New to the game

okbigguy
okbigguy Member Posts: 8
edited July 2020 in Prostate Cancer #1

I was recently diagnosed after a PSA of 54.  Had CT and bone scan yesterday and results next week.  In a quandry as I do not know what to expect.  Hope i can obtain some info from discussion board after I know more what I'm dealing with.

Comments

  • eonore
    eonore Member Posts: 174 Member
    New Diagnosis

    Could you provide some details about your biopsy?

     

    Eric

  • Clevelandguy
    Clevelandguy Member Posts: 980 Member
    Details needed as you get them

    Hi OK,

    As soon as you get the reaults of your scans and biopsy let us know.  We have all been there going through what you are doing so we can share our experiences and ideas with you.  You will definitely need a biopsy to determine if you have cancer and what your Gleason score is.  Gleason score is x+y where is the majority of the cancer cells graded from 3-5 usually and the y is the least amount of cancer cell type again rated 3-5.  3 is least aggressive cancer and a 5 would be aggressive, so. 3+3 is less aggressive that a 4+4: ect,ect.  Your biopsy will also tell you where in your Prostate the cancer is located plus much more. We are not doctors but cancer survivors sharing our stories & experiences.

    Dave 3+4

  • okbigguy
    okbigguy Member Posts: 8
    edited July 2020 #4

    Details needed as you get them

    Hi OK,

    As soon as you get the reaults of your scans and biopsy let us know.  We have all been there going through what you are doing so we can share our experiences and ideas with you.  You will definitely need a biopsy to determine if you have cancer and what your Gleason score is.  Gleason score is x+y where is the majority of the cancer cells graded from 3-5 usually and the y is the least amount of cancer cell type again rated 3-5.  3 is least aggressive cancer and a 5 would be aggressive, so. 3+3 is less aggressive that a 4+4: ect,ect.  Your biopsy will also tell you where in your Prostate the cancer is located plus much more. We are not doctors but cancer survivors sharing our stories & experiences.

    Dave 3+4

    Biopsy

    Appointment wednesday and will get biopsy and scan data then.  Pretty ansy until then.

  • Georges Calvez
    Georges Calvez Member Posts: 547 Member
    edited July 2020 #5
    PSA level
    Hi there,

    It is not possible to generalise on how severe a case of prostate cancer may be on the basis of the PSA level.
    Different cancers produce widely varying levels of PSA. Higher levels of PSA do correlate with more serious cancers but it is not an absolute relationship.
    If you go to the web site below and chose a PSA level of 50 -59.9 and all stories in the search box you will find that sixteen stories come up.
    These range from a Gleason Grade of 6, the least severe, to 9, which is very serious.
    They also range from T1c which is very localised organ confined cancer to T4 which is metastatic.
    The stories will also give you an idea of the treatment options and the possible outcomes.
    https://www.yananow.org/query_stories.php

    Best of luck for Wednesday,

    Georges
  • Georges Calvez
    Georges Calvez Member Posts: 547 Member
    edited July 2020 #6
    Distribution of prostate cancer grades with respect to PSA level
    Hi there,

    You may find the following paper interesting as it deals with the severity of prostate cancer with increasing PSA.
    I count myself extremely lucky as I was diagnosed with a PSA level of 136 but I had an extremely localised tumour.
    After surgery and radiation I am skipping around with a PSA of less than the limit of detection, I might outlive the wife and cat!
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3285713/pdf/kju-53-82.pdf

    Best wishes,

    Georges
  • okbigguy
    okbigguy Member Posts: 8
    edited July 2020 #7

    Distribution of prostate cancer grades with respect to PSA level
    Hi there,

    You may find the following paper interesting as it deals with the severity of prostate cancer with increasing PSA.
    I count myself extremely lucky as I was diagnosed with a PSA level of 136 but I had an extremely localised tumour.
    After surgery and radiation I am skipping around with a PSA of less than the limit of detection, I might outlive the wife and cat!
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3285713/pdf/kju-53-82.pdf

    Best wishes,

    Georges

    Thanks for the info. I am

    Thanks for the info. I am glad I found this site and the feedback I have received.  Still looking forward to Wednesday!!

  • okbigguy
    okbigguy Member Posts: 8
    edited July 2020 #8
    okbigguy said:

    Thanks for the info. I am

    Thanks for the info. I am glad I found this site and the feedback I have received.  Still looking forward to Wednesday!!

    Biopsy Report

    I am 77 years old but emotionally think I am 40 ( body does not agree) and in good health - major problem is obese as do not exercise.  After PSA =54 had biopsy, ct and bone scan.  I am going next week for MRI as back scan was not clear.  Will see Dr on Friday for options. I have no major aches or pains just significant bathroom trips.

     

    Biopsy report had 2 group =3 and 8 group = 4.  2 said suspicious of malignancy.  Tissue involved ranged from 20-95%.

     

    Has anyone had similar experience and what was treatment?  Little old to be cut on and go through problems associated with that.  I know there must be several other options.  Do people generally get 2nd opinion and if so where?  We have CTCA in town or even Houston?

     

    Thanks for your feedback.

  • VascodaGama
    VascodaGama Member Posts: 3,638 Member
    Biopsy Report

    Bigguy,

    From your above short description on the biopsy, I take that you have been diagnosed with prostate cancer, Gleason score 8. Out of the twelve needles, two are Gleason 7 (4+3) and 8 are Gleason 8 (4+4). This represent a voluminous case made up of poorly differentiated cells with high risk for metastases (spread of disease). The MRI may find if you got cancer out of the prostate and at the lymph nodes but you should also request a Bone scan to check bone lesions. Most probably at your age, the doctor will recommend the palliative hormonal treatment. Surgery is usually indicated for contained cases but in your voluminous case radiation treatment could be more appropriate if you aim into cure. It all depends in your other health issues.

    Second opinions are always good. Try getting it away from the circle of doctors doing the diagnosis. Please remember that all treatments for prostate cancer have risks and side effects that will deteriorate your qualitry of life. You should get treated but chose wisely. Do your researches on the side effects of each treatment before deciding.

    Best wishes and luck in this journey.

    VGama

  • Georges Calvez
    Georges Calvez Member Posts: 547 Member
    edited July 2020 #10
    MRI scan

    Hi there,

    You have to wait for the result of the MRI scan to see if there is any local invasion out of the prostate and into the surrounding tissues.
    It is looking good that the cancer seems to be confined but you will need treatment.
    Treatment can range from hormones which is the least invasive through radiation usually with hormones as well to surgery plus radiation and hormones.
    The link I sent you from YANANOW has  a good selection of men's experiences with the various treatment options.
    The relative merits of the various treatments are hotly contested! :-)

    Best wishes,

    Georges

  • Clevelandguy
    Clevelandguy Member Posts: 980 Member
    edited July 2020 #11
    Good advice above

    Hi,

    Good advice from above, if you don't want surgery about the only thing is do nothing or some sort of radiation/hormone therapy.  Cyberknife and Proton radiation are two of the better forms of External beam in my opinion.  Like Vasco said all types of treatment have side effects so now is the time to do your research. Let us know the results of your latest MRI so we can all share our experiences with you.

    Dave 3+4

  • Max Former Hodgkins Stage 3
    Max Former Hodgkins Stage 3 Member Posts: 3,803 Member
    edited July 2020 #12

    Good advice above

    Hi,

    Good advice from above, if you don't want surgery about the only thing is do nothing or some sort of radiation/hormone therapy.  Cyberknife and Proton radiation are two of the better forms of External beam in my opinion.  Like Vasco said all types of treatment have side effects so now is the time to do your research. Let us know the results of your latest MRI so we can all share our experiences with you.

    Dave 3+4

    Big guy,

    Your results suggest significant and aggressive disease.  Surgery is undertaken hesitantly by most surgeons for men 70 or older.  Also, biopsy results like yours suggest likely involvement outside the gland, in which case radiation therapy (RT) is the recommended form of attack by most experts.   IGRT or IMRT are the most common forms of radiation used first-line (initially) in such cases..  SBRT ('Cyberknife') is not usually regarded as a choice for metastatic involvement, although some radiation oncoloigists have reportedly been experieminting with such for a few years now.

    As Cleveland noted above, HT (hormonal therapy) may be started either before or after radiation as a neoadjuvant or adjuvant factor.   

    A full analysis of your case is not yet fully clear to the doctors, but do know that MRIs are of poor value in detecting metastatic PC, due to the tiny size of the tumors involved in minimially metastatic disease.  Similiarly, CT and PET scans are of little value in detecting such spread, except in advanced cases.

    Certainly you have cause for hope, and clinically your case may be curative -- meaning all disease may pottentially be eradicated.  Hoping for the best for you,

     

    max

  • okbigguy
    okbigguy Member Posts: 8
    edited July 2020 #13
    Dr. Visit

    Stage = T1NXMX, Group = 4.  No indication of external spread.  Recommended hormone injection + radiation (8 weeks - 5x/week).  Next PSA in 3 months.

    Happy with report.  GOD is good.

  • lighterwood67
    lighterwood67 Member Posts: 374 Member
    edited July 2020 #14
    Sounds like

    Sounds like a plan.  Good luck on your journey.

  • Max Former Hodgkins Stage 3
    Max Former Hodgkins Stage 3 Member Posts: 3,803 Member
    edited July 2020 #15

    Sounds like

    Sounds like a plan.  Good luck on your journey.

    Yes

    bigguy,

    The staging is indeed wonderful news from the doc.   The eight-weeks of RT will be IMRT or IGRT, which is the BEST Practices response to your particulars.

     

    max

  • Max Former Hodgkins Stage 3
    Max Former Hodgkins Stage 3 Member Posts: 3,803 Member

    Yes

    bigguy,

    The staging is indeed wonderful news from the doc.   The eight-weeks of RT will be IMRT or IGRT, which is the BEST Practices response to your particulars.

     

    max

    Addendum

    Big guy,

    It has likely been mentioned above, but I wanted to add that HT against prostate cancer (PCa) is a long term palliative modality:   It will reduce the cancer, often significantly, and frequently for many years.  As a neoadjuvant, it is usually a debulker, slowing and shrinking any tumors.  As a salvage therapy, it is pallative.  

    Two things currently in medical science are potentially curative of PCa: radiation (many different forms), and surgery.  It is your radiation that will hopefully and perhaps even likely kill off the disease forever.

    max

  • PayneOrtho61
    PayneOrtho61 Member Posts: 15 Member
    edited July 2020 #17
    New CA Diagnosis

    I am reaching out to get some support and information after getting my prostate cancer diagnosis.  I am a 59 year old that recently was diagnosed with an aggressive form of prostate cancer.  Because my father died of prostate cancer at age 79, I have monitoring my PSA for quite some time.  Last year my PSA levels started to rise and earlier this year I had an MRI fused biopsy which detected cancer in four out of ten samples (Gleason 3+4).  I also had a Decipher genomic test of the biopsy samples that rated the cancer as aggressive, so my next decision is what type of definitive treatment.  My urologist has recommended either radical prostectomy or external beam radiation within the next 6 months.  I am leaning towards the surgical removal via robotic surgery, but I am very fearful of urinary inncontenence.  I am not sure that I would handle inontenence well and would consider suicide if I had long term incontenence.  I am very  active and spend a lot of time outdoors as a skier, backpacker, and tennis player.  I am a healthcare professional myself, and I have two busy offices and am a solo practicioner.  I cannot afford to be out of my office more than about 2 weeks as my staff have already been out of work for 2 months due to the COVID shut down.  My stress level is incredibly high, as I have had to keep my practice running through the COVID crisis and now I have to plan to be out for another 2-3 weeks!  My wife is also a healthcare professional and is in denial about my diagnosis and does not want me to consider surgery or radiation, she wants me to wait and monitor through active surveilence.  I would love to get some outside perspective on my difficult situation.

  • okbigguy
    okbigguy Member Posts: 8

    Addendum

    Big guy,

    It has likely been mentioned above, but I wanted to add that HT against prostate cancer (PCa) is a long term palliative modality:   It will reduce the cancer, often significantly, and frequently for many years.  As a neoadjuvant, it is usually a debulker, slowing and shrinking any tumors.  As a salvage therapy, it is pallative.  

    Two things currently in medical science are potentially curative of PCa: radiation (many different forms), and surgery.  It is your radiation that will hopefully and perhaps even likely kill off the disease forever.

    max

    Treatment

    Thanks for your feedback.  HT starts in 10 days and IGMT in  months for 2 months.  Hopefully completed by Decenber 1.  Spirits a little better as a game plan has been established.  Drs. keep saying I will pass eventually but not of PCa.

  • okbigguy
    okbigguy Member Posts: 8
    Firmagon - lupron Side effects

    Dr is going to give firmagon injection next week and switch to lupron after that.  Has anyone had these and experienced any side effects.  Would ne interested in hearing anyone's experience with these drugs.  Thanks.

  • Clevelandguy
    Clevelandguy Member Posts: 980 Member
    Cancer is cancer

    Hi Jj,

    As I stated above if you don't want surgery about the only thing is do nothing (active surveillance)or some sort of radiation/hormone therapy.  Cyberknife and Proton radiation are two of the better forms of External beam in my opinion.  Like Vasco said all types of treatment have side effects so now is the time to do your research.  Gleason 3+3 is not as agressive as a 3+4 or a 4+3 but its still is cancer.  If it was me I would want to know where the cancer is located within the Prostate.  Deep inside the gland or close to the edge which could give you an indication on how much time you have to decide your treatment . At 3+3 you have time to determine whether you want to monitor it for a while(active survielance) or take other actions such as radiation treaments once you know how close the cancer to escaping the Prostate. It never seems to turn out well once the cancer escapes the Prostate into the surrounding tissue and organs. Scans like an MRI or PET scan could help in locating the cancer. Now is the time to do your homework to enable you to make a non emotional educated decision.  Good luck and let us know if we can help, lots of good cancer survivors on this board.

    Dave 3+4

  • Jjb-54
    Jjb-54 Member Posts: 10 Member
    edited July 2020 #21
    New To PC

    I am 65 years odd.

    PSA - 10.5

    Had a Prostate Biopsy - 2 Error, I hit the wrong key - 5 Leason of 3+3=6 Both were " Prostatic Adenocarcinoma Gleason Score 3+3= 6 out of 10

    I'm gettin "mixed messages" .. it's not serious to "you are on the precipice" of concern.

    They threw out Surgery - NOT a big fan of that just yet, 2/b honest. As I told the doctor I've just had too many surigeries on my body, so unless it's a HAS TO BE DONE NOW ... I'm not ready."

    The "Seed Implants" are out of the question, in that I am apparently allergic to the Pre and Post Op meds that are "required".

    I just went in today ( Tues ) for a CT PRE VOLUME STUDY.

    I know that my body has never been "Text Book", as I say I'm in the TEXT BOOKS and my body does not play by the rules and if something strange can happen, it usually will.

    So how serious is GLEASON 6? 

    Can I do Active Monitoring?

    How fast, if at all does GLEASON 6 grow to > than 7??

     

    Thanks! This is a whole new world and I'm trying to do my best to know what is going on and what I need to take seriously and what my options are?

     

    ... Jj ...