Dear Dad diagnosed with PC: Couple questions

My father was diagnosed last week with Prostate Cancer.

Age: 74

Gleason: 7 (3 + 4)

Stage: T2a

PSA: 5.5

With these stats, the calculator at http://www.prostatecalculator.org/ says that he has a

"52% risk of cancer having spread outside the prostate (at the time of treatment.)"

Can someone please tell me what this means? Where does it typically spread & is there anyway to find out  if it already has? 

Also, we are considering Robotic Prostate Surgery. Is there a rush with this? Would doing it next week vs. the first week in March make a huge difference?

Am scared & pretty darn sad. Please help! My heart goes out to everyone on this board.

Welcome,

It is way too soon to think about scheduling surgery. This gleason is serious but the PSA is reasonably low. Radical prostatectomy carries the risk of side effects and for even a healthy person at 74 is a very major surgery.

It is very likely that radiation, cryo, or HIFU would result in substantial remission or cure of his cancer. But before contemplating surgery you need diagnositics to ensure as much as possible that the cancer is still local. This will mean nuclear studies where a tiny bit of tracer is injected and then a bit later he will be scanned, the tracer is picked up by cancerous tissues showing if it has or not spread.

Is he symptomatic? What lead to his having the biopsy?

Best wishes. Scott

Welcome to HW. Sorry to hear about your dad's diagnosis. I know entirely too well what it feels like. As the other members posted, you have time to make a decision. Typically, most will want to wait at least 6-8 weeks after the biopsy is done. My father had similar statistics and unfortunately, his had spread outside the organ. However, there are still many options for treatment. Have you checked into cancer facilities yet? I would recommend either meeting with a Prostate Cancer Team, including a surgeon and a radiation oncologist. Keep in mind, surgeons recommend surgery and Radation Oncologists recommend radiation. There are MRI's and CT & Bone scans that can be done to rule out spread, however, also keep in mind they are not 100% accurate, which was also the case with my father. However, most will encourage these tests prior to treatment.
Cancer does not operate in black and white. Therefore, do the research, go with people that you and your father trust and help him to make the best decision for him. There is a very good chance your father will live a long time and die of other causes. Stay positive and know that you are not alone.

Thank you all for your kind words of encouragement/advice. They mean a lot to me.

Some of you had questions/comments:

Scott: My father had problems with delayed urination and slow flow and decided to get it checked. DRE (felt something), then blood work (elevated PSI), then MRI (they saw a small nodule), then the biopsy (cancer). & Scott my heart goes out to you. I just read your writeup. You are a brave man. You have been through a lot...I wish you a speedy & complete recovery.

Z-bob: My father has started on some anti-androgen pills.

Doting Daughter: You had mentioned that people typically wait 6-8 weeks after the biopsy. But what if it spreads during that time??

So why wouldn't each day of surgery postponement matter?  I understand the risks of surgery, but isn't cancer going out of the prostate and into other organs just a function of time?  And if that is the case, wouldn't a surgery done sooner be always be better than one done later? Sorry if I'm being really naive in my rationalizing....perhaps its just initial panic setting in, but can someone please take a shot at the question?

Again thank you all. I wish you/your loved ones a quick & complete recovery.

Thank you. That definitely makes sense.

pcbegone,
Your dad had plenty of time to make a decision. prostate cancer is very slow growing and 3 months won't make a difference, especially with a low psa. It's much more important to have the cancer staged correctly as most treatment failures are due to improper staging. Put a prostate oncologist on the list of doctors to get recommendations from. I have found that prostate oncologists spend much more time trying to stage the cancer correctly. There are a lot of tests that can be recommended for better staging; PSA3 urine test. MRIS with endorectal coil, or color doppler ultra sound. Prosta scint with CT fusion or Combidex MRI can eliminate lymph node involvement.
Spend the extra time as it will drastically affect your outcome and evaluate all options as to both cure rates and quality of life issues. Wishing your dad the best.
It will be 5 months since diagnosis before I start treatment and I'm not worried at all as the cancer has probably been there for at least 10 to 12 years.
You can also slow the progression with diet and supplements while you wait. My psa has gone down 10% since I changed my diet.
JohnT

This board is a wealth of information & everyone is soo very nice & supportive. A big thanks to all of you for being so generous with your time answering my questions & giving me support.

I have a few more questions. If someone could please answer them:

Gleason score: It's currenty 3+4. Would it have been less if we had done the biopsy, say 6 months ago? Would be more in the future?

Robotic Surgery: Can someone please tell me roughly how much this costs? (ballpark)

Surgeon: Can someone please recommend one in Houston? (One who does Robotic Prostate Surgery)

Thank you.

PC bGone,
Please don't dwell on what might have been. Please put your effort into the future. Treatments and options. It may have been there for a long time, but it has nothing to do with what you are going to do about it. Proper testing and staging and Dr choices will help you decide what direction to take. I am happy to have found this forum and find it great for support and information. Best wishes
DonK

You guys are right. No point dwelling on what's been! Thanks for the support. This board is terrific. Best of luck to all you guys!