Cant make decision

Hi, im a 46 year old husband and father.  My wife "made" me go to the Doctor mid 2011 as I was experiencing "hestation".  Doc completed PSA test and it came back at 4.1.  It was decided I would be monitored and completed blood tests every three months.  PSA continued to rise very slowly until August 2012 when it came back at 6.6.  Was sent to a Urologist and biopsy completed.  Results came back showing 5/7 cores on one side 10%) and 3/6 on the other (5%), Gleason score 6 (3+3), volume 38cc.  Have spoken to surgeon who recommended RP but am not keen on the side effects at my age.  Radiologist recommends radiotherapthy which sounds like the more attractive option.  Repeat blood test completed late Dec 2012 and we got the results back on 31 Dec 2012.  PSA has now risen to 10.5.  My uncle and brother also have Prostate Cancer.  My father died of a heart attack at 47 years so am unsure if he had it also.  We are very confused as to what this all means.  They say the cancer is "low risk" given the Gleason Score but the PSA seems to be rising fast - has gone from 4.4 to 10.5 in six months.  Does anyone have any idea of the best option for me?  If we choose surgery we are not able to have this until approx April 2013 due to waitlists in the public system and we do not have private medical insurance. Unfortunately we are unable to speak to anyone here at the moment as it services are closed for the holidays.

Thanks in anicipation

Nev and family

Comments

  • Samsungtech1
    Samsungtech1 Member Posts: 351
    Choices

    Sorry about your diagnosis.  At your age I would say Radiotheraphy.  Your PSA is worrisome.  It is rising really fast.  Have they done a CT scan on you, or an MRI?   You have a low Gleason, but you need to ensure it has not spread.  Your family historywould give you an idea.  How agressive is it with them?  Everyone is different, and lifestyles make a difference but they should give you an idea.  

     

    Good luck,

     

    Mike

  • laserlight
    laserlight Member Posts: 165
    Nev, PSA

    The psa rising is not good, but you have already confirmed that you have Prostate cancer. Your PSA score is an indicator that something is going on and it needs to be watched. The item to keep in mind now is the treatment options avail to you. I donot think that any body here is qualified to recomend a treatment option for you.

    I would start to look into treatment options and the side effects.

    Cancer treatment is a personal decision. The doctors can only describe the various treatment, but in the end it is your decision.

     keep in mind  you have cancer and it needs to be treated.  Good Luck

     

    Kurt

     

  • VascodaGama
    VascodaGama Member Posts: 3,495 Member

    Nev, PSA

    The psa rising is not good, but you have already confirmed that you have Prostate cancer. Your PSA score is an indicator that something is going on and it needs to be watched. The item to keep in mind now is the treatment options avail to you. I donot think that any body here is qualified to recomend a treatment option for you.

    I would start to look into treatment options and the side effects.

    Cancer treatment is a personal decision. The doctors can only describe the various treatment, but in the end it is your decision.

     keep in mind  you have cancer and it needs to be treated.  Good Luck

     

    Kurt

     

    Image Studies

     

    Nev Family

     

    Welcome to the board. I am sorry for your diagnosis at such young age. Making a decision is difficult and one needs to consider the many "parameters" of his own life. All discussions should involve the family and you may need to check about your financial and economic affairs the fact may bring into your home.

     

    In any case you need to "knock down" the bandit but even with a steep rise in PSA you got time to check details of treatments and their side effects, which should include the possibility of waiting until April. Do not look for a "quick fix". There is not simple answer to your question. You need to write down all the risks that each type of treatment entails and decide what is best or acceptable to you and your family.

    Radical treatments are the ones that can provide cure if the cancer is contained. In cases of extra capsular extensions radiation modalities got better chances than surgery to provide successful outcomes.

     

    A proper diagnosis does make it a difference when deciding on the treatment. Many guys get second opinions on their results (biopsy included) and try to locate the cancer with high standards/resolution machines/modalities of image studies. The traditional equipments give many false negatives which could erroneously diagnose a case as contained.

    I would suggest you to search for information on image studies using the contrast agent C11 acetate and F18 (PET/CT). These agents seem to give better results to identify metastases.

     

    Both radicals; surgery and radiotherapy are good choices in contained cases. Radiation sometimes become the choice to many that are afraid of ED (erection dysfunction) and incontinence, whose side effects are typically associated with surgery. However, radiation can cause those outcomes too but less frequent. There are also the many that decide on surgery because of the possibility of having salvage radiotherapy in case of failure of the first attempt. They base this fact as important because salvage radiation is not recommended to be done to the previous radiated areas (tissues would not resist to rad on top of rad).

     

    It is therefore important to look for apparent metastases before deciding on a treatment. In positive cases of metastases, the isodose planning for a radiation attack would differ from that of a contained case (it would include areas of probable metastases) and such would avoid repeated treatment (radiation) at the same areas.

     

    I recommend you to get a copy of this book that may help you to understand details of the radicals;

     

    “Guide to Surviving Prostate Cancer” by Dr. Patrick Walsh (third edition);

     

    I also recommend you to look for specialists with loads of experience in their field. Outcomes differ much according to the experience of physicians and modernity of facilities.

     

    You could try to get an insurance now that may cover some of the expenses with testing, etc., even if that is late for covering the treatment performance.

     

    You are not the first young "member" joining our boat. Guys here will not leave you alone without an answer to your queries.

     

    Wishing you find peace of mind.

     

    Hope for the best.

     

    VGama

     

  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,333 Member

    Image Studies

     

    Nev Family

     

    Welcome to the board. I am sorry for your diagnosis at such young age. Making a decision is difficult and one needs to consider the many "parameters" of his own life. All discussions should involve the family and you may need to check about your financial and economic affairs the fact may bring into your home.

     

    In any case you need to "knock down" the bandit but even with a steep rise in PSA you got time to check details of treatments and their side effects, which should include the possibility of waiting until April. Do not look for a "quick fix". There is not simple answer to your question. You need to write down all the risks that each type of treatment entails and decide what is best or acceptable to you and your family.

    Radical treatments are the ones that can provide cure if the cancer is contained. In cases of extra capsular extensions radiation modalities got better chances than surgery to provide successful outcomes.

     

    A proper diagnosis does make it a difference when deciding on the treatment. Many guys get second opinions on their results (biopsy included) and try to locate the cancer with high standards/resolution machines/modalities of image studies. The traditional equipments give many false negatives which could erroneously diagnose a case as contained.

    I would suggest you to search for information on image studies using the contrast agent C11 acetate and F18 (PET/CT). These agents seem to give better results to identify metastases.

     

    Both radicals; surgery and radiotherapy are good choices in contained cases. Radiation sometimes become the choice to many that are afraid of ED (erection dysfunction) and incontinence, whose side effects are typically associated with surgery. However, radiation can cause those outcomes too but less frequent. There are also the many that decide on surgery because of the possibility of having salvage radiotherapy in case of failure of the first attempt. They base this fact as important because salvage radiation is not recommended to be done to the previous radiated areas (tissues would not resist to rad on top of rad).

     

    It is therefore important to look for apparent metastases before deciding on a treatment. In positive cases of metastases, the isodose planning for a radiation attack would differ from that of a contained case (it would include areas of probable metastases) and such would avoid repeated treatment (radiation) at the same areas.

     

    I recommend you to get a copy of this book that may help you to understand details of the radicals;

     

    “Guide to Surviving Prostate Cancer” by Dr. Patrick Walsh (third edition);

     

    I also recommend you to look for specialists with loads of experience in their field. Outcomes differ much according to the experience of physicians and modernity of facilities.

     

    You could try to get an insurance now that may cover some of the expenses with testing, etc., even if that is late for covering the treatment performance.

     

    You are not the first young "member" joining our boat. Guys here will not leave you alone without an answer to your queries.

     

    Wishing you find peace of mind.

     

    Hope for the best.

     

    VGama

     

    To Add

    '"

    The traditional scintigraphy scans such as bone and typical CT do not perform that well to locate small tumours or colonies that produce low PSA levels of less than 10. These equipments got limitations (low resolutions) in detecting small sizes less than 1 to 2 mm." ...by Vascoda Gama

     

    "Newer modalities with better contrast agents like C11 acetate and F18, in cross information data base done with PET and CT or MRI can perform better with more accuracy. Tesla 3.0 suggested by Hopeful may be the less standards one should consider in a negative diagnosis."..by Vascoda Gama

    It is very important for you to have proper diagnostic testing so that you will know if there is extracapsular extention or not.........your treatment will be dependent on this information.

  • ralph.townsend1
    ralph.townsend1 Member Posts: 359 Member

    Image Studies

     

    Nev Family

     

    Welcome to the board. I am sorry for your diagnosis at such young age. Making a decision is difficult and one needs to consider the many "parameters" of his own life. All discussions should involve the family and you may need to check about your financial and economic affairs the fact may bring into your home.

     

    In any case you need to "knock down" the bandit but even with a steep rise in PSA you got time to check details of treatments and their side effects, which should include the possibility of waiting until April. Do not look for a "quick fix". There is not simple answer to your question. You need to write down all the risks that each type of treatment entails and decide what is best or acceptable to you and your family.

    Radical treatments are the ones that can provide cure if the cancer is contained. In cases of extra capsular extensions radiation modalities got better chances than surgery to provide successful outcomes.

     

    A proper diagnosis does make it a difference when deciding on the treatment. Many guys get second opinions on their results (biopsy included) and try to locate the cancer with high standards/resolution machines/modalities of image studies. The traditional equipments give many false negatives which could erroneously diagnose a case as contained.

    I would suggest you to search for information on image studies using the contrast agent C11 acetate and F18 (PET/CT). These agents seem to give better results to identify metastases.

     

    Both radicals; surgery and radiotherapy are good choices in contained cases. Radiation sometimes become the choice to many that are afraid of ED (erection dysfunction) and incontinence, whose side effects are typically associated with surgery. However, radiation can cause those outcomes too but less frequent. There are also the many that decide on surgery because of the possibility of having salvage radiotherapy in case of failure of the first attempt. They base this fact as important because salvage radiation is not recommended to be done to the previous radiated areas (tissues would not resist to rad on top of rad).

     

    It is therefore important to look for apparent metastases before deciding on a treatment. In positive cases of metastases, the isodose planning for a radiation attack would differ from that of a contained case (it would include areas of probable metastases) and such would avoid repeated treatment (radiation) at the same areas.

     

    I recommend you to get a copy of this book that may help you to understand details of the radicals;

     

    “Guide to Surviving Prostate Cancer” by Dr. Patrick Walsh (third edition);

     

    I also recommend you to look for specialists with loads of experience in their field. Outcomes differ much according to the experience of physicians and modernity of facilities.

     

    You could try to get an insurance now that may cover some of the expenses with testing, etc., even if that is late for covering the treatment performance.

     

    You are not the first young "member" joining our boat. Guys here will not leave you alone without an answer to your queries.

     

    Wishing you find peace of mind.

     

    Hope for the best.

     

    VGama

     

    Take Action

     Well I'm sorry you and wife had to join this club, but there are many year's a head of you! This prostate cancer that you have is a low grade cancer and can be controlled. The first thing I would look at is your diet and exercising. This could be great to battle against this monster and plus you will feel much better too.

    I have a friend that in 2010 had psa 4 and went to 22. The had gleason scores of 3+3 in 6 out 12. In 2011 had raidation treatment and the psa continue to psa rise to 30. The first of 2012 he went on lupron and by the end of 2012  his psa was less than 1. He has changed his diet and a little bit of exercising.

    All these guy's above comments are great. The last thing I will say, is the last thing you should do is remove your prostate--- at this time. At the age of 47 you should get a second opinion.

    You and wife will be fine! My prayers are with Y'all.

     

     

     

  • Swingshiftworker
    Swingshiftworker Member Posts: 1,013 Member
    What Public Services?

    Where are you located and what public services are you relying upon for treatment?

    You say that you don't have any private medical insurance and, I assume, don't have the money to pay for any medical care on your own.  If that's the case, your choice of treatment would be severely limited and it would do no good to recommend alternative methods of treatment (other than surgery which is apparently available to you) unless you can tell us what other treatments may also be available through the public medical care services that you have access to.