Husband newly diagnosed with PC/any input welcome! SCARED :(

Put on finasteride which lowerd PSA to under 2. DRE in 8/2012 revealed hard spot on left side of prostrate. Ensuing biopsy found 1 of 12 cores of (<5%) with PC on leftside. GS 3+3. Urologist specializes in roboytic surgery but refered to radition oncologist to evaluate other options. Because of an unrelated issue that requires annual abdominal MRI's and a gastro-intestinal problem, I ruled out radiation and had the DaVinci surgery on 11/1. There was minimal pain, had the catheter removed this Monday. The incontinence is not anywhere near as bad as I thought it might be. Some inadvertant loss of control when I make a sudden movement, but nothing all that significant. Pathology report very encouraging; GS 6; staging pT2c, PNX, no positive margins. I feel very fortunate at this point. Best wishes and good thoughts to all. 

With your husband's data, you treatment choices would seem to come down to:

surgery + immediate (Adjunct) radiation + hormones.  (This would be the most aggressive approach possible).

surgery + immediate (Adjunct) radiation without hormones.

surgery alone.

radiation with hormones.

radiation alone.

The choices probably come down to the doctors you will choose.  With a Gleason 8 present in at least one tissue (and don't assume the others will stay at a 7), that would argue for an aggressive approach.  Put another way.  Your husband's cancer has already announced itself as aggressive. A new major study out of Europe (reported October 2012 Lancet medical journal) shows real benefit to immediate radiation (Adjunct) after surgery to men at high risk, as opposed to waiting for biochemical failure down the road (Salvage Radiation).  Of high risk men who receive immediate radiation, 61% are Progression Free for five years after surgery;  only 39% of those who wait to receive Salvage Radiation see the same results over five years.  Randomized study included 1005 high risk men over a period of 10+ years.

Best wishes to you and husband!

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 hormone therapy (Lupron/Casodex) 12/11

Began radiation (SRT) 02/20/12.

Finished SRT 04/16/12

Last Lupron shot 03/12

PSA and testostorone "undetectable"  07/12

Next PSA and testostorone test early January

Todd, I like the phrase "cured guys" and hope to believe Ron is still one.

Camerabug, I know how overwhelmed you are feeling right now.  Doing your research and trying to understand this disease and its treatments is the right step.  For my husband, the DaVinci surgery worked out quite well.  Unfortunately, he does experience ED.  It's just something he accepts for the moment.  Please check out his stats.

You have found an understanding and helpful group here.  I wish you and your husband the very best as you begin this journey!

Peace.

Aimzee

I am also getting into this thread late. I was a G7 with 60% of my old rotten prostate tumor involved. I had my RALP in June 2011 and was 100% continent 3 weeks after surgery and so far no recurrence and an undetectable PSA. I was fortunate that my first URO was kind caring and the best I could have found in my area. Best of all I now think he saved my life and in our 15 month post op meeting he used the C word for the first time and moved me to 6 month PSA testing. I agree you made the right move in changing URO's and your treatment path sounds very well thought out. In this forum there is only one right treatment path and that is the one you choose as you and your husband are the ones who will make the decision. As to when to start RT after surgery your post surgery pathology will give you a lot more information about the cancer in the prostate. It could also be possible that some of the tumor could be even downgraded in the Gleason numbers. The post pathology will be much more accurate than the few needle samples taken at his biopsy.

Terry

From one wife to another, hang in there.  EXACTLY this time last year, we were walking through this.  What a difference a year makes.  I can't begin to desribe how relieved we feel 1 year later.  It was a very scary time in our lives, but we made it through.  Just take it slow, day by day! 

HUGS!!

Many blessings,

Aimzee