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Just diagnosed with PC

tlkeller
Posts: 2
Joined: Oct 2014

Just diagnosed 6 days ago and found the CSN doing some research. I'm 58 and in great health. I had a rising PSA over the last 2 years, last one taken was in Aug 2014 with a 5.90 result. DRE found nodules on right side of prostate. Biopsy performed with following results. 12 cores taken with 4 containing cancerous cells. First 2 from right apex gleason's score 3+3=6 involving 15%. Third core from left base gleason's score 3+4=7 involving 20%. Forth core from left mid gleason's score 3+3=6 involving 5%. Appointment coming up next week with Urologist to discuss options. This appointment will be in the VA system. I have also asked for a referral to another Urologist/Cancer Center with my outside insurance. Would appreciate any advice to help me figure this out.

Old-timer's picture
Old-timer
Posts: 196
Joined: Apr 2011

Welcome tlkeller. With your low Gleason scores, you have time to research, study, consult, and ponder what you are up against. I have high faith and trust in the urologists I have worked with for 23 years. But I suspect that some may rush a recommendatioon and go to work before a patent has pulled everything together in his mind.

Your Gleason scores are almost identical to what the biopsy reported mine to be. My urologist alloowed me to wait three months. I used that time to take a vacation trip. Then prostatecomy without hardly any knowledge of what prostate cancer was. I don't blame my urologist for my not knowing and I would probably made the same decision had I known more. The road since has sometimes been bumpy, but it has turned our well for me as my 23 years as a survivor suggests.

I'll wait to tell you more. What I have told you is only the beginning of my cancer journey.

Meanwhile, relax, don't worry, smile, continue to enjoy life.

Old-timer (Jerry)

Bill91101
Posts: 65
Joined: Apr 2009

Hi tlkeller,

Sorry to hear about your diagnosis, but welcome to the club.  This website/forum has been an invaluable aid to me during my recovery.

It's been 5 1/2 years since I was diagnosed (psa = 89, Gleason = 7, blood in my urine, a lot of pain).  The cancer had spread out of the prostate, and my urologist told me surgery was not an option.

Things looked kind of bleak back then...

I got on this site and started live blogging with other survivors - very very helpful when I thought I couldn't handle the future.  I also found meditation/positive visualization to be extremely helpful.

So I had IMRT radiation and hormone therapy (Monthly Degarelix for 6 months; two annual Vantas injections after that).

Other than having to lie still with a full bladder for 15 minutes, IMRT was a piece of cake.  the injections have been very helpful, but I got hot flashes. gained weight and my libido decreased a lot.

My psa is at 0.2 at the present.  My urologist and my radiation oncologist are both pretty impressed with my current status.  They both expect me to 'die, but not from PC'.

Fortunately PC is slow moving, so you have some time to figure out what to do.  My father had proton beam treatments and did very well.  I have a good friend who had surgery and is doing very well.

Stay positive and you will beat this!

 

 

 

schin
Posts: 9
Joined: Aug 2014

I'm sorry to hear about your cancer diagnosis.  You're wise to ask for a second opinion, especially on the Gleason's scoring.

Some of the main treatment options are:

prostatectomy (laparoscopic with or without robot)

conventional brachytherapy (permanent seeds)

high dose rate brachytherapy (temporary seeds inserted/withdrawn through catheters)

proton beam therapy

intensity-modulated radiation therapy

Stereotactic body radiation therapy (CyberKnife)

Your urologist probably won't know a lot about some of these therapies, and he/she may have a natural bias toward surgery.  So it's important to speak to doctors who perform each of these procedures to get their input--no one doctor can be a single source of information for all of the available options.

Take some time, do lots of research, and collect opinions.  Then make your decision based on what's best for you.

VascodaGama's picture
VascodaGama
Posts: 3356
Joined: Nov 2010

Tlkeller

I have not must to add over what others have told you above. A matter of concern is the nodules found on the right side of the prostate. I wonder if the biopsy took it into account and they directed a needle to the area.
This exam is important because the bumps could involve extra capsular extensions, classifying your case localized but not contained. In such a case, surgery (RP) alone would not assure success. Radiation (RT) is preferred when cancer is out of the capsule.

I would suggest you (before deciding a treatment) to have a more sophisticated exam done with a tesla 3 MRI machine or Multiparametric technique MRI. These can provide a better image for a better diagnosis. The data will also be useful in the decision on RT field of attack, if such becomes your choice.

Here is another similar case to yours;
http://csn.cancer.org/node/288240

Here is a booklet for newly diagnosed patients;
http://www.prostatecentre.com/sites/default/files/Prostate_Cancer_Patient_Education_Booklet.pdf

Best wishes and luck in your journey.

VGama

tlkeller
Posts: 2
Joined: Oct 2014

Thank you for your comments and the links. I found the booklet to be very useful.

Old Salt
Posts: 803
Joined: Aug 2014

Vasco makes a good point: those nodules are a concern.

If the Gleason scores hold up on second exam and if the nodules are non-cancerous, Active Surveillance is another option to consider along with the others listed by schin.

hopeful and opt...
Posts: 2327
Joined: Apr 2009

Since determining the results of the pathology is subjective, in is very important to have a second opinion by a world class pathologist whose specialty is prostate cancer. This may or may not confirm the initial results of your pathology. You do not want to be under or over treated. If not covered by your coverage, the cost of this is about 250 dollars.

If you still have a Gleason of 3+4=7 , and you are in excellent health at age 58 you will not be a candidate for active surveillance. You are too young for this choice

VAsco is right. It is imprtant to have a multiparametric MRI, hopefully using a Tesla 3.0 magnet to see if any extracapsular extension shows...if extracapsular extension exist, this information will be critical for you in making  a treatment decision.

Best,

Hopeful

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