Gleason score of 9

Can you tell us what his PSA score is?  Your surgeon gave you excellent advise about going to a cancer center, and Sloan Kettering is one of the best.  It is entirely possible to have an aggressive cancer that is still confined to the prostate, and therefore treatable and possibly curable.  And even if it has escaped the prostate but is still localized, it may be curable with radiation.  The important thing is not to get ahead of yourself with worry.  The scans will provide useful information to help you in treatment choice.  Stay positive and see what Sloan has to say.

Eric

Hi there,

That sounds a bit nasty but PSA scores are only indicative, they do not relate that well to what the cancer is really doing.
You need to wait to see the scans to find out what you are dealing with.

Best wishes,

Georges

My husband's surgery was 1/31/18.  Fast forward to a year later, and he is doing fantastic!  Cancer Free.  Best physical shape of his life.  Full recovery with very minimal side affects that I feel really aren't side affects!   It's amazing to look back at the journey we've been on.  I am hopeful this story will help anyone new to this board to see that positive outcomes are achievable and realistic with prostate cancer.  Don't be discouraged.  Do your research. Don't be intimidated by the big hospitals/cancer centers that can provide world leading care.  

To bring everyone up to date:

My husband's father was diagnosed with prostate cancer over 26 years ago.  Therefore, my husband has been tested yearly since age 40.  Around age 52, his PSA started a slow elevation. His urologist was concerned once his numbers got above 4, and pushed for a biopsy.   In lieu of having the "big" biopsy, he chose to have Dr. Joseph Busch do several MRI's, and two MRI guided biopsies - Active Surveillance.  All showed nothing of concern. We trusted Dr. Busch to find the cancer - his reputation is stellar.  Over 2 years his PSA rose from 4.2 to 7.9.  (FYI -PSA results -  1/12/15 - 4.2; 02/03/15 - 6.0; 11/18/15 - 6.066; 06/30/16 - 6.4; 01/19/17 - 4.3; 04/27/17 - 7.86; 08/04/17 - 7.9; 08/25/17 - 7.79 - just wanted to show that his results did fluctuate up and down)  The last MRI still led to " inflammation.  My husband's local urologist pushed, and pushed, and pushed until my husband met with the oncologists in his group to do further testing - genetic testing, 4Kscore, various antibodie testing. The 4Kscore showd 92% probability that patient will not have aggressive disease on a prostate biopsy, and scored 8% which led to recommedation of a full prostate biopsy . His urologist pushed and pushed (we were about to leave the practice because of his worry wort attitude), and Jim decided to have the full biopsy to get the doctors off his back - thinking it will show nothing. 

10/13/17 - Friday the 13th - he had the big biopsy.  12 of the 14 biopsies were negative.  2 were positive.  Original grading was 3+3 and 4+3. Never forget that day.  Research after research led to a visit to Dr. Behfar Edhaie at Memorial Sloan Kettering to see if he qualified for an Ablation Study. We initially met with him first week of November.   He also applied to Mayo.  He was accepted in to both.  We also reached out to Futterer Jurgen at Radboud University Nijmegan Netherlands for ablation therapy as well, and was accepted.  We knew we would not stay local for surgery - too much to risk on side affects from surgery at 56 years old. 

Due to my husband's father having barbaric surgery over 26 years ago, he was beyond devasted at the thought of a prostatectomy.  He knew first hand the side affects his dad has endured since surgery.  So, ablation therapy was the way he wanted to go.  Memorial Sloan Kettering wanted to run Jim's biopsies through their pathology department.  We decided to have Dr. Epstein at Johns Hopkins do the same.  With enough left over, same with Dr. David Woodrum at Mayo.

Another blow came with all 3 coming back with a diagnosis of Gleason 9.  Apparently, the local oncologist hit gold with his biopsy by hitting this Gleason 9 at early cellular level.    I cringe to think if he had not "hit the right spot" - where we have been in another year or two?  We are beyond thankful for the worry wart urologist that I feel saved my husband's life!   Wtih this diagnosis, my husband hit rock bottom.  He had listened to Dr. Busch discuss prostate cancer for over 3 years during active surveillance.  Gleason score of 9 is not what you want with prostate cancer.  We both knew this was serious. 

So, this threw my husband out of the ablation studies, although Dr. Futterer stated he could still do ablation with removing the majority of the prostate but save all of the nerve bundle.

Dr. Behfar Edhaie at Memorial Sloan Kettering talked at length with my husband.  My husband felt confident with his surgical techiques for nerve sparing robotic removal of the prostate.  He did research on number of procedures, outcomes, etc.  Plus Dr. Edhaie is one of the highest funded research oncologists  - he eats, breathes, and sleeps on ways to improve techiques/cures.  So, we opted to go with the removal of the prostate via robotic surgery.  This led to meeting with other specialists at Memorial Sloan Kettering.  Bladder specialist, Dr. Jaspreet Sandhu,  to talk to Jim about incontinence issues and how to overcome post surgry.  I cannot stress enough about going to physical therapy PRE-surgery and POST surgery.  We met with Dr. John Mulhall - probably the worlds leading authority oncologist specializing in ED.  Started therapy pre-surgery to help increase blood flow to the area, and build up muscle.  The doctors will prepare you for the worst - so there were mind games to get over after meeting with those two specialists.  But the advice and protocols they started prepared his body for surgery. 

On 1/30/2018, my husband had an 8 HOUR surgery to remove all lymph nodes, prostate, seminal vessels, etc.  Dr. Edhaie took his time to go ml by ml to preserve the nerve bundles and make sure all of the areas surrounding the prostate were "clean".   I left Jim at 11:45 am, and did not see him until midnight. Longest day of my life ever - especially being alone in NYC away from family and friends.  All of the intial pathology came back great.  Nothing had breached outside the prostate.  Initial lymph nodes were clean.  Bladder clean.  Seminal vessel clean. Post surgery he was downgraded to a Gleason 7 which was our hope. 

We spent 10 days at the Hope Lodge in NYC. This is the American Cancer Society's hotel that will provide free lodging to cancer patients.  What a Godsend for sure.

He was discharged around 10:00 that morning after surgery - so less than 24 hours. (MSK's surgery center is state of the art.  Beautiful facility.)  It was an effort to get him comfortable post surgery, but it was bearable.  The catheter was his main enemy.  He hated it.  We did venture outside to the streets of NYC with his leg catheter, but he did the majority of his walking in the halls of the hotel.  His catheter came out on day 7 after begging the doctors to take it out.  We flew home on day 10.  

He was able to walk 3 miles around the surgery halls two hours after coming out of recovery.  Walking helped with the pain from the gas they use during surgery.  Day 3-Day 4 are the worst for pain.  Then after that, so much better.  But walking is key to alleviate pain - even with the catheter.

As a note, his surgeon does not rush in to surgery.  It takes your body/nerves 3 full months to recover from a biopsy.  In order to have the best possible results from nerve sparing techniques, you have to prepare the body.  He had to lose weight, get in the best physical shape of his life, and change bad habits to good habits.  He lost 40 lbs. pre surgery.  He's at 70 pounds down now.  We exercised 7 days a week together pre-surgery.   This helped him so much with recovery.  And this mindset continues today - he still works out 7 days a week. 

It was an awful mind game to wait almost 4 months for surgery.  He had a bone scan in between to alleviate his mind the month before surgery. This helped to get him through the holidays and final weeks before surgery. 

My husband has exceeded all timelines on recovery.  He went back to work 1/2 days day 11 and 12.  He could drive once the catheter came out.  He could exercise with weight limits right after surgery.  They approved elliptical machine without arm movement 2nd week.  He attended a board meeting the week after, attended my daughter's volleyball tournament 2nd week out of state.  Started traveling again for work.   Less than 4 months post surgery, we were walking miles through 8 different countries in Europe without panicking looking for bathrooms, etc.    Looking back, it's amazing how well he did immediately after surgery.  The first 3 months - it was a slow process but physical therapy 3-4 times a week gave him goals to work on, encouragement, and steady improvement on incontinence.   We learned what products to use during the temporary incontinence (TENA Mens brands - online only) , as well as most comfortable boxer jocks to wear.  That was a change for him, and he hated it, but I found some brand that he absolutely loves and will keep on using now.  Under Armour and Duluth Trading Company. 

He is dry now except when he lifts weights so he wears a very light pad when working out with weights.  ED issues - there are none - everything works fine!

I am so proud of my husband's determination and strong will over the past year to beat the odds against prostate cancer as well as the post surgery side affects.  Granted, this personality made it difficult to handle the lows of the journey but it also made him work harder to achieve every goal set. 

I just found this group tonoght My husband is 65 He is diagnosed with prostate cancer that has spread to his bones and pelvis as well His PSA is 23 He had biopsy in April along with bone scan and MRI He had a pain pump unplanted 2 weeks ago to control pain as Oxycotin was not helping He recently had a  3 injections at cancer center I do not have the names with me but I know after a month he is going to start Fermagon?? He started taking chemo pills last Thursday Aeateda?? I will get correct names and post again later As you can tell I am VERY new and do not know what questions I should be asking His next appoint ment is May 7 Please let me know what I should be asking His Gleason is 9 Please I need all the advice I can get to help my husband live a normal life as possible Thank you