Hello just diagnosed and very frightened
I was just diagnosed Thursday by my urologist . PSA 7.8 ..had 5.5 for many years with 3 biopsy’s and were all good. This last one not sooo good.2 out of 12 showed some cancer .thsts all I know until I see the specialist next Thursday.thoughmy urologist did give me encouragement saying we caught it very early whatever that means...don’t know what to ask the specialist on Thursday I guess my biggest fear is if it has spread or not ..any input would be muchhhhhhh apppreciated ..thanks in advance ..how I am 56 years old
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Don't panic
A lot depends on the Gleason score of your positive biopsys and the percentage of the the sample that contained cancer. If the Gleason is 6 and only two of the cores contain cancer, you could be a candidate for active surveillance. At this point, research on your part is critical. The NCCN has an excellent online, downloadable guide for prostate cancer patients. Google it and download it.
I'm currently following an active surveillance protocol because in addiiton to avoiding the potential side effects of agressive treatment, the available technologies for addressing the disease are advancing rapidly.
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Please do not overreact
The best thing that you can do is not to yield to the mentality of "I have cancer, cut it out tomorrow".
Prostate cancer is slow growing, and almost never requires immediate decisions. I was diagnosed in 2009, and my specialists at Johns Hopkins believe that monitoring, rather that any treatment, is my best course. They should know, as they pioneered active surveillance in the USA.
Get your biopsy pathology report, and share the data here (and elsewhere where knowledgable people can advise). Also, if you have a case that may require treatment, please speak with BOTH a urologist and a radiation oncologist. Both can eradicate cancer, but with different side effects. Do not allow one to speak for the other.
Good luck.
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Thanks I have been to the
Thanks I have been to the urologist ..he is the one who now is referring me to the radiation oncologist who I see on Thursday.i am going to get a copy of the report on Monday to see for myself ....hope the findings r lowwwww....just sooo scared it has spread already...haberdashery had pressure and weird little stabbing pains arpinf my sinus and tail bond but I havre to admit it think that’s only been since the biopsy ...will keep the faith .thanks again for the help
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Get a second opinion with
Get a second opinion with your pathology slides and look at your options. If you do surgery first you still can have radiation next if needed.
Or active survelleance is a option if gleason score is below 6. And your anxiety can handle it. Good luck my brother. Your age has alot to do with it also as some are slow growing and not as aggressive.
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Active surveillance1005tanner said:Get a second opinion with
Get a second opinion with your pathology slides and look at your options. If you do surgery first you still can have radiation next if needed.
Or active survelleance is a option if gleason score is below 6. And your anxiety can handle it. Good luck my brother. Your age has alot to do with it also as some are slow growing and not as aggressive.
1. Gleason scores below 6 are not considered cancerous and are not reported.
2. Active surveillance (AS) protocols vary by institution. The number of tumors within the prostate and their location play an important role in determining whether a person migt be a good candidate for AS. This forum has several contributors who are more knowledgeable than me about this approach.
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Wow thanks alot brothers
Wow thanks alot brothers.calling today to have the report sent to my GP and I will go see him to go over it..I trust him sooo much been with him 20 years...I am soo frightened that it had spread..I am still having some discomfort in my rectum from the biopsy which is only supposed to last a week or so and now has been 9 days...of course I am thinking the discomfort is the cancer spreading..trying soo hard to not think like that but it’s tough...will all oncologists do a bone scan to see if it’s spread or not ....sorry for the ranting thanks again
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bone scan
The American Urological Association recommends a bone scan for those with a Gleason 8 and above; not for those with Gleason under 8 unless there is a very large quantity.
Recommend that you have a T3 MRI
This 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.0 -
have report looks very hopeful
core 3 gleason 3+4 tumor size 7mm 80%length of biopsy
core6 gleason 3+4 tumor size9.5 mm 90 % lenght of biopsy
core 8 gleason 3+3 tumor size 2 mm 20 % length of biopsy
urologist recommends radition but my GP whom i have been with for 25 years suggestd removal..get it out and over with he thinks is the most sure way..granted he is just a GP but he is very knowledgable...i think i will meet with both a radiologist and rbotic surgeon just not sure what questions to ask.......many thanks for all your help and guidence ...i will follow up all the y way with my journey...my doc did say take my time and find the right Dr..he says i should find one that has done the surgury at least 500 times...i am fortunate to have excellent facilities around me...i am in the san francisco bay area....UCSF as well as Stanford......i am sure i will find agreat surgeon ...or radiation oncologist
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Suggest more testing
I would strongly suggest an MRI to determine if the tumor is contained in the prostate and possibly Oncotype DX genomic testing of the biopsy sample to determine how aggressive the cancer is. Medicare covers Ocotype testing, but you're too young for that, so check with your insurance company first. I think because of your age, most doctors will suggest some sort of active treatment.
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.
Well to be honest, your GP is not an expert about prostate cancer....in fact after you do your research, I expect that you will know a lot more about this beast than s/he does.
As mentioned above a T3 MRI is critical to determine if there is extracapsular extension and how extensive, that is if the cancer has escaped the capsule and will determine treatment.
I doubt if having a genomic test will affect your treatment decision.
Surgery is a localized treatment, removing the prostate only with great chance of side effects, while radiation treatment can adjusted the perimeter of radiation to be outside the prostate. In your case of intermediate disease, there is a good possiblity of the cancer being outside the prostate, so the perimeter of the radiaiton will need to be expanded with best chance of eliminating all of the cancer, (within the prostate and immediately outside the prostate).
Swingshift is one of our forum posters who lives in the San Francisco area who was treated at UCSF with a form of SBRT called Cyperknife and is best qualified to provide information about facilities in the area for you.
SBRT is given in five sessions or by some doctors four sessions with minimal side effects. Several at this forum have successful undergone this treatment and can give input.
Here is a nine year study about the success of SBRT and the results of treatments. You will note that there is a 89 percent chance of success for intermediate cancer.
https://prostatecancerinfolink.net/2016/01/06/nine-year-outcomes-after-treatment-with-sbrt/
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Hmmm ok
wow I thought I caught this thing early no wonder my dog gone urologist didnt say much....curious how do u determine early intermediate and advanced...I guess intermediate is still better than advanced ..also how do u tell if it’s slow or aggressive .i always heard if u have cancer this is the one to get because it’s so slow moving ...sorry just curious and scared...also seeing an oncologist Thursday that specializes in radiation therapy and only men with prostrate cancer he treats for 17 years now.....hope he is good man will I have questions for him....I will try not to panic I know we just have to make sure of everythinggggggg....I hope there is a chance it has not spread .....man I kick myself for accidentally skipping getting checked one year ...dog gone it
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Words of encouragement and hope
Hello Steve,
I'm 91 years old and a 25-year prostate cancer survivor. You are getting a lot of information from others. That's good. Treatments for PC have changed (improved?) since I began this journey with a prostatectomy, in 1991.
Even though I have had many experiences with and related to PC, I am not qualified to advise you. Learn as much as you can, involve your loved ones in your decision, then grab the ball and run!
By the way, my Gleason score was also 3+4.
One other thought, I feel that my life has been richer as a consequence of experiencing prostate cancer. Think about it.
Best of success to you.
Old-timer (Jarry)
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You are very young and a goodSteve1961 said:Ohh btw swing shift hasn’t
Ohh btw swing shift hasn’t posted since 2010 but thanks
You are very young and a good canditate for surgery if you decide to go that way. Depending on no medical issues.
Seek 2nd and 3 opinions on treatments and go from there. Take your time slow down and educate yourself on this forum
and from reserch and doctors. Im trying to do the same being told oct i had 2 cores positive gleason 6 t2a tumor 25%
left apex. contained in prostate. It is a shock like being hit in stomach after leaving doctors office. Good Luck
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