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Just diagnosed question on treatment

Grtexas
Posts: 1
Joined: Nov 2017

Hello hope all are well. I️ am a 72 year old man just diagnosed with aggressive prostate cancer. The results show 4+3 and 4+4. Prostate is very swolen. Good thing is that it has not spread and contained in the prostate. 

The doctor recommended hormones injections and finesteride and good diet. This for three months until the prostate swelling goes down and then remove the prostate. 

I haven't received a second opinion. Anyone have any thoughts on this course of treatment? I appreciate it.  

drdedtru
Posts: 1
Joined: Nov 2017

I was diagnosed in February... and in April had mine removed I'm 63 years old and since then have had 30 sessions of radiation.. may last psa is 0.1 I have met others who did not have theres removed and have had issues 

1005tanner
Posts: 29
Joined: Dec 2017

Hope you are doing okay at this time.  I am scheduled for robotic in march of 2018 and was wondering how you came to terms with surgery.

How difficult was radiation? 

Old Salt
Posts: 720
Joined: Aug 2014

We need much more information (biopsy report, staging, scans) to respond properly. But at first sight (!) the proposed treatment is debatable. More importantly, please start studying alternatives and set up appointments with qualified radiation oncologists who specialize in prostate cancer.

Grinder
Posts: 440
Joined: Mar 2017

Was your prostate swollen from acute or chronic prostatitis, or from BPH hyperplasia? If you decide against radical prostatectomy in favor of Cyberknife or other radiation treatments, as many advocates of radiation will encourage you to do, be sure to ask how this will affect the prostatitis/hyperplasia. I confess I do not know about radiation, but my experience suggests prostatectomy if your prostate is causing aggravated retention symptoms.

Like OS said ... More info is needed, especially the complete biopsy report which you can request from your urologist/surgeon's office, so the guys here can help you dissect it.

If you elect for RP, be absolutely sure to check the history and experience of your surgeon. If you read into the archives of this forum you will find this is paramount in robotic surgery. With the most expert robotic surgeon, prostate size won't matter as much, but it will with an inexperienced surgeon.

Use the search bar above to research topics pertinent to you and acquire a vast amount of information not available in a brief office consultation with your urologist.

hopeful and opt...
Posts: 2224
Joined: Apr 2009

As old salt recommends, more information is needed; pathology results from the biopsy, how many cores positive and involvement, that is the percent of cancer in each core that was positive...any other information found in the pathology report.....any other diagnostic tests, ie image MRI or PET Scan...the American Urological Association recommends a bone scan for men with Gleason 8 and above, what were the results of your bone scan?...PSA history..........results of the digital rectal exam(finger wave in the anus)....what led to you having a biopsy?

Generally with aggressive cancer , Gleason 8 and above it is likely that the cancer has escaped the prostate, so a localized treatment such as surgery will not cure and other treatments will also be necessary. The side effects from each treatment is cummulative.

Suggest that you not only make an appointment with a radiation oncologist, but also a medical oncologist. The medical oncologist should be the leader of your medical team.

Also, the side effects of surgery are age related, that is the older you are the greater chance of side effects which can be considerable....so a man of 72 can have the exact same operation as a man of 50....the man of 50 will have no side effects while the man who is 72 will.

MK1965
Posts: 177
Joined: Jun 2016

With your age and Your Gleson score, I would go with radiation which greatly improved over past 20 years and gives good if not even better cure rate then surgery especially for more aggressive Ca like yours.

OTOH, radiation will preserve your QoL with significantly less bothered SE.

Surgery will leave you with significant SE regardless of your age 50 or 72.

To gain insight of surgical SE search this forum and you will find all kind of SE after surgery which are not mentioned by urologic surgeons.

Get informed and elect SE that you can comfortably  live with.

Good luck.

MK

Clevelandguy
Posts: 456
Joined: Jun 2015

Hi,

Make sure you get all the tests to detemine where in your prosate the cancer is located.  If it's deep within the prostate then surgery might do the trick, if it's very close to the edge then radiation might be a better option.  Meet with your urologist & oncologist to get their opinions based on the tests they have performed. Study all the side effects of both surgery & radiation to determine which is best for you, both treament protocals have side effects.  Once you have studied this to death you will know which is best for you, your choice based on the facts of your specific case.  Good luck..................

Dave 3+4

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