Husband Recent Diagnosis - Gleason 7
My 55 YO husband was recently diagnosed after high PSA (17), MRI showed spot, biopsy confirmed. Talking with surgeon tomorrow on treatment options.
Does anyone have feedback on which treatments worked for them and has kept them cancer free?
I have a list of questions for the doctor, but would love any specific questions you might suggest.
My husband is very active and healthy, this was a complete blow to him and I'm trying to keep things positive and be strong!
Thank you.
Comments
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Hi,
Do you happen to know what his Gleason score was? The score goes from mildly aggressive (3) to very aggressive (5). The doctor should give you a number like 3+3,3+4,4+3, ect. where the first number is the majority of the cells in the sample and the second is the least amount of cells. A 3+3 is very mild where as a 5+4 is very aggressive. Also in the MRI were they able to determine the location of the cancer, close to the edge of the Prostate or deep inside. To answer your question I had robotic surgery back in 2014 and have been cancer free so far. Some choose radiation like Cyberknife or Proton which can also have very good results. Do your homework and study the side effects, both surgery and radiation have them. Some come out of either procedure with results from good to bad, there are no guarantees. I have included a link to give you some basic info on treatment types. Try and get top notch hospitals/doctors who have lots of experience treating Prostate cancer. Great doctors+great facilities = good success in my opinion. And you know what they say about opinions 😄
Dave 3+4
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Thanks for the information! His Gleason: 3+3=6 (Grade Group 1) and 3+4=7, 10% pattern 4 (Grade Group 2)
He was referred to the best hospital/dr network in our area, so we are confident there. Just seems to be so many different treatments with ranging side effects. Sounds like most can have the same side effects, but you don't know until the procedure is done, right?
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Hi,
Well that’s why you have to get the best doctors and facilities to help you with that decision. If you analyze all the pre treatment tests performed and meet with your team of doctors you should come to a good resolution for treatment. Remember most Urologist will recommend surgery and most Oncologist radiation. You might want to get a bone scan and PET scan to verify no further spread other than the Prostate. There have been great outcomes with either surgery or radiation but there are no guarantees. Its your doctors and you/husband’s decision in the end. I am sure other survivors will chime in with their experiences.
Dave 3+4
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I was diagnosed at 49 with Gleason 3+3. Did AS for a little over a year. Had RP 16months ago. While last biopsy was 3+3, pathology on removed organ was 3+4. So far, I'm currently undetectable PSA, fully continent and sexual active. I consider myself very fortunate as far as side effects. Changed docs a couple of times looking for right surgeon. This was a little challenging as i never had a surgery like this. They can all be good salesman so, do research, ask for that doctors outcomes from their treatments vs. General statistics. Talk to radiologist and surgeons. I ended up at Hopkins with experienced surgeon. Both radiologist I talked to recommended surgery due to my age. In event of recurrence, better options.
Do your research and make most informed decision you can that is best for your husband.
Rob
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The 'offficial' recommendations for cases such as your husband's can be found here:
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Well, I had a RP in March of 2018. My PSA is undetectable for over 5 years now; I am continent; I am intimate with my wife, when I can catch her; she is awfully fast. I am 72 years old. My Gleason score was 4+3=7. I weighed out both the RP and Radiation treatment approaches; I chose the RP. I really never let the treatment get in the way of my Quality of Life. I do my best to do the things my wife and I enjoy doing. I did my best to find a highly skilled surgeon with many robotic surgeries on his resume. Personally, I do not think any cancer treatment is a cake walk. I cannot speak to the radiation treatment. But with the RP, they removed the prostate; seminal vesicles; 8 lymph nodes (the surgical steel clips are still with me); and dissected the internal bladder sphincter. The incontinence side effect started clearing up around the 4th month after surgery and I was continent by the 6th month. I went through a lot of Depends getting to that 4th to 6th month. In the past, I posted my surgical procedure and the post surgery biopsy. You should be able to find them on this site, if you so desire. The Erectile Dysfunction (ED) side effects issue did not really impact me. It was not 100% after surgery, but it was never 0. This took time to fully recover. Please remember when they remove your Seminal Vesicles, semen coagulation, sperm motility, and stability of sperm chromatin and suppression of the immune activity will no longer be. The male will not have the ejaculation he used to have. Probably too much info for some folks. But this should give you enough info to ask a lot of questions. Good luck on your journey.
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As Old Salt posted above, the American Urological Association recommends that men with his pathology consider active surveillance as a treatment option. I have been on AS since 2009, and my last two biopsies found no cancer. Why suffer the sometimes lifelong side effects of radical treatment if you don’t need it?
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After meeting with the doctor yesterday, he's decided on RP. I've read that men who undergo this procedure, who haven't had prior symptoms of the cancer (urinary/erectile issues) prior to surgery, have a higher % of full recovery over time. Dr suggested Kegel exercises in the weeks prior to surgery to minimize the incontinence. Realistically, this will be a roller coaster for the next year or so. If he gets back to even 80% of where he is today, he should be just fine.
AS isn't an option for him for two reasons: 1) the % of tissue with cancer, 2) his state of mind. He will get no rest until the cancer is gone. Just having a plan, after waiting 3+ months for final answers, lifted his mood and spirits yesterday.
Would appreciate any advice you have for him or me as the wife/caregiver through this process. Also REALLY appreciate your candid feedback.
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Considering your husband's concerns, the decision makes sense (for him).
Doing Kegels will help him and yes, the next year is going to be an 'adventure' for both of you.
There are a lot of minor conveniences to make life easier right after surgery (before the catheter is removed). I hope others will chime in with recommendations. I am not in a position to give that kind of advice as I had radiation as the primary treatment.
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Your husband made a reasonable choice considering his situation.
Although I am a 'radiation guy', the advice to start doing Kegels ASAP is spot on. There are a number of other issues that can help with the after-surgery recovery, prior to the catheter removal. I hope that others will chime in with specific advice.
I vaguely remember
Easy-chair for sleeping/resting
Bucket to carry the urine output around
Walking, but don't overdo this
Medication for pain and bowel movements
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Absolutely, kegels. The surgeon had me go to a physical therapist prior to surgery. The physical therapist placed some sensors up my rectum and had me do some kegels. The top number on the scale was a 5. I scored a 4. She said obviously I had been doing my kegels. Also, my surgeon put me on sildenafil (viagra) prior to surgery. He said to think of it as fertilizing the pelvic area. The surgeon performed a cystoscopy (one of the most memorable moments of my life) on me prior to my surgery. He wanted to take a look at my urethra and bladder. He too had me kegel while in my bladder. I saw all of this. He told me he would take a tissue sample close to my bladder neck while doing the surgery. If positive for cancer, he would not go any further with the RP. This tissue sample was negative. He briefed my wife and daughter on this. After surgery, the surgeon was very concerned with the catheter for being stable. I took a bag and a pair of pants that I could zip the leg off and easily place the urine bag in a bag. You may want to get some pants that can stretch, as I was swollen after the surgery and if the pants did not have the elastic waist band, they would probably been too tight. I did not take any of the pain medicine. I did take a few of the bowl movement pills. When getting the catheter removed, a few days after surgery, make sure you relax yourself as much as possible (don't tighten up). When I had this done, I had my Depends with me and put them on. Hope, this helps. Good luck on your journey.
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