just diagnosed Gleason

hunter49
hunter49 Member Posts: 210
I was diagnosed Friday and net with urologist today. My gleason is a 3+4 and only one core (95%) involved out of 15 samples. The tumor is a T-1C. Doctor said only 2 real options surgery or pinpoint radiation. Any advice? Thanks.

Comments

  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,333 Member
    3+4=7
    is an intermediate stage cancer. You are too young to consider active surveiillance. You need to take some time to make the right decision for you.

    As I had mentioned. You need to get a second opinion on the pathology so that you are not under or over treated.

    I suggest that you consider having an MRI with a spectroscopy, as I had discussed, to determine if there is extracapular extension. If so, surgery will not be a option since you would still have to have treatment by another method.

    There are world class surgeons and hospitals in NYC. What institution is your current urologist affiliated with?
  • Old-timer
    Old-timer Member Posts: 196
    Take time to study and consider your options
    Your numbers are low enough that you can take time to study available treatments and to make a choice that you decide is best for you. Based on my 20-year experience with prostate cancer and extensive study of this topic, I do not personally believe that any one treatment stands out as BEST. They all seem to have advantages and short comings. None are successful in all cases; none are failures in all cases. No one size fits all. What one can do is collect as much reliable data as possible, consult appropriate family members and friends, get recommendations from experts you trust, reach a decision, and go with it. It’s a bit like playing poker. You study the situation, decide when and how much to bet, and hope for good luck.

    Except for a significant age difference, your numbers and mine are very close to the same. My PSA was 4.0 and Gleason score was 7 (3+4) when I was diagnosed with prostate cancer in 1991 at age 64. I waited three months before beginning treatment. At that time the only choices were surgery, radiation, and watchful waiting. I chose surgery, which was successful for 13 years. The cancer returned in 2004, I had radiation (2005), which was unsuccessful; it did not change the PSA. I began hormone therapy in 2008. The cancer is now in remission and has been for three years.

    In my judgment, because of your low scores, you need not rush a decision. Relax, if possible, while you take a close look at what is happening.

    Consider your age as you make a decision. Although I was much older than you when my pc journey began, I have always took this factor into account as I have made decisions. By the way, I give my wife and family a voice in my deliberations. I have been married 62 years. Life continues to be good.

    Best wishes to you.
  • hunter49
    hunter49 Member Posts: 210
    Old-timer said:

    Take time to study and consider your options
    Your numbers are low enough that you can take time to study available treatments and to make a choice that you decide is best for you. Based on my 20-year experience with prostate cancer and extensive study of this topic, I do not personally believe that any one treatment stands out as BEST. They all seem to have advantages and short comings. None are successful in all cases; none are failures in all cases. No one size fits all. What one can do is collect as much reliable data as possible, consult appropriate family members and friends, get recommendations from experts you trust, reach a decision, and go with it. It’s a bit like playing poker. You study the situation, decide when and how much to bet, and hope for good luck.

    Except for a significant age difference, your numbers and mine are very close to the same. My PSA was 4.0 and Gleason score was 7 (3+4) when I was diagnosed with prostate cancer in 1991 at age 64. I waited three months before beginning treatment. At that time the only choices were surgery, radiation, and watchful waiting. I chose surgery, which was successful for 13 years. The cancer returned in 2004, I had radiation (2005), which was unsuccessful; it did not change the PSA. I began hormone therapy in 2008. The cancer is now in remission and has been for three years.

    In my judgment, because of your low scores, you need not rush a decision. Relax, if possible, while you take a close look at what is happening.

    Consider your age as you make a decision. Although I was much older than you when my pc journey began, I have always took this factor into account as I have made decisions. By the way, I give my wife and family a voice in my deliberations. I have been married 62 years. Life continues to be good.

    Best wishes to you.

    Thanks I go for scans on
    Thanks I go for scans on Wedenesday hope all clear. Doctor does not feel any reason they should not be. I will look into it.
  • hunter49
    hunter49 Member Posts: 210

    3+4=7
    is an intermediate stage cancer. You are too young to consider active surveiillance. You need to take some time to make the right decision for you.

    As I had mentioned. You need to get a second opinion on the pathology so that you are not under or over treated.

    I suggest that you consider having an MRI with a spectroscopy, as I had discussed, to determine if there is extracapular extension. If so, surgery will not be a option since you would still have to have treatment by another method.

    There are world class surgeons and hospitals in NYC. What institution is your current urologist affiliated with?

    I am going for scans
    I am going for scans wednesday I have not choosen a surgeaon yet my go to SLoan or LIJ I have contatcs there but the one who will diagnosed me is out of Hackensack, NJ. He does not operate anymore.
  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,333 Member
    hunter49 said:

    I am going for scans
    I am going for scans wednesday I have not choosen a surgeaon yet my go to SLoan or LIJ I have contatcs there but the one who will diagnosed me is out of Hackensack, NJ. He does not operate anymore.

    scans
    are you talking about an MRI ......does hackensack hospital have a tesla 3.0 magnate....there is a difference between MRI machines.......are you also going to have a spectroscopy along with the MRI.

    By the way, a lot of time surgeons like to have tests done at their own hospital,,,,,they have confidenece in the skills and equipment.

    As you know there are major medical centers of excellence in NYC
  • mattmans5
    mattmans5 Member Posts: 70
    hunter49 said:

    I am going for scans
    I am going for scans wednesday I have not choosen a surgeaon yet my go to SLoan or LIJ I have contatcs there but the one who will diagnosed me is out of Hackensack, NJ. He does not operate anymore.

    going for scans


    Hi , I was operated on by Dr James Eastham at memorial Sloan Ketering ,

    I found if you go that route it you might think of seeing a urologist there , it will speed up the process of seeing a surgeon from Sloan
  • hunter49
    hunter49 Member Posts: 210

    scans
    are you talking about an MRI ......does hackensack hospital have a tesla 3.0 magnate....there is a difference between MRI machines.......are you also going to have a spectroscopy along with the MRI.

    By the way, a lot of time surgeons like to have tests done at their own hospital,,,,,they have confidenece in the skills and equipment.

    As you know there are major medical centers of excellence in NYC

    I am not having an MRI but a
    I am not having an MRI but a CAT sceen with and without contrast and a bone scan using radio isatopes. If I do a surgery I most likely using Felix Badill at St. Francis in LI. He is also affiliated with LIJ and done over a thousand surgeries using the robot method.
  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,333 Member
    hunter49 said:

    I am not having an MRI but a
    I am not having an MRI but a CAT sceen with and without contrast and a bone scan using radio isatopes. If I do a surgery I most likely using Felix Badill at St. Francis in LI. He is also affiliated with LIJ and done over a thousand surgeries using the robot method.

    no , maybe
    The CT Scan is an innacurate test, not appropriate for early diagnosed.



    It is highly unlikely that the bone scan will be positive. The American Urological Society does not recommend a bone scan for gleason under 8 or PSA under 10. Let it be known that this test however is a very popular test, and a money maker.

    If you are considering surgery, ask the surgeon for the appropriate test at his or her hospital.
  • Noniu
    Noniu Member Posts: 45
    hunter49 said:

    I am going for scans
    I am going for scans wednesday I have not choosen a surgeaon yet my go to SLoan or LIJ I have contatcs there but the one who will diagnosed me is out of Hackensack, NJ. He does not operate anymore.

    My Dad Oncologist is at Hackensack Hospital
    Hunter,

    I am very sorry to hear you have been diagnosed with PC. My dad was diagnosed when he was 71 years old, 10 years ago. At that time he was recommended seed implant, it worked for a while. In 2009 his PSA level started to rise, CT Scan seemed clear, but the cancer was there. At present, his cancer is very advanced, he cannot walk, lots pain and refuses Chemo. He has been approved for Zytiga(Abiraterone), a medication for advanced prostate cancer with mets. My dad's Oncologist is from John Theurer Cancer Cneter, Hackensack Hospital,NJ. We are very pleased with Dr. Alter. Today, he has an appt. for CT Scans and MRI's at the hospital.

    You are young and on an early stage, there many options for you, just research, you will find the one that would be best for you. Good luck!

    Noniu
  • Noniu
    Noniu Member Posts: 45
    hunter49 said:

    I am going for scans
    I am going for scans wednesday I have not choosen a surgeaon yet my go to SLoan or LIJ I have contatcs there but the one who will diagnosed me is out of Hackensack, NJ. He does not operate anymore.

    My Dad Oncologist is at Hackensack Hospital
    Hunter,

    I am very sorry to hear you have been diagnosed with PC. My dad was diagnosed when he was 71 years old, 10 years ago. At that time he was recommended seed implant, it worked for a while. In 2009 his PSA level started to rise, CT Scan seemed clear, but the cancer was there. At present, his cancer is very advanced, he cannot walk, lots pain and refuses Chemo. He has been approved for Zytiga(Abiraterone), a medication for advanced prostate cancer with mets. My dad's Oncologist is from John Theurer Cancer Cneter, Hackensack Hospital,NJ. We are very pleased with Dr. Alter. Today, he has an appt. for CT Scans and MRI's at the hospital.

    You are young and on an early stage, there many options for you, just research, you will find the one that would be best for you. Good luck!

    Noniu
  • Noniu
    Noniu Member Posts: 45
    hunter49 said:

    I am going for scans
    I am going for scans wednesday I have not choosen a surgeaon yet my go to SLoan or LIJ I have contatcs there but the one who will diagnosed me is out of Hackensack, NJ. He does not operate anymore.

    My Dad's Oncologist is at Hackensack Hospital
    Hunter,

    I am very sorry to hear you have been diagnosed with PC. My dad was diagnosed when he was 71 years old, 10 years ago. At that time he was recommended seed implant, it worked for a while. In 2009 his PSA level started to rise, CT Scan seemed clear, but the cancer was there. At present, his cancer is very advanced, he cannot walk, lots pain and refuses Chemo. He has been approved for Zytiga(Abiraterone), a medication for advanced prostate cancer with mets. My dad's Oncologist is from John Theurer Cancer Cneter, Hackensack Hospital,NJ. We are very pleased with Dr. Alter. Today, he has an appt. for CT Scans and MRI's at the hospital.

    You are young and on an early stage, there many options for you, just research, you will find the one that would be best for you. Good luck!

    Noniu
  • Noniu
    Noniu Member Posts: 45
    hunter49 said:

    I am going for scans
    I am going for scans wednesday I have not choosen a surgeaon yet my go to SLoan or LIJ I have contatcs there but the one who will diagnosed me is out of Hackensack, NJ. He does not operate anymore.

    My Dad's Oncologist is at Hackensack Hospital
    Hunter,

    I am very sorry to hear you have been diagnosed with PC. My dad was diagnosed when he was 71 years old, 10 years ago. At that time he was recommended seed implant, it worked for a while. In 2009 his PSA level started to rise, CT Scan seemed clear, but the cancer was there. At present, his cancer is very advanced, he cannot walk, lots pain and refuses Chemo. He has been approved for Zytiga(Abiraterone), a medication for advanced prostate cancer with mets. My dad's Oncologist is from John Theurer Cancer Cneter, Hackensack Hospital,NJ. We are very pleased with Dr. Alter. Today, he has an appt. for CT Scans and MRI's at the hospital.

    You are young and on an early stage, there many options for you, just research, you will find the one that would be best for you. Good luck!

    Noniu
  • Noniu
    Noniu Member Posts: 45
    hunter49 said:

    I am going for scans
    I am going for scans wednesday I have not choosen a surgeaon yet my go to SLoan or LIJ I have contatcs there but the one who will diagnosed me is out of Hackensack, NJ. He does not operate anymore.

    My Dad's Oncologist is at Hackensack Hospital
    Hunter,

    I am very sorry to hear you have been diagnosed with PC. My dad was diagnosed when he was 71 years old, 10 years ago. At that time he was recommended seed implant, it worked for a while. In 2009 his PSA level started to rise, CT Scan seemed clear, but the cancer was there. At present, his cancer is very advanced, he cannot walk, lots pain and refuses Chemo. He has been approved for Zytiga(Abiraterone), a medication for advanced prostate cancer with mets. My dad's Oncologist is from John Theurer Cancer Cneter, Hackensack Hospital,NJ. We are very pleased with Dr. Alter. Today, he has an appt. for CT Scans and MRI's at the hospital.

    You are young and on an early stage, there many options for you, just research, you will find the one that would be best for you. Good luck!

    Noniu
  • Noniu
    Noniu Member Posts: 45
    hunter49 said:

    I am going for scans
    I am going for scans wednesday I have not choosen a surgeaon yet my go to SLoan or LIJ I have contatcs there but the one who will diagnosed me is out of Hackensack, NJ. He does not operate anymore.

    My Dad's Oncologist is at Hackensack Hospital
    Hunter,

    I am very sorry to hear you have been diagnosed with PC. My dad was diagnosed when he was 71 years old, 10 years ago. At that time he was recommended seed implant, it worked for a while. In 2009 his PSA level started to rise, CT Scan seemed clear, but the cancer was there. At present, his cancer is very advanced, he cannot walk, lots pain and refuses Chemo. He has been approved for Zytiga(Abiraterone), a medication for advanced prostate cancer with mets. My dad's Oncologist is from John Theurer Cancer Cneter, Hackensack Hospital,NJ. We are very pleased with Dr. Alter. Today, he has an appt. for CT Scans and MRI's at the hospital.

    You are young and on an early stage, there many options for you, just research, you will find the one that would be best for you. Good luck!

    Noniu
  • Noniu
    Noniu Member Posts: 45
    hunter49 said:

    I am going for scans
    I am going for scans wednesday I have not choosen a surgeaon yet my go to SLoan or LIJ I have contatcs there but the one who will diagnosed me is out of Hackensack, NJ. He does not operate anymore.

    My Dad's Oncologist is at Hackensack Hospital
    Hunter,

    I am very sorry to hear you have been diagnosed with PC. My dad was diagnosed when he was 71 years old, 10 years ago. At that time he was recommended seed implant, it worked for a while. In 2009 his PSA level started to rise, CT Scan seemed clear, but the cancer was there. At present, his cancer is very advanced, he cannot walk, lots pain and refuses Chemo. He has been approved for Zytiga(Abiraterone), a medication for advanced prostate cancer with mets. My dad's Oncologist is from John Theurer Cancer Cneter, Hackensack Hospital,NJ. We are very pleased with Dr. Alter. Today, he has an appt. for CT Scans and MRI's at the hospital.

    You are young and on an early stage, there many options for you, just research, you will find the one that would be best for you. Good luck!

    Noniu
  • Noniu
    Noniu Member Posts: 45
    hunter49 said:

    I am going for scans
    I am going for scans wednesday I have not choosen a surgeaon yet my go to SLoan or LIJ I have contatcs there but the one who will diagnosed me is out of Hackensack, NJ. He does not operate anymore.

    My Dad's Oncologist is at Hackensack Hospital
    Hunter,

    I am very sorry to hear you have been diagnosed with PC. My dad was diagnosed when he was 71 years old, 10 years ago. At that time he was recommended seed implant, it worked for a while. In 2009 his PSA level started to rise, CT Scan seemed clear, but the cancer was there. At present, his cancer is very advanced, he cannot walk, lots pain and refuses Chemo. He has been approved for Zytiga(Abiraterone), a medication for advanced prostate cancer with mets. My dad's Oncologist is from John Theurer Cancer Cneter, Hackensack Hospital,NJ. We are very pleased with Dr. Alter. Today, he has an appt. for CT Scans and MRI's at the hospital.

    You are young and on an early stage, there many options for you, just research, you will find the one that would be best for you. Good luck!

    Noniu
  • Noniu
    Noniu Member Posts: 45
    hunter49 said:

    I am going for scans
    I am going for scans wednesday I have not choosen a surgeaon yet my go to SLoan or LIJ I have contatcs there but the one who will diagnosed me is out of Hackensack, NJ. He does not operate anymore.

    My Dad's Oncologist is at Hackensack Hospital
    Hunter,

    I am very sorry to hear you have been diagnosed with PC. My dad was diagnosed when he was 71 years old, 10 years ago. At that time he was recommended seed implant, it worked for a while. In 2009 his PSA level started to rise, CT Scan seemed clear, but the cancer was there. At present, his cancer is very advanced, he cannot walk, lots pain and refuses Chemo. He has been approved for Zytiga(Abiraterone), a medication for advanced prostate cancer with mets. My dad's Oncologist is from John Theurer Cancer Cneter, Hackensack Hospital,NJ. We are very pleased with Dr. Alter. Today, he has an appt. for CT Scans and MRI's at the hospital.

    You are young and on an early stage, there many options for you, just research, you will find the one that would be best for you. Good luck!

    Noniu
  • Noniu
    Noniu Member Posts: 45
    hunter49 said:

    I am going for scans
    I am going for scans wednesday I have not choosen a surgeaon yet my go to SLoan or LIJ I have contatcs there but the one who will diagnosed me is out of Hackensack, NJ. He does not operate anymore.

    My Dad's Oncologist is at Hackensack Hospital
    Hunter,

    I am very sorry to hear you have been diagnosed with PC. My dad was diagnosed when he was 71 years old, 10 years ago. At that time he was recommended seed implant, it worked for a while. In 2009 his PSA level started to rise, CT Scan seemed clear, but the cancer was there. At present, his cancer is very advanced, he cannot walk, lots pain and refuses Chemo. He has been approved for Zytiga(Abiraterone), a medication for advanced prostate cancer with mets. My dad's Oncologist is from John Theurer Cancer Cneter, Hackensack Hospital,NJ. We are very pleased with Dr. Alter. Today, he has an appt. for CT Scans and MRI's at the hospital.

    You are young and on an early stage, there many options for you, just research, you will find the one that would be best for you. Good luck!

    Noniu