just got the news-lost

I am sorry that you are now part of our brotherhood; a group that nobody wants to join.

But you can stay optimistic because it's very likely that you can be cured, based on the information that you have provided.

I would not be surprised if your urologist is going to recommend surgery. Several of us will advocate that a proper course of radiation therapy will work just as well. Ultimately, it will be up to you to decide. But in the meantime, you will have a lot of time to gain knowledge of the pros and cons of the various approaches that are currently available. Take your time and don't make any rash decisions.

I hope that others will elaborate on my post.

TC,

While your Gleason and PSA are low, the one core at 90% involvement somewhat suggests the possibility (but not certitude) of significant volume (tumor size inside the gland). PCa biopsies are very much hit-or-miss affairs. Imaging, such as Vasco mentioned, is much needed in your case.  I had DaVinci robotic removal, but with your particulars (of which you don't really have enough yet), I would go with radiation therapy (RT).

You admirably mention that you have researched this "two days."  Good.  And it is good that you  found this site.  But the men who have been here 10 years or more (I am not one of them) are still learning new material every day.  Prostate Cancer treatment cannot be learned from Cliff Notes at Barnes and Noble; you will be learing a year from now, if you read every day.

My following statement is subjective and impressionistic:  PCa (Prostate Cancer) diagnosed at very young ages (like yours) TENDS to become more aggressive faster than when found at more conventional ages.  This MAY NOT be applicable to you.  The average age for diagnosis of PCa in the US today is 67 years of age.

Continue your study. Read the book your doctor provided to you.  Do not let a urological surgeon steer you to surgical removal without further imaging and meeting with at least one Radiation Oncologist, minimum.  Most important of all: AVOID THE INTERNET, except for university and premiere hospital sites.  There is a massive amount of nonsense on the internet: magical cures, reefer cures, sad idiocy for desperate individuals.  Use sites like Johns Hopkins Medical Center, MD Anderson CC, Sloan-Kettering, the Cleveland Clinic, etc.  American Cancer Society links are excellent.

 And know that very, very likely your disease is curable.

max

Sorry to hear about your recent diagnosis. 

Anyone newly diagnosed with prostate cancer rated Gleason 6 (and usually Gleason 7) has all treatment options available to him and, since this cancer is considered "low risk", he has time to decide which choice is best for him.  So, the first thing a new prostate cancer patient should do is to do research on the available options before he actually has to make the decision regarding which treatment to choose.

The following is my response to other men who asked for similiar advice about the treatment choices available to them.  It's a summary of the available treatment options and my personal opinion on the matter.   You can, of course, ignore my opinion about which treatment choice I think is best.  The overview of the choices is still otherwise valid.

Choices You Need To Consider:

 . . .  People here know me as an outspoken advocate for CyberKnife (CK) radiation treatment and against surgery of any kind.  I was treated w/CK 6 years ago (Gleason 6 and PSA less than 10).  You can troll the forum for my many comments on this point.  Here are the highlights of the treatment options that you need to consider:

 1)  CK (SBRT) currently is the most precise method of delivering radiation externally to treat prostate cancer.  Accuracy at the sub-mm level  in 360 degrees and can also account for organ/body movement on the fly during treatment.  Nothing is better.  Accuracy minimizes the risk of collateral tissue damage to almost nil, which means almost no risk of ED, incontinence and bleeding.  Treatment is given in 3-4 doses w/in a week time w/no need to take off time from work or other activities.

2) IMRT is the most common form of external radiation now used.  Available everythere.  Much better accuracy than before but no where near as good as CK.  So, it comes with a slightly higher risk of collateral tissue damage resulting in ED, incontienence and bleeding.  Unless things have changed, IMRT treatment generally requires 40 treatments -- 5 days a week for 8 weeks -- to be completed.  I think some treatment protocols have been reduce to only 20 but I'm not sure.  Still much longer and more disruptive to your life than CK but, if CK is not available, you may have no other choice.

3) BT (brachytherapy).  There are 2 types: high dose rate (HDR) and low dose rate (LDR).  HDR involves the temporary placement of rradioactive seeds in the prostate.  CK was modeled on HDR BT.  LDR involves the permanent placement of radioactive seens in the prostate.  1/2 life of the seeds in 1 year during which time you should not be in close contact w/pregnant women, infants and young children.  The seeds can set off metal/radiation detectors and you need to carry an ID card which explains why you've got all of the metal in your body and why you're radioactive.  Between HDR and LDR, HDR is the better choice because with LDR, the seeds can move or be expelled from the body.  Movement of the seeds can cause side effects due to excess radiation moving to where it shouldn't be causing collateral tissue damage -- ED, incontinence, bleeding, etc.   Both HDR and LDR require a precise plan for the placement of the seeds which is done manually.  If the seeds are placed improperly or move, it will reduce the effectiveness of the treatment and can cause collateral tissue damage and side effects.  An overnight stay in the hospital is required for both.  A catheter is inserted in your urethra so that you can pee.  You have to go back to have it removed and they won't let you go until you can pee on your own after it's removed.

4) Surgery -- robotic or open.   Surgery provides the same potential for cure as radiation (CK, IMRT or BT) but which MUCH GREATER risks of side effects than any method of radiation.  Temporary ED and incontinence are common for anywhere from 3-12 months BUT also sometimes permanently, which would require the implantation of an AUS (artificial urinary sphincter) to control urination and a penile implant to simulate an erection to permit penetration (but would not restore ejaculative function).  Removal of the prostate by surgery will also cause a retraction of the penile shaft about 1-2" into the body  due to the remove of the prostate which sits between the interior end of the penis and the bladder.  Doctors almost NEVER tell prospective PCa surgical patients about this.  A urologist actually had the to nerve to tell me it didn't even happen when I asked about it.   Don't trust any urologist/surgeon who tells you otherwise.  Between open and robotic, open is much better in terms of avoiding unintended tissue cutting/damage and detection of the spread of the cancer.  Robotic requires much more skill and training to perform well; the more procedures a doctor has done the better but unintended injuries can still occur and cancer can be missed because the doctor has to look thru a camera to perform the surgery which obstructs his/her field of vision.

5) You may also want to consder active surveillance (AS), which is considered a form of treatment without actually treating the cancer.  You just have to get regular PSA testing (usually quarterly) and biopsies (every 1-2 years, I believe) and keep an eye out for any acceleration in the growth of the cancer.  Hopeful and Optimistic (who has already posted above) has already mentioned this and is your best source of info on this forum about it. 

I personally could not live w/the need to constantly monitor the cancer in my body.  Like most other men, I just wanted it delt with.  Some men gravitate to surgery for this reason, thinking that the only way to be rid of it is to cut it out, but I did not like the risks presents by surgery and opted for CK, which is a choice I have NEVER regretted.  I am cancer free, there is no indication of remission, there were no side effects and my quality of life was never adversely affected.  Other men on this forum have reported similiar results.

So, for obvious reasons, I highly recommend that you consder CK as your choice of treatment.  The choice seems obvious when you consider the alternatives but you'll have to decide that for yourself.

Good luck!

Hi,

The postive margin kind of bothers me, that usually means the cancer is right at the edge of the prostate tissue. You don't want the cancer to escape the prostate, it get's out it's much harder to treat/cure.  Check that out with your oncologist & urologist, more non invasive testing(MRI) would be worth the effort.  IMO if the PCa is right at the edge of the prostate I would not wait very long even if it is 3+3.  If the cancer is more in the center of the prostate then you have some time to study treatment plans.  Which ever treatment you decide on(radiation or surgery) get the best doctors at the best facilities you can find.  The latest technology along with a experienced oncologist & urologist(need to talk to both) will go a long way to getting you rid of the cancer.  Most the time if the cancer is within the prostate then either surgery or radiation will work, if outside the prostate then radiation/drugs might be a better solution.  The up front diagnostic work is invaluable in determining the agressiveness and location of the cancer so you have a clear direction for your treament.

Dave 3+4

Max Former Hodgkins Stage 3 said:

Support

I wish you'd supply some professional studies that support your claims her, PAD.  Not internet articles from some health food store, but professional, academically controlled studies. "Ancedotal" accounts, what happened to this one guy or that other one, are not scientific either.

I have had friends who left conventional treatments for natural/holistic, and every one of them died soon thereafter.  But I realize that that is ancedotal also.

max

 

Max, 

Reread my post.  I claim nothing, other than the facts of my personal situation, which is what I presumed was the purpose of having actual patients going through their cancer sagas post - to learn from their personal experiences.  We all have access to scientific/medical journals, and there are plenty that highlight diet and lifestyle impacts on cancer and cancer prevention.  I did think very carefully about how I worded my post.  Read it again.  I didn't post, "...internet articles from some health food store."  And I was very careful not to assert the abandonment of conventional treatment.  As far as understanding your position, copy, conventional good - unconventional bad=death, "...every one of them died soon thereafter."  That is a very powerful, anecdotal statement.  Actually, that is a very frightening assertion to make, especially to someone with a low grade cancer starting out on their journey.  Sorry, was new to the site, didn't understand how it worked.  Adios.

Max Former Hodgkins Stage 3 said:

Impression

TC,

While your Gleason and PSA are low, the one core at 90% involvement somewhat suggests the possibility (but not certitude) of significant volume (tumor size inside the gland). PCa biopsies are very much hit-or-miss affairs. Imaging, such as Vasco mentioned, is much needed in your case.  I had DaVinci robotic removal, but with your particulars (of which you don't really have enough yet), I would go with radiation therapy (RT).

You admirably mention that you have researched this "two days."  Good.  And it is good that you  found this site.  But the men who have been here 10 years or more (I am not one of them) are still learning new material every day.  Prostate Cancer treatment cannot be learned from Cliff Notes at Barnes and Noble; you will be learing a year from now, if you read every day.

My following statement is subjective and impressionistic:  PCa (Prostate Cancer) diagnosed at very young ages (like yours) TENDS to become more aggressive faster than when found at more conventional ages.  This MAY NOT be applicable to you.  The average age for diagnosis of PCa in the US today is 67 years of age.

Continue your study. Read the book your doctor provided to you.  Do not let a urological surgeon steer you to surgical removal without further imaging and meeting with at least one Radiation Oncologist, minimum.  Most important of all: AVOID THE INTERNET, except for university and premiere hospital sites.  There is a massive amount of nonsense on the internet: magical cures, reefer cures, sad idiocy for desperate individuals.  Use sites like Johns Hopkins Medical Center, MD Anderson CC, Sloan-Kettering, the Cleveland Clinic, etc.  American Cancer Society links are excellent.

 And know that very, very likely your disease is curable.

max

Wow, there are a whole lot of recommendations not backed up by specific scientific references here.  Be very careful, you may actually influence people searching for information to close their minds and go with your generic prescriptions.  

Hi,

Wish it would work, we would all be doing or have done it.  A good diet can  help your body fight any kind if disease or condition.  The human mind is a powerful tool to help in the fight also.  With all that said TC,  I doubt if you can reverse the cancer and make it dissapear just by eating a certain food(s) or chanting a certain hymn.  You do owe it to yourself to take some time and investigate all the treament methods, the people on this board can help with great ideas and resource links. Most if not all people who comment here have been there done that, a great source for you to pull on.

Well, time to go on with my day and hit submit.

Dave 3+4

JJMWFF1955 said:

Max it appears that you have been through it all and gained a lot of knowledge in the meantime.  I take it that you took Radiation treatment with HT

and so far you are staying healthy.  Do you have frequent urination problems? 

Also I wondered that after the treatment it seems like the totally rely on PSA test for reacurrance.  Do any of these Dr's ever do any Imaging scans along with the PSA or do they totally rely on PSA to see if cancer stays in check?

JJ,

Welcome to you.

Since you sort of asked, my medical trials have consisted mainly of being run over by a car in 1986, two years of rehab, Advanced Hodgkin's Lymphoma, and PCa, treated with RP (DaVinci).  I have not ever received therapeudic RT to date (for anything).  I do not now have urinary issues, but did prior to surgical removal; in fact, I had a lot of UT issues, too many to list at the moment.  I was subject to lifetime recurrent Prostatitis for decades, until the gland was cut out.  It was assumed that my problems were BPH/BEP until a urologist insisted on a biopsy.

MOST post-treatment assessment of cure is indeed via PSA testing, both for men who have had RP or some form of RT, or both.  The protocols are different as you may know:  post surgery, PSA should go to "undetectable" almost immediately (definitely within two months, unless HT at some point was employed) and stay there for life. Doctors know the threashold at which slight PSA traces indicate relapse.   After RT, PSA tracking is much more complex, but protocols are in place to know when or if there is relapse in most cases.  Guys must wait significant lengths of time (months or even years) to achive their 'nadir" and other monitoring points.  I am not criticizing RT, just pointing out that this is how the game is played.

In more serious cases or ambiguous cases, other monitoring techniques are employed, such as advance MRIs, bone scans, and others. I am not very conversant in these, but several of the guys here are.  These are usually, as I said, only necessary in cases suspicious or confirmed for metastasis, etc., combined with PSA.  But again, PSA is the core of virtually all post-treatment analysis.  I hope this helps a little.  Vasco is the "Master" of relapse analysis, and can from memory state the variables involved in any treatment, whether surgery, RT, or HT, or all of the above mixed together.  Several others are similiarly profound in knowledge, a  remarkable set of resources.  As I noted, scanning technologies and relapse analysis are not my "main things,"

max