Duration between biopsy and surgery

Greg62 Member Posts: 4
Hello, I'm 62 years old diagnosed with prostatic
cancer two weeks ago. I've talked to several urologists
which gave me two different surgery time date.
Half of them says the surgery needs to be done 1.5 months
after the biopsy.
The Other half says it's better to wait 3 months after the biopsy.
They say that the recovery from the biopsy (bleeding, Inflammation)
is an important factor to the success of the surgery.

My biopsy results are: 1 out of 12 tissues was found with cancer.
Gleason score is 4+4=8.

My PSA has rised about 4 ng/ml in about a year to a value of 10,
and then stays around 9.

I really don't know what to do...

Any advice will be appreciated!!!


  • VascodaGama
    VascodaGama Member Posts: 3,668 Member
    Greg62, Obtain second opinions on the diagnosis and treatments

    Sorry to know about your cancer situation. Your PSA is high and the Gleason score indicates you have a high risk recurrence rate possibility. The Gleason pattern 4 is of an aggressive type of cancer in terms of progress but prostate cancer is slow in comparison with other types.
    Do not be anxious and try to educate yourself on the problem and in the treatment choices which are advised to Gs 8 guys of your status. All treatments cause side effects that you should be familiar with before deciding in one.
    Three months will give you time to get second opinions from other doctors specialized in other treatments such as radiotherapy or hormonal.
    Research the net about types of treatments and their side effects. Here is a good site;

    Can you give more info from your pathologist report, such as positive extra capsular extension or any other detail? Have you any symptoms like difficulty in passing urine?
    Gs 8 patients are on the side of risk for recurrence after a major treatment if they have perineural invasion or extra capsular extension, so you should think about any possible future salvage treatment too.

    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.
    I recommend you similarly to all newly diagnosed guys, to obtain second opinions on the diagnosis and treatment because doctors have the tendency in suggesting treatments of their specialty. 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.

    Two good books on prostate cancer diagnosis and treatment are; “beating Prostate Cancer” by Dr. Charles Myers and the “Primer on Prostate Cancer” by Stephen Strum and Donna Pogliano. You can get them on Amazon. The former is well written by Dr. Myers who is a patient himself of PCa and a survivor of 12 years.

    Welcome to the board.
    Wishing you find the best way to handle your case.
  • shipjim
    shipjim Member Posts: 137 Member
    I personally went about 10
    I personally went about 10 days, that's how long it took to get a good surgeon, do the pre surgery tests, bonescans,ct, ekg etc and a spot on the schedulel
  • shipjim
    shipjim Member Posts: 137 Member
    I personally went about 10
    I personally went about 10 days, that's how long it took to get a good surgeon, do the pre surgery tests, bonescans,ct, ekg etc and a spot on the schedulel
  • Kongo
    Kongo Member Posts: 1,166 Member
    Hi, Greg. Welcome to the forum but I'm sorry you find yourself here.

    As Vasco pointed out, your Gleason of 4+4 puts you in the high risk category and depending on the details of your pathology report you could well be looking at a cancer that has already left the prostate to some degree. In such cases surgery to remove the prostate will not stop the progression of the disease and in some cases could accelerate it. Surgery also carries the risks of a major surgery as well as the potential for additional side effects relating to incontinence and erectile function.

    Before deciding for sure on a course of action, I hope you consult with other specialists and obtain a second opinion on your biopsy report. It is critical that you have as accurate information as possible to make such a big decision.

    You may wish to consider some form of hormone treatment in conjunction with radiation (IMRT or HDR brachytherapy).

    There are some recent studies that have shown that surgery for advanced stage prostate cancer can be effective, at least in five year recurrence statistics. It is very important for this type of surgery where lymph nodes, seminical vesicules and a wide prostate margin will likely be removed that you go with a surgeon with lots and lots of experience.

    Best of luck to you.

  • bdhilton
    bdhilton Member Posts: 856 Member
    Greg- Vgama gives good
    Vgama gives good advice to seek a medical oncologist specializing in PCa. This is what I did and he provided me details and experts to talk too in their particular fields. My oncologist is also a surgeon but referred me to Dr. Catalona in Chicago (I live in Atlanta) after I elected to have surgery.

    I have been cancer free for 14 months with no other treatments but like most everyone here I hope for the best with the future and enjoy the day as none of us know when or If this beast will return if we had gleason 3+3 or a 5+5…I believe a lot of this is just the “luck of the draw” in life…

    I would urge you to get a second opinion on your biopsy by Northwestern or John Hopkins. Your doctor should happily assist you in this… from my perspective 1 in 12 being positive is not alarming but the 4+4 is an aggressive cancer…My oncologist would be positive about only one sample pulled with cancer and your PSA under 10….

    This is a personal choice and after you go through the selection process you need to make the best decision for you and you only…There are serious side effects with all treatments so do not let anyone tell you anything different …

    As one of my friends here states often is that we are all snowflakes….I would strongly recommend diet changes such as removing dairy and red meat from your diet…and adapt a “Mediterranean” type diet…I believe that helps and if you smoke stop immediately…

    Oh the time frame I hear about the most between biopsy and treatment is no less than 6 weeks…It will take you a while to get your head wrapped around PCa but I believe most here would agree it changes you for the best…

    The best to you in your journey …
  • mattmans5
    mattmans5 Member Posts: 70
    I know today everyone that gets told they have cancer needs to pause and look carefully at treatment options ,

    That being said I had surgery at Memorial Sloane Kettering , . I had a biopsy 9/28,10 I had results back 10/1/10 Gleason 3+4 psa 12.3
    bone scan 10/15

    mri 11/12

    surgery Jan 4/2011 I was told not to wait more then 8 weeks after biopsy

    good luck and get informed , also the most important descion if you chose surgey a surgeon who is skilled , I had an open RP Dr James Eastham