Just Diagnosed with Prostate Cancer

Bill sorry that you have to go through this.  I would receommend that you continue to get as much information as you can. I would have John Hopkins review your biospy and provide you an additional pathology interpretation.  This is only $250 and should be cover by your insurance http://pathology.jhu.edu/ProstateCancer/NewGradingSystem.cfm Also you can use those biospy slides for genetic testing. I would recommend at least a TPEN test as that will let you know if you have an agressive cancer.   I used a couple of tests and both were covered by insurance. As was a T3MRI to find locate and rate the tumor.   Now there is a broadspectrum test for more targeted treatment for advance cancers However you won't need this right now, but just so you know.  In 2018, a new genetically based drug was approved by the U.S. Food and Drug Administration to fight cancer: Vitrakvi, a medication for adults and children whose cancers have a genetic mutation called TRK fusion. Also late last year, Keytruda, an immunotherapy drug, received expanded approval by the FDA to fight malignancies that bear a specific genetic signature. Oncologists will have to know the genetic makeup of a tumor to prescribe these drugs, but only 12 percent of patients with late-stage metastatic cancer are getting the tests, according to a report on the genetic testing company, Foundation Medicine, in the MIT technology review. Also pick up a copy of The Key To Prostate Cancer https://www.amazon.com/Key-Prostate-Cancer-Experts-Explain/dp/0999065211 Even if you have an advance form of PC it is much better to take some time now to understand what your best treatment options might be. Good Luck!

I know your emotions are all over the place right now.  Breath, start your research to find the best prostate cancer treatment centers.  My husband was diagnosed fall of 2017.  Initially Gleason 7.  But additional testing from John's Hopkins, Memorial Sloan Kettering, and Mayo upgraded to a Gleason 9.   His was caught early - with no involvement outside the prostate or lymph nodes.

After research, our decision was to go to Memorial Sloan Kettering in NYC (We live in the SE).  Dr. Behfar Edhaie was my husband's surgeon/oncologist.  At MSK,  had access to bladder specialist and ED specialist both pre and post surgery.   Robotic,  nerve sparing surgery was done 1/31/18 to remove the prostate, lymph nodes, bladder neck reconstruction, etc. 

My husband is doing great - he's cancer free!  Incontinence issues were temporary.  He walks 5-7 miles daily, weights 3 days a week, rowing, back to riding a bike now.  Super active.  ED issues - he's fine now.  As his doctor said, it's a process after surgery that takes patience and time for healing. 

Read my one year story I wrote a few days ago.

Do you research, talk with multiple high volume prostate cancer treatment centers.  Look at their protocols for pre and post surgery. 

Also, start walking every day - get healthy/in shape now - best physical shape of your life.  Not only will it increase blood flow to the areas you need pre-surgery, it will ease your mind.  Also, another word of advice - keep you loved ones close.  Include them in your conversations - your lows and your highs.  I don't think I've ever mentioned this online, but my  husband starting writing letters to me some daily/some weekly.  These letters expressed his feelings and gave him an outlet.  It gave me a new perspective too.  We both started walking together to get him in shape - he's lost 60 pounds/i lost 20 pounds.  But mostly it brought us closer together on an emotional level too.

Keep the faith.  Stay focused on getting healthy and getting your body and mind ready to fight!

Bill,

I read your other thread but I will comment here in your initial thread as it got more of your story. You have inquired about the differences between chemo and radiation, and Max gave you a good opinion that "Radiation is potentially curative against PCa ... ... Chemotherapy is not curative against PCa, and is mostly used against it as a palliative treatment".

However, you also describe in the other thread that your doctor told you;

" ...  he felt it was wise to go ahead (with surgery) and remove the nerves as well.  Also, probably to do radiation, but would know more once he does the surgery. I know this is just the beginning, but I felt much better know that it has not spread (for the negative CT and MRI results). He felt we caught if very early."

In such regard I wonder what another urologist and/or radiotherapist would suggest to you. In my opinion your doctor's comments tells me that he is not sure that surgery is your best choice, so that he recommends his trade as a surgeon. This is in fact typical of urologists in recommending surgery as much as radiotherapists recommend radiation. We the patients are the ones to decide on an option which should be done consulting various specialists. Remember that whatever you chose you will have to sign an agreement before the intervention, relieving the doctor from any wrong result from the choice one made.

Surgery is preferred when the cancer is whole contained or when the case shows to be much aggressive so that one tries to remove the bigger tumor (the whole gland) that is followed by adjuvant radiation plus ADT (Max's comment in your other thread). In your shoes I would request from your doctor a clinical stage with more precise information now not as vague as he comments in "... would know more once he does the surgery..." 

Treatments all have side effects prejudicing the quality of life of the patient forever. One should be wise and do the less harm possible. Your case may be proper for radiation alone, avoiding the risks from surgery. I would get second opinions and better exams before deciding.

Best wishes and luck in this journey.

VGama