just diagnosed
Hello I just found this forum and am very happy to have found it.
I was recently diagnosed with prostrate cancer.
I'm still not over the shock and am stressed out a bit.
My psa is 5.3, my Gleason score is 6. Out of 8 biopsy cores, 3 have cancer. All on my left side. Left base 30%, left mid 40%, and left periphery is 40%.
Of course I'm faced with making decisions on what to or not to do. I've decided to just do active surveillance now.
I turn 53 next month.
My first question in the forum is how long can a guy with my metrics reasonably expect to stay in stage one?
Thanks!
Daniel
Comments
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Dear Daniel,I am sorry for
Dear Daniel,
I am sorry for your diagnosis. Virtually all of us are shocked by finding out that we have prostate cancer. For the most most part this lasts a few months. There are coping strategies, try to be upbeat, if so inclined, attend religious services with a clergyman who is UPBEAT. Do service for others. Research this disease so that it is not overwhelming to you, so you know what is going on.
There are many local support groups that are available ; some provide emotional support , some education about the disease and strategies. There is an international organization that you may wish to google for a local chapter USTOO.org
Have you had any other diagnostic tests such as MRI T3, Free PSA test, or second opinions on your biopsy, etc.
Now-a-days the urologist usually takes 12 random cores in a biopsy....your doc only gave 8
The criteria for Active Surveillance is similar from one institution to another. For example at Johns Hopkins , their criteria for a low , low involvement and acceptance to their program is 2 or less cores out of 12 with less than50 percent involvement in each core.....PSA less than 10 , DRE smooth or slight bump.....PSA/prostate size less than 0.15
I suggest that you speak with a specialist in Active surveillance to see if you qualify.
There is a new state of the art biopsy that is available in some centers of excellence......There is a multiparametric mri taken, any suspicious lesions are ranked by potential aggressiveness , then sampled with a 3 dimension biopsy machine(not a 2 dimensional ultrasound machine as had been done in your case)....or using the MRI again so the lesion can be sampled in real time.
Using this method will give better indicaiton of where in the prostate the cancers are located, if any..if there is extracapsular extension. The lesions are targeted so the biopsy will reveal more, and if necessary (say if a cancer is found) a urologist can go back to the exact same spot and area to see how extensive the cancer is.
Please do research, read books , internet, research, research............come back with questions that you may have.
Best
Hopeful
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Family decisions
Daniel
Welcome to the board.
Hopeful gave you sound advice. Having a proper diagnosis is the most important aspect when we “enter” into this “world of cancer”. Initially we all freak out because we are dealing with the unknown. Prostate cancer though is sort of slow growing in comparison with other similar cancers, allowing us time to educate well before making any drastic decision. I wonder why you have chosen Active Surveillance (AS). Was it at the suggestion of your doctor or you just decided to do “nothing”?
Treatments involve risks and side effects that threaten our quality of life so that one should be acquainted with the details to get the best. You may not father a child again. Your family should be involved in decisions along your journey.
AS is a watchful program to follow the disease progression. It is a sort of “military” regimen with steeps that needs to be followed with precision but it allows one to delay a treatment or avoid it, if such ever becomes necessary. It is the best choice if one can “afford” it.
Typically many start by adding information, exams and tests to ascertain the veracity of the diagnosis. The extent (spread) of the cancer will provide the best guess of a clinical stage which will rule the best treatment. Second opinions from specialist (two or three) are essential. Experienced medical oncologists tend to be “friendlier” and just because they have no financial interests “attached”.
In any case the results from tests and exams (MRI, PET, Scans, etc) will provide the guidance to the expert’s opinions so that these should be obtained in modern facilities and under up to date techniques.Medicine and therapies are changing everyday and we are now seeing cancer to be treated in a “Custom Fit” style. Genetics are involved and a genes test can evaluate one’s risk in future spread. Medications are also tailored according to one’s DNA. They call it Molecular profiling and you may benefit from having such test now. Here are links on the subject;
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1069086/
http://online.wsj.com/news/articles/SB10001424052702303819704579318943273912098
http://csn.cancer.org/node/265961
A comprehensive “compendium” on Prostate cancer and care;
http://prostate-cancer.org/decision-aide/where-to-start/prostate-basics/
Best wishes in your journey.
VGama
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