I'm a newbie here

mikedayton62
mikedayton62 Member Posts: 22
edited September 2016 in Prostate Cancer #1

I received my diagnosis last month (on my birthday of all days). PSA = 12, Gleason = 6 in 1 of 12 biopsy samples. The urologist said that there is an 8mm tumor completely contained within the prostate. He recommended three alternative treatments:

1. Robot Assisted Laproscopic Prostatectomy (total removal of the prostate). He said his partner does these, and has a lot of experience.

2. External Radiation - Eight weeks, five days per week of targeted radiation treatments.

3. Internal radiation ("seeds").

 

I'm 54 years old and otherwise in good health. I would appreciate if anyone could provide advice or tell of their experiences with any one of these treatments. My urologist told us that all three have similar chances of successfully eliminating the cancer, and he expects that I will likely not have a recurrence afterward.

A personal note - my wife lost her father to lung cancer in 2007 - on my birthday. To spare her more grief, I might need to get a new birthday. haha

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Comments

  • Old-timer
    Old-timer Member Posts: 196
    edited September 2016 #2
    I extend a reluctant welcome

    You are a newbie, I'm a 25-year prostate cancer survivor. That does not mean that I know answers, and I do not intend to tell you what you should do. Just a few thoughts now; perhaps more later.

    Sorry you must be here--but welcome. This is a good place to get encouragement and informtion. Your numbers suggest that you have time to learn about prostate cancer and your choices for treatment. You are 11 years younger than I was when I began this journey. Likely, this makes a huge difference.

    The major thought I have at this time: don't make a hasty decision regarding a treatment choice. One other thought of encouragement: keep your spirits as high as possible.

    Old-timer (Jerry)

  • MEtoAZ
    MEtoAZ Member Posts: 37
    edited September 2016 #3
    I beat you by two years!

    Hi Mike, Sorry to hear about your diagnosis.  The good news is that with a Gleason of 6 and only 1 core being positive, you have a ton of options AND a lot of time to sort things out. 

    I was diagnosed in January of this year with 2 cores, one gleason of 6 and one gleason of 7 (3+4).  After reviewing histories of others on this and other forums, I opted on doing Cyberkhife radiation instead of surgery or regular external beam IMRT radiation.  Cyberknife requires only 4-5 treatments of 45 minutes each and is much more focused than IMRT external radiation.  An overview of radiation types here - https://www.cancer.gov/about-cancer/treatment/types/radiation-therapy/radiation-fact-sheet

    I would not recommend you get IMRT radiation (the 8 weeks option) as at your age, there is a higher likeihood that you could have problems later on over time as IMRT doesn't just radiate the tumor, but everything around it gets a dose as well.  I suspect if you talk to more radiation oncologists who to IMRT that they will tell you the same thing, the two I spoke with told me that at 52, they would recommend surgery as long as cancer was contained in the prostate.

    The seeds are another option, but when I compared that to Cyberknife, I felt it was a better course, at least for me.  That depends in part of if Cyberknife is avaialble where you live, I live in Phoenix-area.

    As urologists diagnose Prostate cancer and are the ones who would perform a prostatectomy, that is the most common option, especially for younger patients.  

    I opted against surgery after visiting this and other forums and seeing the side-effects of surgery and deciding that at 52, I didn't want to risk having incontinence and/or erectile dysfunction for the rest of my life.  Note, that isn't the "normal" outcome, but it happens and while the doctors downplay it, they certainly cannot guarentee the outcome.

    Spend some time evaluating your options and talk to mulitple doctors, in the end, this is a decision you and your wife need to be comfortable with the decision.  You can also pursue active survelliance as well and wait for a period of time and see how slow it is progressing but with a positive identificaiton of the location and size of tumor, I would be prone to just deal with it but it is certainly not something you have to do immediately. 

    Good luck and keep us posted and jlet me know if you have any other questions about my experience or the process in general.  I am sure you will have several other chipping in as well.  While any cancer diagnosis creates a ton of anxiety, this is one that at this early stage, is deifnately beatable!

  • mikedayton62
    mikedayton62 Member Posts: 22
    edited September 2016 #4
    MEtoAZ said:

    I beat you by two years!

    Hi Mike, Sorry to hear about your diagnosis.  The good news is that with a Gleason of 6 and only 1 core being positive, you have a ton of options AND a lot of time to sort things out. 

    I was diagnosed in January of this year with 2 cores, one gleason of 6 and one gleason of 7 (3+4).  After reviewing histories of others on this and other forums, I opted on doing Cyberkhife radiation instead of surgery or regular external beam IMRT radiation.  Cyberknife requires only 4-5 treatments of 45 minutes each and is much more focused than IMRT external radiation.  An overview of radiation types here - https://www.cancer.gov/about-cancer/treatment/types/radiation-therapy/radiation-fact-sheet

    I would not recommend you get IMRT radiation (the 8 weeks option) as at your age, there is a higher likeihood that you could have problems later on over time as IMRT doesn't just radiate the tumor, but everything around it gets a dose as well.  I suspect if you talk to more radiation oncologists who to IMRT that they will tell you the same thing, the two I spoke with told me that at 52, they would recommend surgery as long as cancer was contained in the prostate.

    The seeds are another option, but when I compared that to Cyberknife, I felt it was a better course, at least for me.  That depends in part of if Cyberknife is avaialble where you live, I live in Phoenix-area.

    As urologists diagnose Prostate cancer and are the ones who would perform a prostatectomy, that is the most common option, especially for younger patients.  

    I opted against surgery after visiting this and other forums and seeing the side-effects of surgery and deciding that at 52, I didn't want to risk having incontinence and/or erectile dysfunction for the rest of my life.  Note, that isn't the "normal" outcome, but it happens and while the doctors downplay it, they certainly cannot guarentee the outcome.

    Spend some time evaluating your options and talk to mulitple doctors, in the end, this is a decision you and your wife need to be comfortable with the decision.  You can also pursue active survelliance as well and wait for a period of time and see how slow it is progressing but with a positive identificaiton of the location and size of tumor, I would be prone to just deal with it but it is certainly not something you have to do immediately. 

    Good luck and keep us posted and jlet me know if you have any other questions about my experience or the process in general.  I am sure you will have several other chipping in as well.  While any cancer diagnosis creates a ton of anxiety, this is one that at this early stage, is deifnately beatable!

    Thank you for your response

    Thank you for your response and encouragement. Yes, this has caused a LOT of anxiety, especially with my wife. I have an appointment next week with a radiation oncologist. I will definitely ask about the CyberKnife.

  • mikedayton62
    mikedayton62 Member Posts: 22
    Old-timer said:

    I extend a reluctant welcome

    You are a newbie, I'm a 25-year prostate cancer survivor. That does not mean that I know answers, and I do not intend to tell you what you should do. Just a few thoughts now; perhaps more later.

    Sorry you must be here--but welcome. This is a good place to get encouragement and informtion. Your numbers suggest that you have time to learn about prostate cancer and your choices for treatment. You are 11 years younger than I was when I began this journey. Likely, this makes a huge difference.

    The major thought I have at this time: don't make a hasty decision regarding a treatment choice. One other thought of encouragement: keep your spirits as high as possible.

    Old-timer (Jerry)

    Thank you Jerry. I appreciate

    Thank you Jerry. I appreciate the welcome and the encouragement.

  • VascodaGama
    VascodaGama Member Posts: 3,495 Member
    Keep the birthday. You will bit the odes

    Mike

    I would suggest you to read about the treatments risks and side effects. Many of us suffer more from these effects than the cancer it self, and some of these risks can become permanent nightmares. I wonder what lead you to do the biopsy. Was there any symptom or was it just the high PSA?

    Do you have more PSA tests previous to the one of 12.0 ng/ml? What about image studies, have you done any CT/MRI/PET scan or Bone scan? Why is the urologist so sure that the 8mm tumor is completely contained within the prostate?

    One core out of 12 with Gleason 6 is indicative of low risk. With these results you could choose Active Surveillance instead of a radical therapy. I would suggest you to read details on the matter too. In any case I would be looking for second opinions in other specialists not from the same group of your doctor, even including a second look into the biopsy slides by a PCa pathologist (JH laboratory, etc). 

    I believe you do not need to rush. Do your researches before commiting.

    Welcome to the board.

    VG 

     

  • Max Former Hodgkins Stage 3
    Max Former Hodgkins Stage 3 Member Posts: 3,721 Member
    edited September 2016 #7
    Similiar

    Welcome, Mike.

    My case was quite similiar to yours: I was 58, Gleason 6, one core of 12 positive at 5% involvement. I never had a PSA of over 4.6, however.  A PSA of over 10 can sometimes countersuggest seeding according to some sources.  You will find that oncologists are a lot like lawyers: no two will have identical takes on a situation, although each take is reasonable.

    After a lot of reading and consultation with three oncologists I chose DaVinci (robotic) removal.  For early stage, first-line treatment of PCa in the US today, right at 50% of all men choose surgery, the other half choose some form of radiation .  Both modalities have statistically identical cure rates.  It really comes down to which doctors you most feel comfortable with, and your priorities.  The more I studied, the less certain I was about what to do. PCa has more sound alternatives than most other cancers, a good thing, of course.

    The pathologist's analysis of the gland after it was removed showed more involvement than the biopsy had suggested -- also not uncommon, I have read.  I was a Stage II at the time, not Stage I.

    For what it is worth, 2.5 years later, I have normal continence, and sex about as good as prior to surgery, although once the gland is removed, ejaculate fluid is a thing of the past (orgasm and ejaculation are actually distinct phenomenon, I learned).  'So what' is my reaction; I'm a 60 year old man, not a surfer at Malibu.  Actually, my continence post surgery is much better than prior to surgery, since I had been dealing with significant BPH for a few years. Go figure.,.

    Bless your decision. With your numbers, you should achieve a cure with relative ease.

    max

  • mikedayton62
    mikedayton62 Member Posts: 22

    Keep the birthday. You will bit the odes

    Mike

    I would suggest you to read about the treatments risks and side effects. Many of us suffer more from these effects than the cancer it self, and some of these risks can become permanent nightmares. I wonder what lead you to do the biopsy. Was there any symptom or was it just the high PSA?

    Do you have more PSA tests previous to the one of 12.0 ng/ml? What about image studies, have you done any CT/MRI/PET scan or Bone scan? Why is the urologist so sure that the 8mm tumor is completely contained within the prostate?

    One core out of 12 with Gleason 6 is indicative of low risk. With these results you could choose Active Surveillance instead of a radical therapy. I would suggest you to read details on the matter too. In any case I would be looking for second opinions in other specialists not from the same group of your doctor, even including a second look into the biopsy slides by a PCa pathologist (JH laboratory, etc). 

    I believe you do not need to rush. Do your researches before commiting.

    Welcome to the board.

    VG 

     

    Thank you VG

    Thank you for the advice. My wife and I have been doing a lot of research, and I have an appointment with a radiation oncologist tomorrow.

  • mikedayton62
    mikedayton62 Member Posts: 22
    edited September 2016 #9

    Similiar

    Welcome, Mike.

    My case was quite similiar to yours: I was 58, Gleason 6, one core of 12 positive at 5% involvement. I never had a PSA of over 4.6, however.  A PSA of over 10 can sometimes countersuggest seeding according to some sources.  You will find that oncologists are a lot like lawyers: no two will have identical takes on a situation, although each take is reasonable.

    After a lot of reading and consultation with three oncologists I chose DaVinci (robotic) removal.  For early stage, first-line treatment of PCa in the US today, right at 50% of all men choose surgery, the other half choose some form of radiation .  Both modalities have statistically identical cure rates.  It really comes down to which doctors you most feel comfortable with, and your priorities.  The more I studied, the less certain I was about what to do. PCa has more sound alternatives than most other cancers, a good thing, of course.

    The pathologist's analysis of the gland after it was removed showed more involvement than the biopsy had suggested -- also not uncommon, I have read.  I was a Stage II at the time, not Stage I.

    For what it is worth, 2.5 years later, I have normal continence, and sex about as good as prior to surgery, although once the gland is removed, ejaculate fluid is a thing of the past (orgasm and ejaculation are actually distinct phenomenon, I learned).  'So what' is my reaction; I'm a 60 year old man, not a surfer at Malibu.  Actually, my continence post surgery is much better than prior to surgery, since I had been dealing with significant BPH for a few years. Go figure.,.

    Bless your decision. With your numbers, you should achieve a cure with relative ease.

    max

    Thank you Max

    Thank you for relating your experiences. I neglected to mention that my one positive core had 35% involvement. As of this moment my wife and I are leaning toward robotic removal, but will not make a decision until after my appointment with a radiation oncologist tomorrow. I understand that surgery and radiation have similar chances of a positive outcome with regards to eliminating the cancer, and that surgery seems to have a higher chance of negative side effects. One side effect not mentioned, however, is the long term anxiety of recurence if we opt to leave the prostate in place. Intellectually we understand that there really is no difference in the odds, but from an emotional standpoint, we would have more peace of mind if it were removed.

    My urologist's partner does all of the robotic surgeries, and he has tons of experience, so I'm optimistic about the outcome if we opt for that route.

  • mikedayton62
    mikedayton62 Member Posts: 22
    CC52 said:

    Go Slow!

    Mike,

    Welcome to the board. Please...as VG says, your numbers would indicate several options, the first being Actice Surveillance (AS). AS candidates usually have no more than 2 of 12 positive samples, and with your Gleason 6, AS seems a real possibility. That's what I hoped for when I got the news, but I had 3 of 18 positive with a 3+4=7 Gleason. At 61, I decided the time was right for treatment.

    After about a year of research, I decided on CyberKnife (SBRT). Some advance work, including placement of gold markers (fiducials) in my prostate prior to receiving 5 treatments over 1 1/2 weeks. Looking back, it was no big deal. I'm celebrating two years since completing my treatments as I write this, and while I have had some side-effects for the most part I feel I'm much better off for having chosen SBRT than any surgical option. Of course, we all have to decide what's best for us.

    Here is a thread I began after my treatment for those considering CyberKnife: http://csn.cancer.org/node/292915 

    All the best as you proceed.

     

    Thank you

    Thank you for the encouragement. I fully intend to ask about CyberKnife at my oncologist appointment tomorrow.

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

    Thank you VG

    Thank you for the advice. My wife and I have been doing a lot of research, and I have an appointment with a radiation oncologist tomorrow.

    PSA

    Vasco gave good advice.

    He asked excellent questions.

    Do you have a history of PSA tests. Did you have any other diagnostic tests?

    Except for the high PSA you may be a candidate for Active Surveillance. I would interview an expert in Active Surveillance, hopefully at a major institution of excellence.......one that can provide a mulitiparametric MRI with a three dimenisional biopsy machine such as an Artemis.

    Not saying that you qualify but I have been in an Active Surveillance program for almost 8 years now.

    .....................

    Generally surgery has the greatest side effects from active treatment, to include but not limited to erectile dysfunction and incontinence. If you choose an active treatment a type of radiation such as SBRT would have less side effects

    As others have mentioned, take your time to make the best decision for you.

  • Max Former Hodgkins Stage 3
    Max Former Hodgkins Stage 3 Member Posts: 3,721 Member
    edited September 2016 #12

    Thank you Max

    Thank you for relating your experiences. I neglected to mention that my one positive core had 35% involvement. As of this moment my wife and I are leaning toward robotic removal, but will not make a decision until after my appointment with a radiation oncologist tomorrow. I understand that surgery and radiation have similar chances of a positive outcome with regards to eliminating the cancer, and that surgery seems to have a higher chance of negative side effects. One side effect not mentioned, however, is the long term anxiety of recurence if we opt to leave the prostate in place. Intellectually we understand that there really is no difference in the odds, but from an emotional standpoint, we would have more peace of mind if it were removed.

    My urologist's partner does all of the robotic surgeries, and he has tons of experience, so I'm optimistic about the outcome if we opt for that route.

    Yes

    You are correct on all of the particulars, Mike.

    I had a career in submarines, in which there is a manditory backup for every system.  Surgery has RT as a backup, and surgery also has the advantage of, after the pathologist has the gland on the table, knowing EXACTLY what the situation was in, and outside, the gland.  No scan matches the pathologist cutting slices, and putting it under a microscope.  Yes:  surgery can (rarely) be done after initial radiation, and even re-application after radiation is sometimes possible, but both of these options are rarely suggested by doctors, and are problematic  (the gland become fiberous after radiation, similiar to a sponge that has been put in a microwave).

    Virtually all surgeons today do erectile nerve sparring, when possible.  But, if the nerves were determined to need removal during surgery, it also means that they would have needed irradiation.  Recovery of potency, even with nerve sparring, will take months in most cases, if not a year or more.

    Good luck.  As I mentioned before: The more doctors I met, the MORE confusing it got, not less.

    Take your time, as many have suggested.

    max

  • Joe B 70
    Joe B 70 Member Posts: 3
    edited September 2016 #13
    A little late here, and I didn't read all the Post but...

    It sounds to me like you can expect a long, cancer free life after treatment. 

    I had four cells involved, two 6's and two 7's with a PSA of 4.8. I chose RT. But I am 71 years old. If I was 54 I would have found the best surgeon I could and gone for prostate removal.

    My urologist and RT Oncologist both said if I was younger, and had a longer life expectancy, surguery would be their recomendation. Mainly because after RT, if the cancer returns, surgery on the protsate is not done because of scare tissue. That limits your options down the road.

    If you do chose RT, I would find a location that has Image guided external radiation systems or other newer methods of delivering the external radiation. Also, I would look for a facility that did a space-oar type of implant prior to radiation to protect the rectem from damage. 

     

     

  • Swingshiftworker
    Swingshiftworker Member Posts: 1,013 Member
    edited September 2016 #14
    Joe B 70 said:

    A little late here, and I didn't read all the Post but...

    It sounds to me like you can expect a long, cancer free life after treatment. 

    I had four cells involved, two 6's and two 7's with a PSA of 4.8. I chose RT. But I am 71 years old. If I was 54 I would have found the best surgeon I could and gone for prostate removal.

    My urologist and RT Oncologist both said if I was younger, and had a longer life expectancy, surguery would be their recomendation. Mainly because after RT, if the cancer returns, surgery on the protsate is not done because of scare tissue. That limits your options down the road.

    If you do chose RT, I would find a location that has Image guided external radiation systems or other newer methods of delivering the external radiation. Also, I would look for a facility that did a space-oar type of implant prior to radiation to protect the rectem from damage. 

     

     

    Surgery after RT is irrelevant!!!

    It is often suggested that surgery is the better choice "because" you cannot resort to surgery after RT.  Frankly, this argument is irrelevant. 

    I have heard of no one on this forum who has ever had a failed RT.  However, even if that occured, the patient would not need resort to surgery BECAUSE further radiation treatment after a failed RT is the better option. 

    However, I can't count the number of men who have reported here that they had to resort to RT and hormone treatment as a result of a FAILED surgery.  So, the whole notion that one should choose surgery to increase you future treatment options is simply BOGUS!!!

  • hunter49
    hunter49 Member Posts: 210
    Hey man welcome to the party.

    Hey man welcome to the party.  Sorry you got an invite.  I was 49 had a PSA 4.1  biopsy 1 of 15 posative Gleason 3+4 PNI present.  When I had surgery I was up graded to a 4 +3 and it was in both sides much more than biopsy showed and was luckily contained.  No Seminal or lymph nodes with any signs.  My first thought is with a PSA 12 you have more going on.  Was there a lot of BPH present, any idea of the prostate size?  A PSA of 12 is high for your dignosis .  At a young age as we are both 54 2 things I believe firmly.  First remove it, get it out and see what you are actually dealing with.  Second, nobody can ever predict re-occurences. I have 3 friends all good outcomes now after 5, 5  and 4 years all are getting radiation for slavage treatment.  You need to go to a good oncologist and if you do surgery go to a place that specializesin it.  MAke sure the doctor has done hinreds of them at least.  Good luck man and stay posative. 

  • MEtoAZ
    MEtoAZ Member Posts: 37
    edited September 2016 #16

    Thank you for your response

    Thank you for your response and encouragement. Yes, this has caused a LOT of anxiety, especially with my wife. I have an appointment next week with a radiation oncologist. I will definitely ask about the CyberKnife.

    oncologist..

    Hi Mike, one thing I may have neglected to mention, if the oncologist you see does not do Cyberknife, it is very likely that they will either play dumb or not recommend it.  You are going to get exposed to the "marketing" side of disease management where the recommendations will mirror closely what the doctor specializes in, usually as the sole recommendation.  This was likely one of the reasons for the later recommendation by Max of more doctors just adds confusion.  He is not incorrect, but I recommend you filter through the noise.  Also I noticed a comment that once you radiate, surgery is not an option.  That is another lie that the urologists use.  Most urologists lack the skill required to remove a radiated prostate.  There is a more solective list of doctors who can perform such a surgery but it absolutely can and has been done.  

    If you are going to check out Cyberknife, you likely need to find someone who does it and yes, they will have their marketing jazz like all the others but, check out the various forums on men who have done Cyberknife to get their experience. 

    Surgery will work and likely the side effects will be temporary BUT not guarenteed and you will have to work at restoring "function".. take a look at Amazon on books related to restoring sexual function after surgery.. wake up call for me after reading a couple of them.

  • Swingshiftworker
    Swingshiftworker Member Posts: 1,013 Member
    The choices you need to consider . . .

    Mike: People here know me as an outspoken advocate for CK and against surgery of any kind.  I was treated w/CK 6 years ago (Gleason 6 and PSA less than 10).  You can troll the forum for my many comments on this point.  Here are the highlights of what you need to consider:

    1)  CK (SBRT) currently is the most precise method of delivering radiation externally to treat prostate cancer.  Accuracy at the sub-mm level  in 360 degrees and can also account for organ/body movement on the fly during treatment.  Nothing is better.  Accuracy minimizes the risk of collateral tissue damage to almost nil, which means almost no risk of ED, incontinence and bleeding.  Treatment is given in 3-4 doses w/in a week time w/no need to take off time from work or other activities.

    2) IMRT is the most common form of external radiation now used.  Available everythere.  Much better accuracy than before but no where near as good as CK.  So, it comes with a slightly higher risk of collateral tissue damage resulting in ED, incontienence and bleeding.  Unless things have changed, IMRT treatment generally requires 40 treatments -- 5 days a week for 8 weeks -- to be completed.  I think some treatment protocols have been reduce to only 20 but I'm not sure.  Still much longer and more disruptive to your life than CK but, if CK is not available, you may have no other choice.

    3) BT (brachytherapy).  There are 2 types: high dose rate (HDR) and low dose rate (LDR).  HDR involves the temporary placement of rradioactive seeds in the prostate.  CK was modeled on HDR BT.  LDR involves the permanent placement of radioactive seens in the prostate.  1/2 life of the seeds in 1 year during which time you should not be in close contact w/pregnant women, infants and young children.  The seeds can set off metal/radiation detectors and you need to carry an ID card which explains why you've got all of the metal in your body and why you're radioactive.  Between HDR and LDR, HDR is the better choice because with LDR, the seeds can move or be expelled from the body.  Movement of the seeds can cause side effects due to excess radiation moving to where it shouldn't be causing collateral tissue damage -- ED, incontinence, bleeding, etc.   Both HDR and LDR require a precise plan for the placement of the seeds which is done manually.  If the seeds are placed improperly or move, it will reduce the effectiveness of the treatment and can cause collateral tissue damage and side effects.  An overnight stay in the hospital is required for both.  A catheter is inserted in your urethra so that you can pee.  You have to go back to have it removed and they won't let you go until you can pee on your own after it's removed.

    4) Surgery -- robotic or open.   Surgery provides the same potential for cure as radiation (CK, IMRT or BT) but which MUCH GREATER risks of side effects than any method of radiation.  Temporary ED and incontinence are common for anywhere from 3-12 months BUT also sometimes permanently, which would require the implantation of an AUS (artificial urinary sphincter) to control urination and a penile implant to simulate an erection to permit penetration (but would not restore ejaculative function).  Removal of the prostate by surgery will also cause a retraction of the penile shaft about 1-2" into the body  due to the remove of the prostate which sits between the interior end of the penis and the bladder.  Doctors almost NEVER tell prospective PCa surgical patients about this.  A urologist had to nerve to tell me it didn't even happen when I asked about it.   Don't trust any urologist/surgeon who tells you otherwise.  Between open and robotic, open is much better in terms of avoiding unintended tissue cutting/damage and detection of the spread of the cancer.  Robotic requires much more skill and training to perform well; the more procedures a doctor has done the better but unintended injuries can still occur and cancer can be missed because the doctor has to look thru a camera to perform the surgery which obstructs his/her field of vision.

    4) You may also want to consder active surveillance (AS), which is considered a form of treatment without actually treating the cancer.  You just have to get regular PSA testing (usually quarterly) and biopsies (every 1-2 years, I believe) and keep an eye out for any acceleration in the growth of the cancer.  Hopeful and Optimistic (who has already posted above) has already mentioned this and is your best source of info on this forum about it. 

    I personally could not live w/the need to constantly monitor the cancer in my body.  Like most other men, I just wanted it delt with.  Some men gravitate to surgery for this reason, thinking that the only way to be rid of it is to cut it out, but I did not like the risks presents by surgery and opted for CK, which is a choice I have NEVER regretted.  I am cancer free, there is no indication of remission, there were no side effects and my quality of life was never adversely affected.  Other men on this forum have reported similiar results.

    So, for obvious reasons, I highly recommend that you consder CK as your choice of treatment.  The choice seems obvious when you consider the alternatives but you'll have to decide that for yourself.

    Good luck!

     

     

  • Will Doran
    Will Doran Member Posts: 207
    Robotic Surgery, Radiation, and ADT

    Mike,

    Sorry to hear of your diagnosis.  I was diagnosed in August 2013, with a PSA fo 69, Gleason 7 and I had no symptoms.  Doctors sent me to Chemo,  Radiation Oncologists as well as Surgeon to make my decision.  I decided to have the surgery.  It was good thing, since I had a birth defect, where my prostate was adhered to my bladder.  Thus the Radioactive seeds could not have been place where they needed to be.  My post surgery results came out as me being a Stage pT3bN1. One small spot in a lymph node.   My doctors told me they were going to be aggressive and they were.  I was treated as a Stage 4 and had two years of Lupron and 8 weeks of radiation after the surgery.  So far, after three years, my PSA is considered undetectable.  It's been a rough three years, but it's getting better.  They had my testosterone knocked down to 17.  Normal is 250 - 1,100.  My "T" levels are back up to 320 at this point.  That part of this was rough.

    All of our cases are different, so what has worked for me will not be what others would do or have done.  Make sure a research all the options and side effects of treatments and decided what makes the most sense for your situation.  Think about quality of life.  This is a hard battle, but there is hope.

    Fight like the devil

    Love, Peace and God Bless

    Will

  • mikedayton62
    mikedayton62 Member Posts: 22

    Thank you VG

    Thank you for the advice. My wife and I have been doing a lot of research, and I have an appointment with a radiation oncologist tomorrow.

    PSA history

    I have had a PSA of 6 on two exams in the last 3 or so years. Both times the urologist put me on antibiotics. When I went to my GP for my annual physical in June, my PSA was 10, but I had not been celibate, so two weeks later the urologist tested it again. I was celibate for a week and was certain that my PSA would go back down, but was shocked when it came back at 12. DRE at GP and the urologist did not reveal anything. Both said it felt normal.

  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,333 Member
    edited September 2016 #20

    PSA history

    I have had a PSA of 6 on two exams in the last 3 or so years. Both times the urologist put me on antibiotics. When I went to my GP for my annual physical in June, my PSA was 10, but I had not been celibate, so two weeks later the urologist tested it again. I was celibate for a week and was certain that my PSA would go back down, but was shocked when it came back at 12. DRE at GP and the urologist did not reveal anything. Both said it felt normal.

    3T MP MRI

     

     


    There is an MRI scan for prostate cancer that is very effective in indicating if there is any nodule involvement, if there is involvement in one or two lobes, will show size of prostate, may show evidence of extracapular extension, will stage the disease. An MRI with the 3.0 Tesla magnet, is the gold standard. There are certain major hospitals that have MRI machines with a 3.0 Tesla magnet. 

    In my layman’s opinion it is advisable to have such a test before any treatment. If the cancer is outside the prostate you may wish to reconsider a treatment decision.

    Basically the MRI provides finer resolution than the bone and cat scans, and is more effective in determining if the cancer is outside the prostate.

    An 3T MRI will do the job for you.

    here are some studies from pubmed about mri's and a high tech pet scan

    multiparametric mri t3 

    The impact of Magnetic Resonance Imaging on prediction of extraprostatic extension and prostatectomy outcome in low-, intermediate- and high-risk Prostate Cancer Patients. Try to find a standard.


    http://www.ncbi.nlm.nih.gov/pubmed/26154571



    The impact of multiparametric pelvic magnetic resonance imaging on risk stratification in patients with localized prostate cancer.


    http://www.ncbi.nlm.nih.gov/pubmed/24785987



    Preoperative 3-Tesla multiparametric endorectal magnetic resonance imaging findings and the odds of upgrading and upstaging at radical prostatectomy in men with clinically localized prostate cancer.
    http://www.ncbi.nlm.nih.gov/pubmed/23040223

  • CC52
    CC52 Member Posts: 103 Member
    Go Slow!

    Mike,

    Welcome to the board. Please...as VG says, your numbers would indicate several options, the first being Actice Surveillance (AS). AS candidates usually have no more than 2 of 12 positive samples, and with your Gleason 6, AS seems a real possibility. That's what I hoped for when I got the news, but I had 3 of 18 positive with a 3+4=7 Gleason. At 61, I decided the time was right for treatment.

    After about a year of research, I decided on CyberKnife (SBRT). Some advance work, including placement of gold markers (fiducials) in my prostate prior to receiving 5 treatments over 1 1/2 weeks. Looking back, it was no big deal. I'm celebrating two years since completing my treatments as I write this, and while I have had some side-effects for the most part I feel I'm much better off for having chosen SBRT than any surgical option. Of course, we all have to decide what's best for us.

    Here is a thread I began after my treatment for those considering CyberKnife: http://csn.cancer.org/node/292915 

    All the best as you proceed.