Father in law finished surgery but cancer was not contained...

rockys

My father in law just had his prostate removed. Prior to the surgery, he had a gleason score of 6 and a PSA of 6.2. The surgery was nerve sparing.

After the surgery, the Gleason Score was raised to 8 and the tumor grade was 3. The margins were not clean.

His bone scan and cat scan showed that the cancer had not spread. The lymph nodes also came up clean.

His doctor is recommending radation, giving his a success rate of 90%. Does that sound right? My mother in law is reading that with a gleason score and tumor grade so high, that localized radation may not do enough or anything. She is thinking maybe to wait until the PSA number rises again.

We are also getting conflicting thought on hormone treatments. To do them and when to do them?

Any thoughts? This is all so scary.

Raquel

jls05

I had surgery 6 years ago. My PSA was 15. I went along 5 years thinking everything was OK. My PSA never went to 0 however. Finally one year ago my PSA rose to 1 and I went through radiation. My PSA has gone to 0 for the first time. My recommendation is to go through all the treatments ASAP. Prolonging and waiting are much to depressing and nerver shattering. I had harmone treatment prior to surgery and for 3 months post surgery. I would opt for all at once and ease your mind.

nutt

The following is just opinion since you have not indicated age, overall health and etc... factors to also consider.

Firstly, the overall objective is to rid the body of cancer.

Secondly, the procedure is the next important consideration as each will have their own potential quality of life affects.

If, there were any doubt that the original procedure did not get all of the cancer I would consider two things:
1. a second opinion

2. additional radiation / Chemo if deemed necessary

You need to be careful on which doctor you ask these questions of. Fortunately, my doctor was all for surgery but referred me to an oncologist for a second view of options and between the two I had the best of both worlds to make a decision.FYI, my decision and situtation allowed me to elect seed implant. Hopefully, it was the right decision for me - time will only tell.

Again, if it is of great concern: your father in-law is still a young man: a second opinion is cheap insurance / advise on course of action.

One thing I have found is that there are no easy answers; every procedure has it down side and could have pround impact on quality of life but beating the cancer is foremost --

Keep in touch and let us know how he progresses. Many of our members may not respond but read and value others input in helping them make decisions.
God Bless and good luck,
Joe

nutt

As a follow-up thought re: hormone treatment. I had hormone therapy (injection) before and after seed implant. Reasons offered by medical community for such was:

1. hormone therapy physically reduced the size of the prostrate allowing for fewer radiated seeds (amount of radiation required)

2. hormone therapy eliminated the male hormone which is a food for the cancer (believed to put the cancer cells on a starvation diet)or under stress.

3. Hormone therapy supposedly made the cancer cells more acceptable to radiation (seeds or external) by putting them under stress removing their source of food.

Now, the "rest of the story". We all react differently but I had:

a. real honest to goodness "hot flashes", sweating and what the women call "flushing" anytime of the day - especially at night. This was not unbearable, just a real inconvenice.

b. mood swings, initially I would feel the need /want to sit down and have a good cry for no apparant reason.

c. was overly sensititve to the world around me. I found myself wanting to go shopping or having coffee clutch with my wife and friends (little humor)

c. had total loss of sex drive, thoughts or ability untill the hormone therapy flushed itself from my body. It wasn't 100% total but watching the news was as interesting as naked women. Again, depending on your father-in-law's age, cancer spread/psa level and life style may be a consideration for hormone therapy.

I however elected it for the above stated reasons that made my elected procedure more effective, hopefully.

EVERYONE reacts differently to all of these. Others experienced no affects or minimal, some worse but, it is a tool to keep the cancer in check or slow growth by depriving it of the majority of its food source. It isn't 100% effective as hormones are produced elsewhere in the human body I am told.

Hope this helps your family in a decision.

Joe