Prostate Cancer - Out of Nowhere

A routine physical four weeks ago showed a high PSA (11.84). They did a second test that showed the same result. Was referred to a urologist and had a biopsy performed four days later resulting in a positive cancer (4 of 12) with Gleason 9. Followed that up with a pelvic CAT scan and NUC Bone Scan showing no spread to lymph nodes (only good news so far). Have decided on robotic surgery for removal by a good expert in the procedure.

A real shock because I'm in good shape (58) with no symptoms. I never went into denial but the anger factor has been pretty high. Am well aware of all the risks but knowing the extent of the cancer and having made a decision has relieved a lot of stress. I go in for surgery on 9 May and can only hope for the best. I'm into acceptance now and hope I can hold on to that but won't go without a fight. I guess my order of priority is to get rid of the cancer, remain continent and continue to be able to have sex - guess it's a no brainer at this point.

Welcome to HW, sorry you have to be here, but glad you joined us. There's a ton of experience, and a bunch of people ready to walk with you during your journey. You came to the right place....

G9 is a rough lick to take, I'll be honest, but we got a bunch of guys here in your shoes who will be glad to offer their experiences. It's a cruel fact that most PCa doesn't have any symptoms, other than increasing PSA and a lumpy DRE.

Brad, it was a bolt from the blue for me also. Similar tests and procedures. So far, recovery is going very well, zero club, continence returning slowly, but no opportunity for sex.

Brad,

Welcome to HW, under stressful circumstances, from another G9. You can see my treatment approach in my signature line.

Hi Brad,

It is good that you have come to a decision. I hope the cancer ends up being confined to the prostate, and you have no positive margins.

You might want to check into plans for lymph node removal. I have read papers that encourage extensive lymph node removal in high Gleason cases, both to test for spread to lymph nodes and to eliminate sources of micrometastases. From what I've read, robotic surgery doesn't lend itself to lymphnadectomies as well as open surgery. As I'm sure you're aware, regardless of the type of surgery, results depend on the quality of the surgeon.

One last thing: make sure to get another PSA test before your surgery. It sounds like you don't have a PSA history, so this would be important to determine your PSA velocity, which might be very helpful in the future.

However you choose to go, I wish you the best.

Nellie

Brad, you've come to the right place, my feelings ran the course also, plus I was thrown a curve after the surgery (small cell carcinoma). So many ways to attack the beast but it will be your choice and there will be no going back...hang in there and peace to you in your journey.
Ken

PS: I've checked the Partin tabels and they are not nice to G9's so save yourself some grief and don't go looking....

Thanks for the feedback - first time I've talked to other guys about this other than a bunch of doctors. The guy I'm using is Robert Carey (co-author of "Conquer Prostate Cancer" with over 2,000 DaVinci procedures under his belt) who has a good stats with his patients. He'll be going after local lymph nodes for good measure while he's in.

The Gleason 9 bums me out but don't know what else to do other than accept it and get on with the program. Wish I could make it go away but prefer reality at this point. "Crying like a *****" doesn't seem like a rewarding option right now and feeling sorry for myself when all you guys are facing the same problem seems pretty darn petty.

Thanks again for the comments - will need you guys as I go forward.

Brad,

Best wishes with your surgery.  May your recovery be quick and complete.  Sounds like you have a top guy -- surgery will go very well.  Best wishes.

Newspaper Lover

Age 68

DaVinci surgery 11/09. Clean margins, clean seminal vessels.

Rising PSA noted 06/11

Gleason 8

Time to recurrrence 18 months

Three month doubling time (summer 2011).

PSA rose from .07 on 06/11 to .17 on 11/11.

MRIs and bone scans negative so far.

Started Lupron/Casodex 12/11

Began IMRT 02/20/12.

Finished IMRT 04/16/12

Follow up in July, 2012.

 

Brad, Welcome to HW and sorry you have to be here. Our numbers are fairly similair as I had a Gleason of 9, 10 of 12 mostly 40 to 90%. Also PSA of 94. I was recommended that Radiation would be the best option as I would more than likely need it after anyway. I went through the partin table with my URO and he came back with 93% chance it had escaped.

The good thing about surjery is you will know what your stage is and will know if it has escaped by the pathology report. I sometimes hate not knowing if Its somewhere else or not. Hope whatever treatment you choose works for you...I can see wanting to get it OUT of you. That was my first reaction too.

That said, if you end up going with HT, It works well and pretty quick as far as lowering your PSA. Not many side effects for me but the normal ones like Sex drive dissappearing....also tend to be a lot more emotional for some reason. I guess the HT will do that to some.

You sound like you have a great Medical team as youve already had the biopsy and have scheduled surjery just 4 weeks from initail diagnosis. It took me 35 days just to get an appt. with my first URO...then another 3 weeks for the biopsy. Good luck and keep us posted, Chris