46 with prostate cancer what to do?

To make a long story short in 2009  I was diagnosed with prostrate cancer psa 110 gleason 9. Local doctor said any kind of surgery was to dangerous as it was probally out of prostrate.Iwent to Ok. cancer treatment of america for second opinion and they said the same thing and I would have to have radiation.after bone scans,mri and cat scans were negative except for a hump on the prostrate I had to take a hormone shot and wait 90 days for radiation treatments and seed implants.In the mean time a friend talking to his uroligist about me called me his self and said Ineeded to get the prostrate out as if cancer returns after radiation there is no cure left he put me in touch with Dr. seth Lerner at Baylor Clinic houston and he said he would open me up but if the cancer was in my lymph nodes he would have to sew me back up. The lymph nodes were fine so he removed the prostrate with no side effects at all and really no pain.After about ayear my psa began to rise eventually to .06 and the doctor said I would need salvage radiation so in june 2011 I had 35 treatments with no side effects and did not really no I was recieving radiation.My osa as of Feb.2013 is .0003.Maybe this will help you with your decision and pray your acse will turn out fine.One thing I wii add the hormone shot I had to take before I thought Iwas going to have radiation was the worst 90 days of my life with hot flashes and could not sleep at night and as it tuned out I would not have had to take the shot for surgery,but it did give me time to do what  I think turned out to be best for me.

yankeefan said:

it's the pits, but doubt watchful waiting is the way to go..

I assume you are scheduled for a consult with your urologist. He should go over the options with you and provide you with some names for a second oppinion...

I just had my biopsy in Feb, it came back with one core our of 13 with cancer...gleason  7. My urologist advised against watchful waiting...and I had a radical prostatectomy a little over two weeks ago.....

The urologist's recommendations may depend on his view re the likelihood the cancer has spread behond the prostate. What did your sonogram show? What does your dre show? If the Doc thinks there's a chance that the cancer is still only in the prostate, I imagine he will advise either an operation or radiation. Check these options out and make your choice. Of course, it may be that some sort of hormone therapy is possible too...this is why you need to sit down with your urologist and go over all the options and get a second oppinion..

If you decide on surgery...do you home work and find the best surgeon you can...the results can vary widely, but generally are a function of the skill of the surgeon......so you want a good one...one who has done hundreds if not thousands of these operations...and some one with a good reputation. depending on where you live, you may want to travel to another location to have your surgery done, if that is what you decide to do.

best of luck...hopefully you can get rid of the cancer before it spreads.....but even if has spread, there are treatments that can be effective.

From you Gleason score of 7, your PCa is classified as intermediate risk. It's a tough call for a young man because treatment could have side effects.  Some more thans others.   At the same time, your PCa will not likely get less risky over time. While PCa is typically a very slow growing disease, it will almost certainly continue to grow.  Knowing you have cancer is a huge burden no matter what your age and risk classification.

If you do intense and extensive homework your answers will come.

Best wishes to you.

I have a friend who's in his early 70's. He was diagnosed with pc when he was 55. His gleason score was 7 too. He had his prostatectomy circa 1997. He went to probably the best doctor at that time, patrick walsh at johns hopkins. He has not only been cancer free for the last 16 plus years, but is in great health...no incontinence and even still has his erectile function!. My guess is this guy will live till he's 90 plus....he's not over weight, doesn't smoke, doesn't drink, gets regular check-ups, etc. There are no guarantees that anyone else will have similar experiences; in fact, just reading the posts on this site will tell you not everyone has such great outcomes..my only point is that it is possible to survive this disease relatively intact. Only god knows your genetic makeup and family history, but if you are in good shape, take care of your body, and get a really good surgeon, it is possible, but absolutely not guaranteed, that you can get past this pc in good shape. I debated posting this as I don't want to make it sound like cancer surgery is definitely the way to go or is even likely to be trouble free...in your case and many others perhaps it isn't. You should get multiple opinions from reputable urologists. on the other hand, all is not necessarily lost, there is perhaps a decent chance you will survive (whatever treatment you choose) and still be continent and sexually capable. I think one factor in a successful out come is in routine testing. If you have a psa every year, followed by a good urologist, your chances of the cancer being advanced outside the prostate, when it is ultimately found, are reduced because pc is relatively slow growing and if it hasn't been there years undetected it is likely to still be organ contained. Have you had a dre? If it is negative, that increases the odds that it hasn't spread. Another key factor in having a good out come is having a really skilled surgeon (should you choose surgery); that is probably the single biggest factor in how well you would tolerate the surgery. 

I was just recently diagnosed with pc myself, also gleason 7, and just had a radical prostatectomy. I'm only a month out from surgery and I still leak a little now and then and I have no erectile function yet. I hope I ultimatley get to where my friend is, but I have to realize that I may not. I'm 22 years older than you so sexual functioning, while important, probably isn't as important as it is at your age. if I can be cancer free and have no problems with incontinence I will live with it...in other words, 2 out of 3, while not the best, ain't bad.....

again, for what it's worth, my urologist told me that watchfull waiting was not a good option, based on my biopsy of gleason 7, in one core out of thirteen. So based on my very limited layman's view, I believe you should pursue some sort of treatment...rather than do nothing.

sorry you are in this situation but wish you all the best....

Mounty said:

What to do?

D Love,

You beat me into the prostate cancer club by one day (I was diagnosed on April 24).  So I don't have a whole lot to offer in the way of experience about the best way for you to proceed.  What I can tell you though is that my younger brother Dave, who is ten years younger than I am, was diagnosed with a similar case to yours ten years ago when he was forty one. At fifty one he is hearty and hale and free of cancer. I do know enough about prostate cancer at this point to tell you that this is very likely your fate as well.

Best wishes

Diagnosed April 2006

LRP 6/6/6

sex fine

Incontinent 7 years and counting

Everyone's different...so unique.

The folks above gave you a load of good advice.

Lion1

VascodaGama said:

D-Love

I am sorry for your diagnosis.

You should try to get as many opinions as you can. Young guys with many years of life span got lots to loose from treatments. Try getting educated firstly. There are many threads on this forum with good information. Read them all.

I recommend you to prepare a long list of questions even if they seem odd to you. When visiting the doctors, it will be better to be accompanied by a family member. Here are links for you to read;

http://www.cancer.net/patient/All+About+Cancer/Newly+Diagnosed/Questions+to+Ask+the+Doctor

 

Diet and a change in live tactics become important to counter the treatment effects. Physical fitness programs and proper nutrition are important when dealing with prostate cancer. UCSF got a publication on Nutrition & Prostate Cancer, which copy I highly recommend you to get.

http://cancer.ucsf.edu/_docs/crc/nutrition_prostate.pdf

 

Newly Diagnosed Prostate Cancer:  Understanding Your Risk
http://prostate-cancer.org/PDFs/INSIGHTS/Insights-Aug-2012-ROUNDY.pdf

 

Some books;

http://csn.cancer.org/node/213559#comment-1017931

 

Welcome to our boat.

Wishing you luck in your journey.

VGama 

 

Another good source for information is Dr. Patrick Wash's  "Guide to Surviving Prostate Cancer-Third Edition"

This is an excellent reference book, easy to read, and full with information that will help you to make a decision.  I was introduced to the book after I had made the decision for RALP.  Wish I had had it sooner.  BUt even after surgery ( 8 weeks out) I continue to consult it.    A good investment. 

At any rate, do take your time, and make the decision with which YOU feel most conmfortable.  I am a bit older than you and so my age was also a factor to consider.  Your doctor should be able to confirm just how agressive your particular case is; but from what I understand, Prostate Cancer is slow growing, especially if it is still maintained within the capsule (has not matastisized).  So exhale, and do your research.  The book can be purchased online. Barnes and Noble--I believe or Amazon.  Good Reading, Good Luck, be Calm.