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Posted 10/22/2013 2:26 PM (GMT 0)
1) When and How did you find out that you had PCa?

Returned from winter vacation & was feeling great! Had apt with primary care doc for annual physical the following week, my old doc had retired a few months prior and I was seeing a new guy in the practice. I found him to be very through which I didn't appreciate at the time. At the end of apt he said he felt a small nodule during DRE and wanted to schedule me for biopsy which was done a couple weeks later, got a call from the URO that 5 of 12 were pos, four were sixes and one was 3+4. I was shocked in the sense that I had no symptoms and felt so good. I didn't know anything about PCa.

2) Why and How did you choose your primary treatment?

Went with DiVinci surgery mainly because my URO was a surgeon and told me that I could go with radiation but if it wasn't successful, surgery afterwards would be problematic. Those were the only two choices I was aware of. I didn't discover this forum until after surgery, had I found it earlier not 100% sure I'd have went with surgery??

3) Why and How did you choose your secondary treatment?

No secondary treatment as of yet, at my 1st post op 3 month check up my PSA was undetectable and he pronounced me cured, I need to get a couple years of >0.1 before I buy into that totally. My PSA at time of surgery was 2.9.

4) How are you doing now?

I was totally dry at three weeks and will always be grateful for that. I'm nearly five months post op and physically feel pretty much back to normal with one exception, ED. I understand five months isn't that long but I've never been the most patient person either. The ED is the only reason I may have chosen a different treatment had I been more knowledgeable prior to choosing surgery.
Posted 10/22/2013 7:51 PM (GMT 0)
1) When and How did you find out that you had PCa?
June 2009 - Thought I was developing some urinary issues with a weaker stream so I went to see my doc. Had an exam which included a PSA. Doc called a week later and said that PSA was 6.4 which was up from 4.something 18 months before. So I scheduled a meeting with a URO. DRE indicated something so a biopsy was scheduled and Gleason 7 was found in 4 of 12 cores. Originally was 3+4 going in and 4+3 after surgical biopsy review.

2) Why and How did you choose your primary treatment?
My wife was in the hospital in ICU when I got the news. She had been fighting her own cancer for 3.5 years at this point and was in a drug induced coma while fighting swine flu. By day I was with her and by night I was on the net learning. This is how I came to find HW. As her primary caregiver, I was looking for the best way to attack it with the least amount of downtime and/or recovery. I chose surgery and selected Dr. Menon at Henry Ford in Detroit. He is recognized as one of the fathers of daVinci Prostatectomys and had developed many of the refinements in surgical procedures that are being used today.

3) Why and How did you choose your secondary treatment?
My PSA never dropped to zero following surgery and 3 months following I started Radiation. 35 treatments for a total of 70Gys.

4) How are you doing now?

I have a continuously rising PSA. My last test was Oct 2012 when I completed a 1 year Diagnostic Clinical Trial (F18 Pet scans for Micro Mets) at the NCI/NIH. My PSA was 34.6. I have not had a PSA test since then. I do have test every 3-6 months to include soft tissue and bone scans. I have another complete body scan scheduled for next Monday. To date nothing has been found in the last 2+ years.

My Onco at MDA and I are in agreement that HT is probably in my future, but so far I have no evidence of Mets or any Life affecting issues. I have been continent since surgery and have recovered in the ED arena to be fully functional about 70-80 percent of the time. Other times a VED works very well for me.

I do not have my head buried in the sand about this stuff, but at this point I am in better shape than most 65 year old men who do not have cancer. I have a very active and satisfying QoL. I am living life large and enjoying the hell out of it. The term Cancer does not scare me. For the time being it is leaving me alone and I am leaving it alone. I will address it when the time requires.

"Every Day is A Bonus, choke the life out of it".

Sonny
Posted 10/24/2013 6:34 AM (GMT 0)
1) When and How did you find out that you had PCa?

After much grief from the missus, I finally gave in and had a physical prior to my 55th birthday. I was more concerned about my cholesterol than anything. PCa wasn't even on the radar. She made sure I got a referral for a colonoscopy. My primary doctor, a young female, thankfully advised my PSA level was high for someone my age (2.8) and referred me to a Uro. Four months later, I decided to visit the Uro and had him run the PSA twice (3.6 then 3.4) prior to agreeing to the biopsy. DRE was negative. 4 of 12 came back with initial Gleason 6 score.

2) Why and How did you choose your primary treatment?

My Uro recommended surgery, he did traditional but advocated that I get second opinions and research - didn't need to make a quick decision. The oncologist I spoke with more or less gave the indication that he would be glad to treat but that I'd be better candidate for surgery. Spoke to another surgeon in the same practice that specialized in davinci. Decided I wanted the cancer out and davinci seemed to have a quicker recovery period according to my research. Surgery performed on June 10 this year. Still have not conquered the continence, using two pads daily, one night & one day, unless I work out then I use three. I leak about 8 - 12 grams. On the ED front, I had a slight chubby 2nd night after surgery. Still not back but hopeful. I can achieve about 75% erection on cialis trial. Have two others to try but the leaking is more severe even with just the thought of stimulation.

3) Why and How did you choose your secondary treatment?

I was undetectable three months after my surgery and will hopefully continue as such. I did start physical therapy for the leaking and I believe it has made a difference with just two sessions.

4) How are you doing now?

With the exception of the issues above, I'm doing well. I'm back to a normal routine of running and working out. The initial shock of dealing with cancer has subsided for the most part and does not consume my daily thoughts. I find I am much more patient in my daily encounters.
Posted 10/24/2013 3:37 PM (GMT 0)
1) When and how did you find out that you had PCa?

Last year around this time. PSA was up, tested it twice again and then a biopsy and BLAMMO!

2) Why and how did you choose your primary treatment?

Explored options. Agonized. Agonized. Agonized. Decided.

3) Why and how did you choose your secondary treatment?

So far just seeds.

4) How are you doing now?

Doing well. Will be getting my 2nd PSA post-implant next week. Crossing my fingers.
Posted 10/24/2013 5:25 PM (GMT 0)
1) When and how did you find out that you had PCa?
I hadn't seen a doctor for 2 or 3 years on the assumption that if I didn't have a broken bone or need stitches, why bother. I had a complete physical in 2002 and my primary care doctor didn't like what he felt on doing the DRE. He ordered a PSA test (my first ever) and referred me to a urologist. The PSA came back at 9.4. The uro sent me for biopsy which came back with 5 of 10 cores positive and an estimated 75% involvement of left lobe and a small focus on right.

2) Why and how did you choose your primary treatment?
My wife and I read Dr. Walsh's book (which was then in first edition) and also read many journal articles (we had both worked as medical writers and editors in the past). My uro also arranged an appointment with a medical oncologist, who said in her opinion I could also consider EBRT, which was by then showing long term results similar to surgery. She also discussed Brachy, which as of then had less of a track record than it does now. I finally chose open RP (robotic was still too new for me to seriously consider it) on the assumption that the cancer might still be organ confined and if needed, I could later do SRT.


3) Why and how did you choose your secondary treatment?
The primary surgery brought a remission of about 3 years until my PSA climbed to 0.1, and then I had about another 3 years before it then started to climb again. When PSA hit 0.4 my uro referred me to an RO. The RO did initial xrays and identified an enlarged lymph node. Given my initial staging of T3B plus this lymph node I was at the outer edge of patients who should probably be considered for SRT, given high chance that the PCa was no longer local. The RO and I ultimately decided to go ahead and he arranged for a portion of each day's EBRT to target the lymph node directly. He also put be on Casodex for 3 months during treatment.

4) How are you doing now?
So far, so good. It is now 3 years since SRT and I'm still effectively 0 PSA.
Posted 10/24/2013 6:43 PM (GMT 0)
1) When and How did you find out that you had PCa?        I was told I had PCa on July 9th, 2012, at 5:30 p.m., over the phone, while in a Walgreens looking for a birthday card for my wife whose birthday was the next day. I was told over the phone because the Uro that did my biopsy was in the midst of moving his practice and not available, which I knew when the biopsy was done. I did not want to wait any longer so I pushed his office and the Uro covering for him finally returned my call. "This is not something that we usually discuss over the phone, but I understand why you are not willing to wait another week. I'm sorry but you have Prostate Cancer." 2) Why and How did you choose your primary treatment?        I chose my treatment, LDR Brachytherapy, based on what I would consider an almost unbelievable amount of research on PCa and the various treatment options. I was beyond infatuation with needing to understand all of this, literally spending several hours a day, every day, for months doing this research. Internet, reading, phone consultations, travelling to meet with medical professionals, phone calls, meeting with brothers that had gone through treatment. For me, while clearly addressing the cancer was the primary consideration - QOL and SE's were a really, really close 2nd. Based on my analysis of all of the above it was clear to me that Brachytherapy had equal and/or better results in terms of addressing the cancer, and far better results in terms of QOL and SE's than surgery. Once I decided on treatment the next step was determining who the practitioner would be. I had decided early on that cost and geographic location would have zero weigh in on this part of my process - we are talking about my life, and QOL. Making this decision then was based heavily on the reported results of those that I met with, as well as touring the facilities and meeting the staff. 3) Why and How did you choose your secondary treatment?        Thankfully at this point in time I have not had to consider secondary treatment. 4) How are you doing now?        Absolutely, positively doing awesome! I was in excellent physical health prior to my Dx, and if anything due to the PCa I am even better off now because it caused me to take an even harder look at my dietary habits. This experience has given me a renewed outlook on my life, what is important, what I want out of it. I have also developed an undeniable need to try to help the newbies that will unfortunately follow us - as I remember all too clearly what I felt like and went through, and I also know that this beast can be beat without having to give up any QOL and I want others to know that as well.
Posted 10/24/2013 7:24 PM (GMT 0)
I went in for my annual physical and my GP ordered the PSA with everything else. I had had PSA done the two previous years and got conflicting results - 12/11 it was 4.2, 10/12 it was 3.4, this latest one came back 8/13 at 4.6. My GP felt it was probably an infection considering the rise and fall he had already seen. He gave me the option of antibiotics or have a Uro check it out. I opted for the Uro who felt an abnormality on the DRE and did a biopsy (NEVER EVER EVER do that again on a local!). I got the dreaded phone call from the URO on 9/23 telling me I had the BIG C.

The Uro pushed me explore the Robotic option, he sold it pretty well and I had a fast consult with a local doc here in Chattanooga who has about 1300 of them under his belt. Being a surgeon, he pushed his option as the best and jumped on the train. That is scheduled for next week, 10/30. However, I have been doing some research since - the reason for my being on the board - and now think that maybe I was too hasty. I am exploring other treatment options. We have and oncologist in town with almost as many Cyberknife treatments to his credit as the sawbones has to his. I will see him tomorrow. Thanks to information I have gotten here I am being more proactive. Today I requested my biopsy samples be sent to Johns Hopkins for a 2nd opinion to ensure the Gleason is correct. 13 samples and I am positive in 6 of them. 2 samples 3+3, 2 @3+4, those at 65% and 45% respectively. The other samples are all at or less than 10% and 3+3. The surgeon has ranked me at T2a. If all this is accurate, I am a good candidate for Cyber or Robo.

I dont know which to choose yet, really I am quite confused about all of it, but this is probably not the right place for that post - I will do it in another thread - but when I decide I will follow up.
Posted 10/28/2013 2:30 AM (GMT 0)
Hi all,

Anymore G7's out there?

All the best,

Joe.
Posted 10/28/2013 5:54 AM (GMT 0)
1) When and How did you find out that you had PCa?
Slowly rising PSA for several years, then went from 2.0 to 2.7 in one year, next year jumped to 3.6 and my GP referred me to a Uro, and the biopsy came back positive. An unusual feature of my case is that between october when I was diagnosed and February when I had the surgery I had one more PSA done, and it went from 3.6 to 5.3 in 4 months, which was a very significant increase in the growth rate. There is a lot of research that says such a rapid rise is a big red flag and it may turn out to be true in my case.

2) Why and How did you choose your primary treatment?
Talked to several specialists and both radiologist and surgeon suggested that surgery was best approach for my case due to it likely to be capsule contained, based on Color doppler ultrasound. DaVinci Surgery done in February of 2010. everything looked great post surgery, fully capsule-contained, first psa post surgery was <.01.

3) Why and How did you choose your secondary treatment? No secondary treatment yet but I'm headed in that direction.

4) How are you doing now? Urinary control very good, just occasional dribble, no pads needed. Erectile function is probably 80% of what it was before. With viagra or cialis it's serviceable. Problem is that PSA is moving upwards and while I'm still technically undetectable, the trend is not good. With my stats the probability of recurrence should be under 5% but I seem to be one of the unlucky ones.
Posted 10/30/2013 3:39 PM (GMT 0)
1) When and How did you find out that you had PCa?

Early this year PSA 5.6 refered to URO byopsy Right 1 of six 3 + 3 total G6 Left 1 of 6 3 + 4 (Scant 4) G7

2) Why and How did you choose your primary treatment?

Initially chose RP, after serious research changed to IMRT/IGRT Currently completed 32 of 44 total

3) Why and How did you choose your secondary treatment?

Hope there are none

4) How are you doing now?

experincing some slow sown in my daily excercise routine

Posted 10/30/2013 3:45 PM (GMT 0)
Forgot to clikc on the sig box
Posted 10/30/2013 6:22 PM (GMT 0)
"Sonny" glad to read your story. Bravo.
Posted 11/12/2013 7:03 AM (GMT 0)
Good thread, why only gl 7's. Are we dividing into feudal kingdoms. First only 9's now only 7's not to rain on a parade. IT reminds me of when they were filming the original Planet of the Apes. During lunch breaks when the actors , in costume, sat down together for lunch. the apes would sit on one table together, the chimpanzees another all together, and the orangutans another all together. True story, we are an interesting species. Oops hope I didn't sit down at the wrong table. Please take it in as food for lunch….
PS. Muckraking is a noble and time honored form of writings accepted in all forums of discussion
Posted 11/12/2013 9:51 AM (GMT 0)
1) When and How did you find out that you had PCa?

On a regular PSA test , July 2012 the value moved from previous 3.3 to 4.4 in one year. A rising speed higher than suspicious 0.75 in one year, according my doctor. He requested a free PSA which comes at 12%. Based on that 3 months after a new PSA and free PSA which cames at 5.5 and 9%. Biopsy was done 2 weeks after with 2 positive cores, one at 40% and second with 5%, Gleason 3+3. cry  

 2) Why and How did you choose your primary treatment?

After severe signs of depression and lots of reading and investigation of competent doctors of different techniques, I´ve choosed brachyterapie , but at the final interview with radiologist he refused to proceed because my urinary flow was too small, and obstruction with this technique could occur. Due to this, I moved to laparoscopic RP, once in Portugal there is only 1 place to perform Da Vinci, and the main doctor comes from Belgium 1 time per month.Others do not have experience.

RP laparoscopic was performed at British Hospital in Feb 2013.

Histological report, Gleason score 3+4, no SV invasion, negative margins, limph nodes not checked.

3) Why and How did you choose your secondary treatment?

Not performed yet and praying to not need or at least only after some years from now.

4) How are you doing now?
8 months after RP I´m doing phisically great. No incontinence (never did) and running 6 kms (4 miles) per day. Still some ED (mild erections).

My concern is with PSA rising after RP. First PSA 3 months after RP came 0.03, 6 months after came 0.05 and this month I will check by the third time and praying for stabilization.


Posted 11/12/2013 2:48 PM (GMT 0)
1. PSA rose from 3.6 to 5.0 in 14 months or so. Biopsy revealed Gleason 7 (3+4). 5 cores on left positive. One core was 90%. Other cores were also significant. PNI.

2. Decided on cryoablation because I was afraid of surgery. Seed radiation might have been better in hindsight. Had major side effects from treatment at first. The Clinic did not enter any of my side effects or complications into my medical record.

3. No real secondary treatments. My PSA rose to 0.06 from <.03 .
Then I evolved to a vegan diet most of the time. Take several supplements.

4. Last PSA was 0.04 2 years 5 months after cryo. Get up to pee twice a night or more. Urinate frequently in afternoon but I drink a lot of water because of kidney stone condition. Also have hydorcele and inguinal tear.
Posted 11/12/2013 3:47 PM (GMT 0)

logoslidat said...
Good thread, why only gl 7's. Are we dividing into feudal kingdoms. First only 9's now only 7's not to rain on a parade.

We may have the making of a softball league -- 7's vs 8's vs 6's vs 9's.
Posted 11/12/2013 5:15 PM (GMT 0)
Good point bohemond. Im glad you said softball and not hardball. Yikes, now where did I put that armour. Oh yeah !! Armour. As Jim Cary said in the mask, Staap May, somebody Staap May. I have no idea where this stuff comes from, no lie…. but its fun….
Posted 11/12/2013 5:22 PM (GMT 0)

 Hey Joe. I suck at baseball, but here goes...

 

1) When and How did you find out that you had PCa?

Started testosterone replacement therapy in early 2013 for very low testosterone (<200) and associated symptoms including depression, lack of energy, bone and joint problems, etc. Mid-2013 was fantastic--lots of energy, working out, losing weight, romance back in life and a great outlook. So of course a routine PSA in August showed high (8.0) and the retest also showed high (4.8). Off the TRT immediately, with resumption of all earlier problems plus the added bonus of hot flashes. Biopsy (read by Bostwick labs) in September showed 7a, 3 cores and multiple lobes, staged cT1c. Bought copies of Walsh, Blum and Scholz, and McHugh. Also found HW and  yananow—thanks Guys.                                                                                                                                                                                                                                                                                                                                                                                                                                                      

2) Why and How did you choose your primary treatment?

This was actually a fairly clear decision for us. With G4 present and my age (57) some type of intervention is necessary, and with the huge quality of life improvement due to the TRT and my desire to get back on it as soon as possible, surgery, with the possibility of complete removal of the problem and the ability to quickly resume TRT, is our clear preference. Additional factors included the desire to avoid radiation down there, both because I’m already prone to colorectal polyps and because I’d like to save my lifetime radiation budget down there for adjuvant, salvage or some other problem that may occur later. Also, I’m an engineer and control freak and am biased toward making a decision and getting things handled. That brought us to the hard part: selecting a surgeon. I won’t go on a rant about urologist surgeons that won’t provide hard numbers on procedures done and outcomes, but I ultimately chose to not use my urologist and instead chose a surgeon at UT Southwestern that has great creds, great experience and outcome numbers, and a great sense of humor (important while getting a DRE with the wife in the room). Surgery is scheduled for early December 2013 after we finish our traditional Thanksgiving backpacking trip.

3) Why and How did you choose your secondary treatment?

Hope it’s not necessary.

4) How are you doing now?

Fine. I realize how fortunate I am and that things could be much, much worse--losing a best friend to pancreatic cancer two years ago gave us a lot of perspective. We’re comfortable with our treatment decision and our choice of surgeon, and we know and have accepted the risks of side effects to get the best probability of the outcome we want.  Not to say that this isn’t way up there on the sphinct-o-meter…

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