Apr 20, 2013 - 3:10 pm
I was suffering from some urinary symptoms so I vistied the urologist 1st time in Fall 2011. PSA 4.7. DRE normal. Cystoscopy revealed nothing. Stayed on Rapaflo for a while but with little benefit and feeling good, I stopped that and felt good for a year or so. In the Fall/Winter of 2012/2013 the urinary and sexual symptoms got worse so I had a checkup. Minor pain in lower abdomen when sitting. PSA now at 4.2, all bloodtests good. Dr prescribed CT scan. Everything normal except for "prominent seminal vessicles". Dr performed biopsy to rule out anything to worry about. Just this past week I learned that 11 of 12 samples were positive and he mentioned gleasons of 8 to 9. Obvioulsy, it's spread to the seminal vessicles. He immediately put me on bicalutamide in preparation for a hormone therapy injection Monday. He mentioned that he wanted to reduce the prostate before a radical prostatectomy after waiting a month or so after the first injection. I should add that I just turned 50 this January. My and my wife's heads are spinning. He suggested a bone scan but felt that my insurance co won't cover at this time. It seems to me that he is prescribing the most aggressive course of treatment I can seem to find - which is fine with me. As I understand it, the initial bicalutamide is supposed to prevent a "flash" after receiving the hormone therapy injection. The hormone therapy is supposed to reduce the prostate and make it more easliy "resectable" and will aid any required radiation treatments. The prostatectomy will eliminate the affeted organ/tissue. He can biposy the lymph nodes and other tissue while inside. The raditaion and hormone treatments would round out the treatment if/as required. I'm OK with the removal procedure. Sexual function is already gone and minor incontinence is a small price to pay for a cancer free liestyle. Everyone says get a second opinion. I'm at a total loss. I trust the guy, and he spent nearly an hour reviewing my results - not that I understood a word he was saying after I got the results. After researching non stop for two days, I have so many questions for him when we go back Monday we may never get out of his office. I'm lookiing into Sloan Kettering in NY and Hackensack Medical Center in NJ next week. I need to check with my ins co regarding a second opinion as well. I feel funny about confronting my Dr about a second opiinion when I agree with his prescribed treatment - I think anyway. From what I can understand, removal of any affected tissue would still yield the best overall result, even if radiation and hormone therapy is required, barring the ill effects of the procedure. I've looked into support groups in the area, but they all meet at obscure times and only about once a month - that's why I turned here first. Any thoughts ort comments are welcome.