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newly diagnosed

orcaman
Posts: 6
Joined: Apr 2011

I just learned last week I have prostate cancer. psa of 2.55 and gleason score of 3 + 3. Doctor recommending brachytherapy. Frankly I'm scared. Can any one tell me what these numbers really mean in english and doctorese? Thanks.

mattmans5
Posts: 70
Joined: Jan 2011

Welcome ,

Im glad you found this site.

I was diagnosed in August and had numbers a little then you gleason , 12.3 and
with a 3+4 gleason score , as of today I am doing well , and this site has been a blessing , You will get many replies , from brothers who will be able to explain , your numbers ,

Take a deep breath relax , please use the information , you will get here to help you ,

also it is a good idea to get , DR Patrick Walsh

GUIDE TO SURVIVING PROSTATE CANCER it was mentioned to me and is a good book to have in the house ,

good luck and keep posting your concerns and questions

joe

orcaman
Posts: 6
Joined: Apr 2011

Thanks joe for the quick reply...kinda hard to relax, but I'll try.
Carl

VascodaGama's picture
VascodaGama
Posts: 3406
Joined: Nov 2010

Hi Carl

Your PSA and Gleason score indicate you are in the group of Low Risk patients. This means that any treatment you choose could handle your case. Prostate cancer is a slow type that takes time in its progress and that gives you time to educate yourself in all matters before making any decision on what to do. I was diagnosed with PCa eleven years ago on my 50th year old and I managed to confront it. You too will do well.
I would recommend you to investigate in the net and read books on PCa. Just google the word “Prostate Cancer” and you will find articles to read. A good one is here;
http://www.webmd.com/prostate-cancer/guide/prostate-cancer-treatment-care

Treatments for prostate cancer have side effects and you should be familiar with them because they can harm you permanently. Your status however, indicates you as a proponent for active surveillance (AS) or watchful-waiting which is a way of controlling the cancer without enduring the side effects. In fact, nowadays doctors are recommended to advice patients of low risk to “manage” their cancer under AS. This is a status were your progress is monitored with periodical tests of PSA, DRE, biopsy and occasional MRI. If found to be aggressive then you are promoted to a radical treatment.
Here is the post indicating a site on AS but you should investigate about the procedure in detail by typing its name.
http://csn.cancer.org/node/216326

I wonder how your case has developed. Most probably the rises in PSA lead you to a biopsy which found cancer. Can you give more info from your pathologist report? Such as; how many cores and how many were positive, and if there were extra capsular extension or other detail. Also was there other previous PSA tests and how high were them.
Many recommend having second opinions on the biopsy because the truthfulness of its results is crucial in defining status of a case. If you are suspicious of the laboratory that did the analysis then you may request a second opinion on the slices/cores from reliable places such as Johns Hopkins or Bostwick laboratories.
Second opinions on the diagnosis and treatment are always recommended because doctors have the tendency in suggesting treatments of their speciality. Surgeons will advise surgery, radiologists will advise radiotherapy, etc. A medical oncologist specialized in PCa is usually the one that gives the best biasness opinion on your case.

A good introductory book on prostate cancer diagnosis and treatment is the “Primer on Prostate Cancer” by Stephen Strum and Donna Pogliano. You can get it on Amazon.

Welcome to the board.
Wishing you find the best way to handle your case.

VGama

ob66
Posts: 227
Joined: Apr 2010

Welcome aboard. You will find great resources here. The early posters will issue welcome, the info is at your fingertips. First off, to you,your fear is very real. I remember it and will never forget it-------May 6, 2009, the day of diagnosis. The day my whole life changed. My numbers were higher than yours (not to brag, but to reassure). I have been through great treatment and feel 100% right now. So relax a bit. Do your homework. Find out what is best for you. First do read Patrick Walsh. But,he is but a single very good source. Develop a plan of a action. What is best for you? Cyberknife, surgery, seeds, IMRT, IGRT, even watchful waiting. Take some time (and believe me, this is easy for me to say now, but difficult when I was in your shoes) and learn as much as you can. You need to learn the best choices for you. Some will settle on watch/wait, some will opt for surgery to extract the evil cancer, and some will choose the RT route. There is no one best way to go, so explore it all. Explore it in lieu of your numbers, your situation. Then ask questions. Believe me, the resources here are not just great, but they are interested. Interested in their own situations, but also in PCA and all it's ramifications. Throw it to the wind, and you will believe. Welcome and cheers!!

lewvino's picture
lewvino
Posts: 1010
Joined: May 2009

Hi and glad you found our forum. I'm sorry to hear about your cancer and yes it is normal to be scared when the doctor gives you the 'C' (Cancer) Word. Now the good news is as others have said they have found your cancer very, very early. My Dad also had a gleason 6 and is still doing fine about 14 years later. I had a gleason 7 and am doing fine at 20 months post surgery treatment. All of the different treatment options have the same goal of getting rid of the cancer. You didn't mention how old you are. Some treatments appeal to different men at different ages and side effects of treatment should be considered.
The psa of 2.55 is low. I didn't get a biopspy until my psa was above 4. There are only two things I know of that make psa....The Prostate and Prostate cancer cells. I'm assuming your psa was rising over a period of time which is why the doctor wanted to test you I'm assuming via the biopsy. The biopsy samples are sent to a lab and looked at under a microscope. They compare what they find to what a normal cell looks like. 1 being normal and 5 being that the cell does not look like a cell. They look for the most predominate cells in your case 3 and then the secondary cell patern also 3 in your case so you have a 3+3 (6). Mine was a 4 + 3 (7) which means the majority of the cells were not looking very pretty but some of my cells looked like yours did so the 3.
A really good book to buy and read is by Dr. Patrick Walsh and called "Guide to surviving Prostate cancer" he explains it in great detail and discusses different treatment options.

Good luck and hope this helps you some with your fears. I believe you will be around for many more years following treatment.

Lewvino (larry) Age 56

Kentr
Posts: 111
Joined: May 2009

You've found a very good site to learn about prostate cancer. There are people on here that will stun you with their knowledge.

For my two cents, I think your psa and gleason score are pretty low and more information would be helpful. For instance, how many samples did they take and how many indicated cancer? What is the "history" of your psa, has it been rising steadily for a protracted period of time?

Absent any evidence that this thing is growing by leaps and bounds, the recommendation to have brachytherapy (or any treatment for that matter) seems somewhat premature.

In my case, I had brachytherapy in January 2008 (gleason was 3+3, 3+3 and 3+4 out of ten samples and psa was 3.4 one week prior to treatment). All is well at this juncture even though I did experience various side effects that went on for quite awhile before things settled down.

I'm not, by any means, saying you should follow my lead, it's an individual decision that you should make after educating yourself.

Best of luck to you!

Kent

orcaman
Posts: 6
Joined: Apr 2011

I am truly shocked by all the responses. I wish I could answer some of your questions and I think my urologist probably gave me those answers,but I am not sure I heard much of what he said after he said cancer. I have an appointment with oncologist tomorrow and will make sure I get the answers on how many cancer cells were found. I do know that there were 12 samples taken in the biopsy. As for my psa history, over the last few years it was 1.9, 2.0, 3.3, 2.55 respectfully.

I am glad I found you guys.

Carl (age 64)

lewvino's picture
lewvino
Posts: 1010
Joined: May 2009

The 12 samples is the standard that is used. When you meet tomorrow ask for a copy of your test results. Each of the 12 samples will be graded as to the amount of cancer found in the sample and the Gleason score they give each sample. Should be something as an example of 15% involvment in core 1 with Gleason 3+3. Also it will note if there is any perinural invasion present. Also it will indicate where in the Prostate the sample was from. Upper, lower, right, left etc. That is all good information to know. The doctor should discuss with you all of the different treatment options. Just remember that this is the one cancer where YOU GET TO PICK THE TREATMENT! A surgeon will say surgery is best, a doctor that does brachytherapy will say that is best, etc.

Your choices are:
1. Active Survellance - That is to do nothing and watch and see what happens. Will your psa rise? Be tested in another 6 months to a year, etc.
2. Brachtherapy - This is where they will put 'radioactive seeds' in the prostate to kill the cancer.
3. Surgery - Prostate removed
4. Davinci Robot Surgery - Prostate removed via a robotic controlled device called the Davinci.
5. Radiation - Many forms of radiation including Proton, Cyperknife and traditional radiatioin. Several men on the forum have had Cyperknife for the Gleason 6 and are doing very well. Proton is only offered at certain places around the USA. My dad had Proton at the original Proton center at Loma Linda California.
6. Hormone Drug Therapy - used for the more advanced cases or as a followup if the cancer returns after the primary treatment.
7. Hifu - This is not approved by the FDA and I believe has to be done offshore such as Mexico or the Bahama's - Many insurance companies will not pay for this treatment since it is not approved by the FDA.
8. Cyrotherapy (might have spelt that one wrong) but they freeze the prostate to kill the cancer.
9. Prosticision - This is offered in the Atlanta area by a Dr. Critz and is a combination of seeds implanted and radiation.

So you see many, many choices. Read about each one and the side effects. They can range from mild to severe.

Keep us posted. All the men and there are some wifes, girlfriends or children of patients on the forum. Everyone loves to help.

Larry

shipjim's picture
shipjim
Posts: 137
Joined: Apr 2006

Welcome the club none of want to belong.
take a bit of time research, your gleason was the same as mine, I don't remember the PSA but as with othes it was the trend and family history Had 12 core biopsy that was much more painful than the DaVinci!
You'll have to change your life some, start practicing kegels,(ask your wife about them) this isn't necessarily a death sentence, most men get through it fine, the horror stories are the minority albiet they do happen. Don't be embarrased, you didn't do anything wrong to get it.
I still wear a pantyliner (no panties thcugh) and you'll adjust how you lift, stand or swing a golf club by keggleing first.
Stay on the site and report your progress, we all care. jj

Kentr
Posts: 111
Joined: May 2009

Don't be shocked by the responses - there are more guys on here are ready to pounce (as in help out)as soon as they get more info. :)

It's completely understandable that you didn't "hear" much of what your doctor said after the word "cancer" - it happens to many people so it's a good idea to have someone with you when you see the doctor to ensure all the information communicated is gathered accurately.

For what it's worth, here's the history of my psa readings:

06/13/05 2.5
10/20/06 3.8
08/10/07 4.8
11/09/07 3.5
01/04/08 3.4 I had brachytherapy on January 10, 2008 (a week after this reading)
04/10/08 1.1
07/09/08 0.4
10/07/08 0.2
01/08/09 0.4
07/02/09 0.5
08/31/09 0.7
12/07/09 0.8
07/14/10 1.0
11/17/10 1.3
03/17/11 0.3

According to my doctor, my urologist and the oncologist, my psa reading of 4.8 on 8/10/2007 was not "that" high for my age (66 at the time) but the "trend line" was somewhat disturbing and that's why they wanted to do the biopsy. When the psa dropped to 3.5 on 11/9/2007 (this was after the biopsy), I asked the oncologist if that might support the cancer was likely "slow growing." He said there was definitely a good chance that was the case but that he still felt treatment was in order and that I shouldn't wait until it reaches the point where they can't do much, if anything.

Did I do the right thing by getting treatment? I'll never know for sure. Perhaps I could have gone on for years and years without a problem, perhaps not. In any event, what's done is done, I'm still here and will turn 70 in November (provided I don't get hit by a truck or something) :)

So, hang in there and keep educating yourself - we're all here for you!

Kent

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