I just found out that my father in law has cancer I already told my wife :(

orioner00

Hi I just found out today from our doctor that my father in law has prostate cancer I already told my wife and the news broke our hearts badly, tomorrow we are going to see the doctor and he will explain to us treatment options. Any suggestions on how you guys handle this my father in law still does not know.I hope everything will be ok. I was researching on Robotic Prostatectomy but from where I live at only a few doctors have experience in doing this and not even sure if their good at it. any inputs guys? the doctor told me over the phone that it's low risk I have not asked what's my father in laws gleason score I will post it tomorrow.

Thanks
Orion

Kongo

Low risk
Sorry that this has upset your family. If the doctor told you and not your FIL then I am guessing he is elderly. A low risk diagnosis for an elderly patient usually doesn't require any treatment at all. In fact, most men who reach old age have some degree of low risk prostate cancer that poses no risk at all to their health. Any treatment given to men with less than a 10-year life expectancy from normal aging or other health causes would likely cause more harm than good.

If indeed your FIL is elderly and has been diagnosed with a Gleason 6 low risk prostate cancer and the urologist suggests treatment you need to seek other opinions.

Good luck

K

hopeful and optimistic

We
all go through shock and all the negative feeling for the first few months, even if the cancer is indolent, not likely to spread.

I suggest that your father get a copy of the biopsy report, and all the medical records pertaining to this, so that he and you will have correct information when doing research, and intrviewing other docs if necessary.

I am doing Active Surveillance, that is, my treatment choice is to monitor carefully and have active treatment in the future if warranted.

Please repost, listing trend of PSA numbers;for the biopsy, number of cores taken, how many were positive, and involvement of each (percent cancer in the core), the gleason score. The age of your father in law, and his general health. Also what prompted the doc to do a Biopsy.

In most cases you will not be in any rush to make an immediate decision. Make sure to throughly research anything that is recommended .


Also read, read,, read, research, read and research.

Determine face to face local support groups in your area.

docholmes52

Prostate cancer
The words Tumor, bump, nodule, growth, risin', lump, and knot all mean the same thing, Cancer. Whether the cancer is malignant (moves somewhere else) or benign is the key. Are you considering "Alternative Medicine?" There are almost 7 billion people on the planet, nearly half are chinese. Western medicine (ours) has been around since roughly 1492. Thats about 519 years. Chinese medicine has been around thousads of years. Since there are more or less than ten times as many Chinese, one could postulate they may know something about herbal, holistic, and otherwise known as Alternative Medicine. There are many books on the subject.
Hope this helps, docholmes52

orioner00

Kongo said:

Low risk
Sorry that this has upset your family. If the doctor told you and not your FIL then I am guessing he is elderly. A low risk diagnosis for an elderly patient usually doesn't require any treatment at all. In fact, most men who reach old age have some degree of low risk prostate cancer that poses no risk at all to their health. Any treatment given to men with less than a 10-year life expectancy from normal aging or other health causes would likely cause more harm than good.

If indeed your FIL is elderly and has been diagnosed with a Gleason 6 low risk prostate cancer and the urologist suggests treatment you need to seek other opinions.

Good luck

K

My FIL is around 60 years of
My FIL is around 60 years of age and today the doctor told me he got a gleason score of 6 and the doctor still suggests a Robotic Prostatectomy. Tomorrow the doctor will tell him hes got the disease I hope everything goes well.

orioner00

hopeful and optimistic said:

We
all go through shock and all the negative feeling for the first few months, even if the cancer is indolent, not likely to spread.

I suggest that your father get a copy of the biopsy report, and all the medical records pertaining to this, so that he and you will have correct information when doing research, and intrviewing other docs if necessary.

I am doing Active Surveillance, that is, my treatment choice is to monitor carefully and have active treatment in the future if warranted.

Please repost, listing trend of PSA numbers;for the biopsy, number of cores taken, how many were positive, and involvement of each (percent cancer in the core), the gleason score. The age of your father in law, and his general health. Also what prompted the doc to do a Biopsy.

In most cases you will not be in any rush to make an immediate decision. Make sure to throughly research anything that is recommended .


Also read, read,, read, research, read and research.

Determine face to face local support groups in your area.

Thanks for the advice sir
Thanks for the advice sir today the doctor only told me the gleason score of 6 tomorrow I will get a copy of all the blood work and tests done. I think he was recommended to get a biopsy because he had an abnormal psa score but the DRE did not show signs of cancer. I will try to find support groups here for my father in law thanks again.

orioner00

docholmes52 said:

Prostate cancer
The words Tumor, bump, nodule, growth, risin', lump, and knot all mean the same thing, Cancer. Whether the cancer is malignant (moves somewhere else) or benign is the key. Are you considering "Alternative Medicine?" There are almost 7 billion people on the planet, nearly half are chinese. Western medicine (ours) has been around since roughly 1492. Thats about 519 years. Chinese medicine has been around thousads of years. Since there are more or less than ten times as many Chinese, one could postulate they may know something about herbal, holistic, and otherwise known as Alternative Medicine. There are many books on the subject.
Hope this helps, docholmes52

As of now I don't know what
As of now I don't know what would be their decision on the treatment sir but I will also raise this thanks to your advice I'm a big believer of othe alternatives sir Thanks.

hopeful and optimistic

orioner00 said:

Thanks for the advice sir
Thanks for the advice sir today the doctor only told me the gleason score of 6 tomorrow I will get a copy of all the blood work and tests done. I think he was recommended to get a biopsy because he had an abnormal psa score but the DRE did not show signs of cancer. I will try to find support groups here for my father in law thanks again.

OK
Gleason 6 is a less aggressive cancer which is a good thing. When you get the results of the biopsy you still have to answer the other questions that I previously posted, as a first step in determining a treatment choice. If there is a small number of cores involved with low involvement, your FIL is a candidate for active surveillance as I am doing. Click my name to determine what I have been doing in th "about me" section.

There are also treatments other than surgery that might be considered if necessary, .

I wonder why the doctor has contacted you, and has not directly contacted your
FIL.

By the way, and this is very very very very important. You want to have the slides sent to an independent lab where there is an expert pathologist that specializes in this. There are only about 10 that are considered the top of the field. Boswick is one, and johns hopkins is another. Instruct your doc to have it sent out at your meeting. This is important so you are not under or over treated.

orioner00

hopeful and optimistic said:

OK
Gleason 6 is a less aggressive cancer which is a good thing. When you get the results of the biopsy you still have to answer the other questions that I previously posted, as a first step in determining a treatment choice. If there is a small number of cores involved with low involvement, your FIL is a candidate for active surveillance as I am doing. Click my name to determine what I have been doing in th "about me" section.

There are also treatments other than surgery that might be considered if necessary, .

I wonder why the doctor has contacted you, and has not directly contacted your
FIL.

By the way, and this is very very very very important. You want to have the slides sent to an independent lab where there is an expert pathologist that specializes in this. There are only about 10 that are considered the top of the field. Boswick is one, and johns hopkins is another. Instruct your doc to have it sent out at your meeting. This is important so you are not under or over treated.

It's good to hear that his
It's good to hear that his gleason score is at low risk and I'm very happy that there is someone like you who is willing to help, you are an angel to us sir I hope for the best in your treatment and fight with cancer. I will know tomorrow everything regarding his biopsy report and some tests that were done. My FIL panics to small things so the doctor decided that he talks to me first then tomorrow my FIL atleast there's someone else who can accompany him during the check up.. I will ask for the slides and the results he gave me we are located in Manila and I don't know yet where else we can have the slides checked. Where's boswick and John Hopkins located sir can we just mail the slides to them and get results or how do we go about this? thanks so much sir

hopeful and optimistic

orioner00 said:

It's good to hear that his
It's good to hear that his gleason score is at low risk and I'm very happy that there is someone like you who is willing to help, you are an angel to us sir I hope for the best in your treatment and fight with cancer. I will know tomorrow everything regarding his biopsy report and some tests that were done. My FIL panics to small things so the doctor decided that he talks to me first then tomorrow my FIL atleast there's someone else who can accompany him during the check up.. I will ask for the slides and the results he gave me we are located in Manila and I don't know yet where else we can have the slides checked. Where's boswick and John Hopkins located sir can we just mail the slides to them and get results or how do we go about this? thanks so much sir

Second opinion of pathology
The labs that aI mentioned are in the united states. Johns Hopkins University is in Maryland, USA abd Botwick is in Virginia and I think also in Arizona 1800214-6628

Below are labs that I know of that are outside the USA....... Source:A Primer on Prostate Cancer..stephen B. Strum



Prof Dr. B. Helpap at the Chefarzt Institut fur Pathologie
Hegau Kinikum
Virchowstrasse 10, 78224 Singen/Htwl.
Tel: 07731/892100; Fax 07731/892105

Prof. Dr. med Helmut Bonkhoff
prof. of Pathology
Tietzenweg 129
12203 Berlin, Germany, or:
P.O.B. 450211, 12172 Berlin, germany
Tel: +49-30-84317882
e-mail info@prostapath.de

Prof. Dr. Wernert at the Uniklinik Bonn, Pathologie
Sigmund-Freud Srasse 25 53127 Bonn
Tel: 0228/2875030
e-mail: wernert@meb,uni-bonn.de

Hopefully another poster will provide information of a qualified lab in Asia.

Sending the slides to another pathologist: Simply have your doc instruct the lab that has them now to pack them (probably best if they do it) and send it to a qualified lab( probably the best since you can discuss the lab choice with your doc). You are also able to call the lab directly and have them sent it. Additionally you can go, pick up the lab work pack it and send it out( I do not suggest this, since you may not pack the slides as well as the lab)

mrspjd

hopeful and optimistic said:

Second opinion of pathology
The labs that aI mentioned are in the united states. Johns Hopkins University is in Maryland, USA abd Botwick is in Virginia and I think also in Arizona 1800214-6628

Below are labs that I know of that are outside the USA....... Source:A Primer on Prostate Cancer..stephen B. Strum



Prof Dr. B. Helpap at the Chefarzt Institut fur Pathologie
Hegau Kinikum
Virchowstrasse 10, 78224 Singen/Htwl.
Tel: 07731/892100; Fax 07731/892105

Prof. Dr. med Helmut Bonkhoff
prof. of Pathology
Tietzenweg 129
12203 Berlin, Germany, or:
P.O.B. 450211, 12172 Berlin, germany
Tel: +49-30-84317882
e-mail info@prostapath.de

Prof. Dr. Wernert at the Uniklinik Bonn, Pathologie
Sigmund-Freud Srasse 25 53127 Bonn
Tel: 0228/2875030
e-mail: wernert@meb,uni-bonn.de

Hopefully another poster will provide information of a qualified lab in Asia.

Sending the slides to another pathologist: Simply have your doc instruct the lab that has them now to pack them (probably best if they do it) and send it to a qualified lab( probably the best since you can discuss the lab choice with your doc). You are also able to call the lab directly and have them sent it. Additionally you can go, pick up the lab work pack it and send it out( I do not suggest this, since you may not pack the slides as well as the lab)

FedEx option for international delivery
Using FedEx or a similar air delivery service to send the slides to a lab in the USA might also be an option. To find reputable labs in the U.S. for a 2nd opinion pathology report on biopsy specimens, follow this link for info: http://csn.cancer.org/node/212732. It would be advisable to first verify that a U.S. lab will be able to ship the slides back to an international address (probably they will, but you'll need to check). You may need to include/provide a return, postage paid shipping parcel/label.

VascodaGama

orioner00 said:

As of now I don't know what
As of now I don't know what would be their decision on the treatment sir but I will also raise this thanks to your advice I'm a big believer of othe alternatives sir Thanks.

Second Opinions may be possible in Singapore too
Orion

The best place for diagnosis and treatment of prostate cancer in Manila is the St Luke’s Medical Center Hospital. Doctors have been trained at USA major health care hospital-Universities and facilities such as the Memorial Sloan Kettering Cancer Center of New York.

The advice for surgery (robot) may be too premature because other data is required to verify the success of such treatment. Doctors performing robot surgery should also have years of experience (over 350) in the procedure, and I would recommend your FIL to not commit before knowing all pos and cons of the treatment.
Risks and side effects may be nasty and permanent.

The full pathologist report on the biopsy is important in the decision (number of cores, total and positive, and percentage of cancer found in cores), and so it is other relevant details in regards to the reason for him to get to a biopsy (any symptom? High PSA?). DRE test, if positive, may indicate that your FIL’s case is advanced even in the presence of a low grade Gleason score of 3+3=6.
Try to get as many information as possible in your next visit with the doctor, particularly the “Clinical Stage” that has been designated to your FIL. You can adapt a List of Questions from this link;
http://csn.cancer.org/node/224280

If not satisfied or confident with the doctors in Manila, you could consult (get second opinions) in Singapore which is 3 hour away from Manila. Johns Hopkins IMC in Singapore has an excellent oncology department. Here is their site;
http://www.imc.jhmi.edu/index.html

When (2001-2005) assigned to the Philippines, I was under the care of Mario Eisenberger, JH at Baltimore but the doctor following my case while in Asia, was Dr. Alex Chang (oncologist at JH Singapore), who was in contact with Baltimore.
Prostate cancer is of the slow-type in growing cancers so that your FIL may have time to get second opinions in the USA or at Singapore. If his case is found to be indolent he could follow a regimen of AS (active surveillance). You can read details in this site;
http://www.prostate-cancer.org.uk/media/11599/activesurveillance.pdf

Hope for the best.
VGama