. We are in the Kaiser system, which I recently heard was a very good system, but I of course wish for my husband to have the best of the best. He is having a whole body bone scan this week, then a CT scan next week. I wonder, however, if a pelvic CT is included in this test as someone had suggested the benefit of this sort of exam.
I'm a bit overwhelmed with all the information so please forgive me if some of my questions are random. For instance, the idea of multiple second opinions seems daunting. How can this be done? Does this mean that he will have to be biopsied again and again, or can he just send his results from Kaiser to other doctors. I would like him also to see any experts outside the Kaiser system and hoping there are a few in the Bay Area. Does anyone know any top urologists/surgeons?
As for the suggested prostatectomy, it seems to make sense why the doctors are recommending this to be the best route. They say there is a better chance than radiation concerning the removal of all or most of the cancer since it's such a radical procedure. The Kaiser doctor we spoke with said that open surgery and the DaVinci method are fairly equivalent in the outcomes even in regard to nerve sparing. With the robotic removal, they will remove the seminal vesicles even though, at present, there is no indication of cancer present in the vesicles.
His numbers look like this:
a. right apx, gleason 6...positive, 8 of 45 mm affected
b. right mid, gleason 7, positive 4 of 31 mm affected
c. right base, benign, negative
d. left apex , gleason 7 12 of 38 mm affected, positive (1/3)
e. left middle, gleason 7, 19 of 38 mm affected, positive (1/2)
f. left base, gleason 7, 3 of 48 affected, positive
If anyone has any illuminating advice for me, especially in regard to excellent doctors in the area. I would be very grateful. I am very heartbroken over this diagnosis. We only just got married.