Looking for Advice/Thoughts

Concerned daughters

I have used this forum as a great resource for information and to answer many of my questions in the past. Now I'm asking this forum for some advice/thoughts about the current situation with my dad's prostate cancer.

Information about my dad:
- Currently 74 years old
- 2000-present watched closely for elevated PSA; also problems due to large prostate
- 5/12 PSA 9.2
- 6/12 biopsy, prostatic adenocarcinoma found, Gleason 3+4; two out of six cores involved
- 7/12 Bone scan and CT scan negative
- 8/12 RP Due to size of prostate (which was causing issues with urination) and adenocarcinoma
- 8/12 Post-surgery Pathology came back with two nodules of confluent high grade adenocarcinoma of Gleason score 5+5=10, ea. measuring approx. 1.5 cm, additional foci of adenocarcinoma of Gleason score 4+3=7, together measuring approx. 1 cubic cm for a total tumor volume of approx. 4.0 cubic cm. Perineural invasion identified, negative seminal vesicles, negative radial margins, negative proximal urethral and distal urethral resection margins, with carcinoma approaching the right proximal urethral.
- First PSA test approx 7 weeks after surgery 3.8
- 10/10/12 PSA 3.94
- 10/22/12 Prostacint scan negative
- 11/10/12 PSA 5.2
- 11/13/12 Eligard (6 mos.) injection

Before he had the injection we spoke to the doctor at length about options, side effects of the HT, etc. To be honest, based on everything I've read on this forum and other research online, and based on my dad's doubling rate and Gleason score, I believe this is an emergent situation. However, the dr. seems to have a much more laid back approach with very little urgency for the situation. I'm a straight shooter and just don't feel like he's being totally honest with us in terms of prognosis. I realize he doesn't have a crystal ball and can't give us exacts but we are just trying to figure out what we are up against. We asked about visiting a cancer center specializing in prostate cancer (i.e. Cancer Center of America or Mayo Clinic, etc.)and he didn't feel it would be beneficial to us at this time. He gave us the impression that these centers deal more with "experimental" treatment and we're not there yet. My dad has been incontinent since surgery. This alone has caused him a great deal of anxiety. Everything runs right through him all day long; constant changing. He is scheduled to have the sling surgery on 12/5. The dr. assures him that he will be bone dry the next day. My mom passed away from ovarian cancer in 2010 so he does not have the 24/7 support that I know he needs. I am encouraging him to join a local man-to-man prostate cancer group. We would really appreciate any feedback from this group. Please do not worry about upsetting us or being too straight forward, in fact we encourage it. Thank you so much!!

ralph.townsend1

Straight shooter
If the gleason scores was 5+5 (10) at removal of prostate. Yes, I would seek a professional prostate cancer doctor or the best a cancer center you can get in your area. I go to MD Anderson cancer center and use a local doctor and VA Hospital as backup. With the Gleason score that high, you should not have a laid back approach. Your feeling are right!!!! With the Prostate gone the psa should at 0.0 and not 5.2. Like mine at 0.9 is not good and growing some where

Your dad is young and he can handle some of these new drugs.

Good luck

God Bless you and your DAD

laserlight

ralph.townsend1 said:

Straight shooter
If the gleason scores was 5+5 (10) at removal of prostate. Yes, I would seek a professional prostate cancer doctor or the best a cancer center you can get in your area. I go to MD Anderson cancer center and use a local doctor and VA Hospital as backup. With the Gleason score that high, you should not have a laid back approach. Your feeling are right!!!! With the Prostate gone the psa should at 0.0 and not 5.2. Like mine at 0.9 is not good and growing some where

Your dad is young and he can handle some of these new drugs.

Good luck

God Bless you and your DAD

Get another opinion
Straight, look at another doctor that can give you more advice and help you out. And yes encourage your Dad to look into support groups both in person and on line.

I have found this site and others to help and have made some very good contacts, There is a lot of information on these sites.

I am sorry to hear about your Dad. Get another doctors opinion on the cancer and treatment methods.

I agree with Ralph. I have 3 doctors right now that work with me on PCa and they for the most part are all on the same page. I am thankfull for that.


Take care you have come to a good site Kurt

mrspjd

Concerned advocates
CDs,

My sincere condolences on the loss of your mom. Sorry for the situation your dad, you and your family are now in, coping with your dad's high risk PCa so soon after your mom's battle with ovarian cancer. I can only imagine how challenging and difficult this must be for your family.

You received some good info on your last thread in October. Since you asked for feedback again, here are some thoughts/suggestions:
> find a well established active/knowledgeable face to face PCa support/networking group in your area that welcomes women, daughters, wives & loved ones. Attend the meetings with dad. If dad won't go, please go without him to find caring emotional and educational PCa support for both YOU & dad. 
> obtain the names of the best PCa medical oncologists you can afford and make an appt with one for an evaluation & 2nd opinion.  It doesn't sound like you & dad are comfortable with the current doctor's approach or knowledge (a urologist?) in the management of dad's case. 
> continue to be diligent & proactive re your/your sisters' health care since prostate, breast & ovarian cancers are all hormone sensitive cancers and, when found in first degree family members, MAY put you and your sisters in a high risk group for breast and/or ovarian cancer considering your parents' cancers. Please check with a knowledgeable oncologist about the BRCA1 gene in PCa, ovarian & breast cancers. 

Your dad is fortunate to have you and your sisters as his advocates on this PCa journey. Best wishes as you go forward together. 

mrs pjd
Wife of a T3 stage PCa Survivor