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Posted 10/22/2010 1:56 PM (GMT 0)
I just found out yesterday that my dad has prostate cancer. His Gleason is 9. His PSA is 10.33. I am very emotional right now and don't know what to do. He told me that he was going to get hormone therapy. He sounded like he was unclear and unsure about things, and I want to make sure that he is looking for options out there. I joined this because i want to see what other experiences some of you have gone thru. He had a bone scan, and his bone scan looked good. I need help, and i love my dad. I want to give him all the support and pick up some more knowledge about this disease!
Posted 10/22/2010 2:22 PM (GMT 0)

sorry to hear about your father.  what is his age?

i have an older customer who recently shared that he has PC. he was diagnosed as a gleason 9 with a psa of 20.  he was diagnosed several years ago and they started him on HT.  in a couple years the HT no longer worked so he had BT and IGRT (two years ago).  he's 82 now and i believe his PSA has risen slightly and he's taking casodex.  he said that he was going to the doctor that day because he just started having hot flashes.

i won't tell you i understand his treatment strategy.

when i was undergoing IGRT i met plenty of older guys and many of them had high gleasons and PSAs.

ed

Posted 10/22/2010 2:24 PM (GMT 0)
Hi Lynn,

Your Dad has options. At this point I would say all options... surgery, radiation, and hormones. There are a number of sites that have a good deal of information regarding PCa. National Institute of Health is a good one so is PCRI (prostate cancer research institute). Just google either with PCa and you will be flooded with information. Be aware that some info on the net is old. I restricted my own research papers published in the last five years and much has happened since my own diagnosis.

Most important thing right now is to "characterize" the disease. Is it local, has it spread, and so on. What is the state of your father's health? Age? Have you sought and recieved a second opinion from another urologist or oncologist?

 

Posted 10/22/2010 2:30 PM (GMT 0)
Hi, Lynn:

I just went through surgery and recuperating.

I know this can be overwhelming - sort of like trying to take a sip from a firehose. Please refer to GUIDE TO SURVIVING PROSTATE CANCER by Dr. Patrick Walsh. My wife bought this and I could browse through and find info pertinent to my situation. It put many fears at ease.

Please let us know what is going on and I wish you and your father all the best.

Alex
Posted 10/22/2010 2:39 PM (GMT 0)
My dad turned 60 this past April. The doctor told him it is Stage 1 PCa. His overall health seems to be ok. He gets up in the middle of the night to urinate, and I know he was some joint pain, but nothing to severe. The doctor told him that it hasn't spread anywhere, and I looked at his bone scan report and his scan was good. My dad told me that the doctor wants him to do the hormone therapy. He said it will help stop the spread. Im just confused. Can you have stage 1 PCa with a Gleason of 9? I've been doing alot of reading, and there has just been cases of Gleason 9 with stage 3. Im just afraid my dad is not telling me everything. I don't want to upset him with all these questions but im just concerned
Posted 10/22/2010 2:51 PM (GMT 0)
Thank you again for responding. Its really nice and comforting when you can get support like this.
Posted 10/22/2010 3:02 PM (GMT 0)
Gleason scores are determined by examining tissue. That can be from a biopsy, where the T (stage) is more speculative, or from a post-op pathology, where they have the whole organ to examine.

T (stage) pre-op has to do with how palpable it is on a DRE, and if the cancer is known to be out of the capsule (hence bone and CT scans).

So, you could be initially T1 (stage 1) with a Gleason = 9. That means there was nothing obvious in the DRE, but that something was found in a biopsy.

Post-op T is determined by the pathologist.

My pre-op was T2a (the uro could feel abnormalities in the DRE), Gleason 4+4=8; post-op was T3a Gleason 4+5.

There is a good explanation in the "Cleveland Clinic Guide to Prostate Cancer" (2009).

The Walsh book already mentioned is the best book, but this one is a good summary with diagrams approach.

Posted 10/22/2010 3:19 PM (GMT 0)
Thank you so much. I will have to check that out. I will doing more research tonight and to further my knowledge. Again, this news is new to me and I am just trying to help my dad because i don't want him to think that since he has the big "c" that it is the end. I want my dad to be around for a long time.
Posted 10/22/2010 4:44 PM (GMT 0)
You might also want to buy your Dad a copy of Walsh's Book that was mentioned in a number of the above posts. He would do well to seek a second opinion about his treatment options. I think that a large percentage of the men who post on this forum sought second opinions before undergoing treatment.
Posted 10/22/2010 5:01 PM (GMT 0)
Lynn,

You might try a local library for these books just as a start, but I've found that having a copy is better.

Check online at www.ustoo.org. If there is a nearby chapter, contact the co-ordinator. Depending on the finances of the chapter, they may have reference material to loan or give you. The on-line site has a lot of information. They have a monthly "Hot Sheet" with current articles.

If there is not a local chapter, check for a state prostate cancer foundation office. My copy of Walsh, and several other books, were long term loans - ok, they didn't really expect to get them back, but I am "paying out" my loan with some volunteer work.

If all else fails, and you have a state or university medical center nearby, call and ask about cancer support programs for family.

Lance Armstrong's foundation will also send some general material that is generic to all cancer patients. They sent a diary - you would be surprised how many things get lost on scraps of loose paper.

Just some thoughts -

 

Posted 10/22/2010 5:18 PM (GMT 0)
Lynn,
After my DX I was T1c with Gleason 8 and 9. The doctor didn't feel anything during the DRE and my bone and CT scans were negative. I opted for surgery. The pathology report confirmed the gleason 8 and changed the staging to T3A because the cancer was found in both lobes of the prostate. Your dad has all options on the table. HT therapy is normally recommended when the cancer may have metastasized which makes surgery pointless. It is also used when other treatments have failed. HT itself doesn't offer a cure but it can keep someone alive for many years.
Posted 10/22/2010 6:11 PM (GMT 0)
Your dad is on the young side for being diagnosed with PCa (our uro doc said average age at diagnosis is 72). If your dad is healthy otherwise, he has a life expectancy of more than 20 years. Personally, I don't think he should be messing around with any treatment that isn't aimed at a cure....and hormone therapy from what I understand is not considered curative - it merely slows down the growth of the cancer.

My husband was diagnosed at age 64 and our urologist was very forceful in urging him to have the surgery because he is very likely to live longer than the 10 to 15 years other treatments might provide in longevity.

You are right to research and find out all you can about the stage of his disease and what treatment options there are. I think it would be very difficult for your dad to do this all on his own though many men who participate here do take a very active role in figuring out everything for themselves. However, I and other wives who post here for their husbands are testimony to the fact that some men just don't want to deal with the research, bewildering array of options all by themselves and/or are not comfortable posting on forums about such a personal matter. You sound like a very loving daughter - your dad is fortunate to have you in his corner.
Posted 10/22/2010 6:11 PM (GMT 0)
Hi lynn, Its not the end of the road. H.T. is a good start. if the tumor is confined it will shrink it and make surgery easier. If it is not confined there are other options but most start with h.t. I myself am gleason 7 but my initial psa was 3216.17 It has been 5 years and I am still doing well. I am now 47 years old. Take a deep breath. Relax. Its a battle but there are many more victories than even 10 years ago. God bless you and your dad. Todd
Posted 10/22/2010 6:41 PM (GMT 0)
THANK YOU ALL SO MUCH FOR YOUR RESPONSES! I am looking through loads of websites and going to the library in a few. I told him that I will support him with whatever path he chooses but I will offer him my advise as much as I can. I will update again when he has his appointment. I believe his appointment is early next. Here to the first step of a very long journey!
Posted 10/22/2010 9:01 PM (GMT 0)
Prepare for brain overload and brain drain and don't let emotion or good sales pitches throw you a curve, the docs are not all experts and disease is not at all simplistic. Your task is omnious, best to you, he will need all the options discussed. The good news is controlling of PCa may exceed your expectations.

PCa University (LOL)-  www.yananow.net       www.prostate-help.org   www.ustoo.org   www.phoenix5.org 

Posted 10/22/2010 9:15 PM (GMT 0)
Todd

During the past 6 years, I have heard hundreds of personal stories and read thousands of posts from individuals who are doing battle with PC.  I have NEVER heard a story equal of the great success that you are enjoying.  All this with only Lupron and Casodex?  Surely there is more to this story.  Whether there is or not, makes not a lot of difference.  You have made a miraculous recovery, which is an inspiration to us all.

Posted 10/22/2010 11:31 PM (GMT 0)
Lynn, the Gleason 9 is aggressive, high-risk cancer..The PSA of 10.3 while not wonderful is not a disaster either..

Starting HT now can not hurt anything and will suppress but not CURE your fathers cancer..From what you have told us, a cure might still be possible and is CERTAINLY worth pursuing. The combination of seeds and beam radiation has had very good success with high-risk PC like your Dad has..

One downside of starting HT now is that it can lower the PSA to very low levels, making it very difficult to judge the effectiveness of other treatments should he choose to be treated with the intent of being cured...

Read Walsh's book and have your Dad read it...Gleason 9 can be a tough fight, but it's not hopeless...This board has many members who were G-9 and are now 5 years or more out and are doing fine...
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