UPDATE - 40, 3.9 PSA with family history

First, thanks to everyone who responded to my first post -- feedback was appreciated.

I went ahead with the biopsy -- what an experience that was.

Anyway, while my prostate appears healthy, I did receive the bad news that I have prostate cancer. Ugh.

Gleason score 6, so, it is not very aggressive and it has been caught very early. Because of my age and family history, a prostatectomy is advised.

Can anyone who has had one give me any insight into what to expect? Anyone around my age here who has had this done? It will likely be a robotic prostatectomy.

Very good Tom - thanks. I think your experience is what I'm striving for. I don't expect miracles, but being able to get back to as close as possible to "normal" within a relatively short period of time would be nice. Given my family history, I knew I had a pretty good chance of getting PCa relatively young, and that if I did a prostatectomy was likely going to be the result. So, it's a bit earlier than I thought it would happen, but here I am. Now, I just want the darn thing out!

Keane,

Gleason 6 is not only not very aggressive, it is actually the lowest grade you can get. Gleason 2 to Gleason 5 grades are not given anymore to TRUS biopsies.

The problem is that this is just one sample, and there may be higher Gleason grade cancer lurking in the prostate. The Gleason score is upgraded around 30% of the time after a prostatectomy.

In any case, before you make a decision as to how you plan to treat the cancer, get a second opinion on the biopsy. In my case, I had the biopsy slides sent to Dr. Epstein at Johns Hopkins for a second opinion. It is well worth the cost.  

Keane, as PeterDA said, we could all be more helpful/responsive to you if you would provide a more detailed view of your cancer. Perhaps you will put together a "signature" like most of us have so we can have a snapshot of you every time you post.

I would suggest that you review the sticky thread at the top of our forum that can be helpful to new patients: www.healingwell.com/community/default.aspx?f=35&m=2652250

I would also strongly suggest that you do some serious reading, e.g. Dr. Walsh's "Guide to Surviving Prostate Cancer" and Dr. Scholz' "Invasion of the Prostate Snatchers".

One of the best things you can do now is catch your breath and get yourself fully educated on our disease. With a G6 you likely have time to make sure of your decision. You may also want to consider some other testing to help stage your disease. You should also make sure your biopsy slides have been read by one of the prostate pathology experts such as Bostwick or Epstein.

Most certainly you should speak with experienced doctors in different disciplines, including surgery, AS and radiation (including brachytherapy). With a G6 most any treatment should cure you so I would advise that you focus on your remaining quality of life as well as the cure.

Good luck,

Jim

We've all been there. Once the doctor says "cancer" the rest of the words are just sounds going on outside your head.

You doctor will be glad to print you a copy of the report if you ask.

Keane100 said...
2 positive cores, both Gleason 6. 12 cores taken. The 2 positive cores were on the same "side".

I don't recall any other information I was given during the call -- I heard the basics and then my head started spinning and racing. I was in an elevator and the whole thing was surreal even though I sort of expected the worst. I have a meeting with my doctor on Friday and I will get all the info.

Coach K has coached 77 more games with his team ranked at No. 1 in the country than not ranked at all. Incredible.l
Definitely get paper copies of all reports and if you do any scans, get both the paper report and a copy on a CD.

Also recommend that before you let the first urologist you see talk you into surgery, make a second opinion appt with an unaffiliated urologist/surgeon and an appt with a radiaiton oncologist.

The "AS" that Jim alluded to in a prior post is Active Surveillance where you do not have any immediate surgery nor radiaiton but monitor PSA regularly and so periodic biopsies.

Never good to hear the "C" word, but your case is about as mild as they get, so you have time to do your due dliigence.

LupronJim

Keane100 said...
2 positive cores, both Gleason 6. 12 cores taken. The 2 positive cores were on the same "side".

I don't recall any other information I was given during the call -- I heard the basics and then my head started spinning and racing. I was in an elevator and the whole thing was surreal even though I sort of expected the worst. I have a meeting with my doctor on Friday and I will get all the info.

Hi,

How old are you? You're much like my situation was in that I was wondering more of "when" rather than "if" I would get PC. My Dad had it and at least one of his brothers had it. My local urologist told me my chances were twice the average risk since my Dad had it -- and thrice the average risk since another direct blood relative had it.

Mine was also Gleason 6.

Can you tell us, along with your age, your PSA history including, of course, your latest one.

As others have noted, up to 30% of PC cases turn out to be more aggressive than originally estimated by the biopsy. That's because a standard 12-core biopsy only samples about 1/1,000th of the prostate.

I can sure understand how hard it was to absorb all the info you were getting over the phone. When you see the doctor in person, be sure that you walk out with a printed report of your biopsy including a schematic, the staging, etc.

One thing to take heart in is that almost nobody ever dies from Gleason 6. So, if your biopsy report is accurate, you should have plenty of time to decide if you need treatment or AS.

If treatment is indicated, you should consult radiation oncolotists and surgeons to learn all about each form of treatment.

Having your biopsy slides read by another lab, for a second opinion, is also very wise.

Please share your biopsy report when you have it. Then we can give you more thoughts about your particular case.

Good luck!
Chuck

Resident of Highland, Indiana just outside of Chicago, IL.
July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA Sept. 2011 was 5.7.
Local urologist DRE revealed significant BPH, but no lumps.
PCa Dx Aug. 2011 at age of 61.
Biopsy revealed adenocarcinoma in 3 of 20 cores (one 5%, two 20%). T2C.
Gleason score 3+3=6.
CT of abdomen, bone scan both negative.
DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
My surgeon was Dr. Matthew Tollefson, who I highly recommend.
Final pathology shows tumor confined to prostate.
5 lymph nodes, seminal vesicles, extraprostatic soft tissue all negative.
1.0 x 0.6 x 0.6 cm mass involving right posterior inferior,
right posterior apex & left mid posterior prostate.
Right posterior apex margin involved by tumor over a 0.2 cm length, doctor says this is insignificant.
Pathology showed Gleason 3 + 3, pT2c, N0, MX, R1
adenocarcinoma of the prostate.
Prostate 98.3 grams, tumor 2 grams. Prostate size 5.0 x 4.7 x 4.5 cm.
Abdominal drain removed the morning after surgery.
Catheter out in 7 days. No incontinence, occasional minor dripping.
Post-op exams 2/13/12, 9/10/12, 9/9/13 PSA <0.1. PSA tests now annual.
Firm erections now briefly happening in early mornings, 2 years post-op.

Sorry, but I totally (but respectively), disagree with that last post. If your allbeing says you want it out, GET IT OUT.
IMO, Being satisfied now is a whole lot better than being regrettful later. You do what you think is best and don't look back.

I agree with Lotsahope regardless of his next to last sentence. LOL

This IS a "support" group and, while we're here to try and increase the knowledge of newcomers, we're also here to respect a person's desire to "get it out of me."

While we would all certainly caution them to take a deep breath and review all of their options before making a final decision, we must also recognize that some of us simply will not settle for knowing there is cancer inside of them -- not when they have the option of having it removed.

Some of us are wired that way including, to a large extent, myself. While I am scared $h!tle$$ of surgery, I would also want to eliminate it all at once if that were possible.

Others, if given a choice between both major treatment methods, would have no problem in irradiating the cancer and waiting out the time required to cure it.

Neither choice is wrong as long as it does the job.

Take care,
Chuck

Resident of Highland, Indiana just outside of Chicago, IL.
July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA Sept. 2011 was 5.7.
Local urologist DRE revealed significant BPH, but no lumps.
PCa Dx Aug. 2011 at age of 61.
Biopsy revealed adenocarcinoma in 3 of 20 cores (one 5%, two 20%). T2C.
Gleason score 3+3=6.
CT of abdomen, bone scan both negative.
DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
My surgeon was Dr. Matthew Tollefson, who I highly recommend.
Final pathology shows tumor confined to prostate.
5 lymph nodes, seminal vesicles, extraprostatic soft tissue all negative.
1.0 x 0.6 x 0.6 cm mass involving right posterior inferior,
right posterior apex & left mid posterior prostate.
Right posterior apex margin involved by tumor over a 0.2 cm length, doctor says this is insignificant.
Pathology showed Gleason 3 + 3, pT2c, N0, MX, R1
adenocarcinoma of the prostate.
Prostate 98.3 grams, tumor 2 grams. Prostate size 5.0 x 4.7 x 4.5 cm.
Abdominal drain removed the morning after surgery.
Catheter out in 7 days. No incontinence, occasional minor dripping.
Post-op exams 2/13/12, 9/10/12, 9/9/13 PSA <0.1. PSA tests now annual.
Firm erections now briefly happening in early mornings, 2 years post-op.

Post Edited (HighlanderCFH) : 2/27/2014 12:50:25 AM (GMT-7)

When I found out that I had PC, I wanted it out immediately. As Chuck stated "We're all wired differently". I had my surgery about a 45 days after a saturation biopsy. Would have had the surgery done even sooner but my Surgeon said we had to wait for the prostate to heal after the biopsy.

I'll be 4 months post op in a few days. I've been totally dry basically since the catheter was removed. Still waiting for Junior to wake up since both nerves were saved but I've had some success with 100mg of Viagra. Next event will be another PSA test at the beginning of April.....Praying for another low number.

Good luck to you on your decision. The guys on this site have helped me so much. Can't thank them enough.

Tailwinds...........Berk

Oh and BigMac surfs before and after breakfast, when the surf is up, which sadly is not as often as, arguably, Hawaii, the mother of surfing.

Keane

You have your priorities right. You have plenty of options. I think you are making the correct decision.

mel

it would help to understand the perspective of the folks who "want to get it out" and their reasons before affirming that it's not something you don't support, or, as has been done in the past, label it as hysterical and/or irrational.

Men who get it out usually have fantastic reasons for doing so given their personal preferences.

Post Edited (davidg) : 2/27/2014 12:04:53 PM (GMT-7)