Hello,
My husband was just diagnosed this week with prostate cancer. Biopsy results indicate:
12 cores taken, 6 are positive for cancer.
Right apex - 10% occupied
Right base - 30% occupied
Left base - 10% occuied
We are waiting for an appointment to see the oncologist, however, his urologist suggests he should seriously consider surgery. He is 50.
Any advice would be greatly appreciated.
thank you so much
Don't make any decisions yet until you have seen everybody. There are also a number of trials running in which you can get involved and you will then be assessed regularly. Prostate Cancer is not one of those ones which grow quick so you have plenty of time, and read the many items on here to see results and side effects. Not the best of clubs to be in but there is light at the end of the tunnel. Best Wishes.
David
It would help you to know if the cancerous cells are definitely still contained within the prostate - this would tell you how urgent the decision about surgery would be. Some prostate cancers don’t grow or spread, but others are rampant and fast-growing. Nerve sparing radical removal can keep erections possible but sexual function and feeling will almost surely be worsened. However most would say better safe than sorry. I’m lucky in that I seem to have minimal cancer cells which seem not to have increased or spread over 5 years of active surveillance- your man’s situation sounds much more serious to me.
Very sorry to hear. But as with everything, get a 2nd opinion. Doctors are very quick to suggest surgery but there are many things to consider. My husband just got back from 9 weeks of radiation therapy in Phoenix. He seems a lot better but we won't know anything now until sometime in March when they will test his PSA again. They can't test now due to the radiation. The reading wouldn't be accurate. Our doctor tried surgery to remove the prostate entirely but when they went in that's when they discovered it had spread to the bladder neck. Do your own online research as well. A good place to start is the website for Cancer Treatment Centers of America. God speed to you both.
Thank you for the replies, it is certainly a scarey time for him. The urologist said the cancer is confined to the prostate. The concerning part is the number of cores affected and the volume. His PSA over the last year has elevated from 6.4 to 9.7.
That's a lowish PSA score. Mine's hovered around 8 since first diagnosis. I've needed no treatment.
Hi Willie, a worrying time for you and your husband. My husband got a PSA of 12 on a blood test after I sent him to GP when he was complaining of back pain and she did a routine blood test and included PSA. He had no symptoms. He had an MRi scan and his first biopsy. We were told low grade in one side about 5% would probably be watch and wait Gleason 4+3 and T2a, but the surgeon he went on to see upgraded his MRi and sent him for a targetted biopsy. They found more cancer in the same half but a difficult to reach area so went through all the treatments and said nothing else but surgery Still 4+3 but T2b now, it was robot assisted and we hoped they could save both sides of the nerves. After removal we were told it was in the whole prostate but was luckily still contained but could only save one side of the nerves. Final tumour score was T2c. From initial diagnosis to surgery took 7 months.His recovery surgery wise was brilliant. urinary wise took him a few months to regain full control but that was because he kept forgetting to do the kegal exercises before and after the op. Now erections and ability to have intercourse is another story. Tried two different pills not much help, he has regained some function down there naturally but not enough for penetrative sex, and the two times it did happen it wasn't that good. In a couple of weeks we go to try out the injections. he is 13 months post op and PSA is undetectable. When you first get this diagnosis and have to have surgery, your first thoughts are his alive and cancer free. But in time the lack of intimacy does cause problems especially with him saying he isn't a man anymore etc. You have to have a strong relationship to get through this. You really need to know what grade the tumour is as it is in both sides. 50 is very young so you need to make the right decisions. A friend who had both sides of nerves spared has no erections at all so it isn't always about one or two sets. Definitely seek another opinion, but don't leave it too long. Be there to support your husband and make sure you find someone to talk to too.
Hi Willie...I was diagnosed last December when I was 50 years old also. I had cancer in 9 of the 12 cores and it graded out at a Gleason 6. We read everything we could to understand all of our options. We chose to move forward with removal, just for piece of mind. I had my surgery on 7 March 2017, with no complications. Recovery felt slow, but in retrospect it has not been. 9 months post op, I have regained 98% contenance, and am able to achieve enough of an erection. The ED has been the hardest (no pun intended) thing to deal with. It's just not the same anymore for me or my wife. That being the down side, my PSA's indicate all of the cancer is gone. My most recent test (This week) was 0.03. I have confidence that I am cancer free and can move on with life. Good luck with your decision. Best wishes.
Did he get a gleason score?
Ditto - what is his gleason score?
Hi. Gleason score is 6. Although the urologist says low grade there is concern that 6 of the 12 cores are positive for cancer and it's bilateral. That combined with the elevation of psa in just over a year.
The gleason is favorable, along with low percentages in the positive cores. My numbers were similar, I chose to hold off on doing anything. New treatment options ( that spare your prostate) are becoming very popular. Take your time
For folks like us who have been in same shoes can only give advice from personal knowledge. EVERY case is individual. At Gleason 6, PSA at 8, its VERY low grade. Please read the NCCN patient guidelines found here: https://www.nccn.org/patients/guidelines/prostate/. Its what every doctor should provide any patient. Personally, I was Gleason 6 and Gl 7, age 73, watchful waiting for 2 years; eventually decided on Seeds plus a short course of hormones and a follow up of external radiation. I never missed a day of work, felt great, and tested free of cancer 8 weeks after last radiation treatment. My libido is returning, my testosterone is improving and I can actually maintain an erection.
While prostate cancer is often slow to progress in older men, surgery can have significant side effects — such as the possibility of lifelong erectile dysfunction or chronic urinary incontinence. Though the procedure might differ according to the patient and case. Though consulting for some more prostate cancer treatment options in New York(http://advancedradiationcenters.com/cancer/prostate-cancer/ ) should be beneficial. try to have a brief discussion with the oncologist, so that you can take a decision positively. Though other prostate cancer treatment options are radiation therapy, immunotherapy or proton therapy.
Hi willie93634, I just had my prostate surgery 7 days ago. Out of the 12 cores taken for my biopsy, only 1 showed positive for cancer. My urologist also suggested surgery because of the aggressiveness of the cancer. However he did go over all my other options. There is a test to show how aggressive his cancer is. Once that is known then you should go over all your options. Good luck
Update: Saw the radiation oncologist yesterday. Indicated that while the biopsy results suggest low grade, based on the volume, rise in PSA and my age, it is considered intermediate. He recommended robotic surgery based on this criteria. See the surgeon tomorrow. So looks like a bit of a journey for the next few months....
First step is to take a deep breath and consider the options before making a decision you might later regret. Time is very much on your side; the word cancer strikes fear into most people and they often act irrationally. Firstly, look at survival rates which should put your mind at ease. Then, do research - there are plenty of good books out there and websites - I found prostatediaries useful as it is by an American urologist who was diagnosed with the disease. It gives excellent tips on which form of treatment would suit your husband. You should also evaluate other results - PSA (doubling time, reading), DRE findings etc., PIRADS score.
I opted for IMRT (in the UK) and I am pleased with the outcome. Please read the comments of those who chose RP.
I wish you all the best.
Hello again
More confused than ever. On Monday the radiation oncologist says must be treated recommends surgery. Today see the surgeon who says "surgery will be needed at some point may be 3 years from now but let's do MRI. If you think you want the surgery I will do it." So now what?? Feeling worse now then when first diagnosed with the contradictory messages.
Mine was 14... no treatment needed
Wait and see what the PSA results are over the next year or so.