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Husband recently diagnosed with prostate ca

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Posted 3/27/2014 7:51 PM (GMT 0)
Pete- with your biopsy results I can see where Dr Hemal or any uro might recommend AS. Good thing you opted for the surgery. The one thing I have learned so far is that every situation is unique and there are no guarantees.
That making it all the more scarier.

With my husbands biopsy scores we haven't really considered a second opinion. My rationale is that while it could decrease or increase a bit, I don't think it would affect our "plan of attack".
We will definitely do more research on urologists though.
Posted 3/27/2014 8:47 PM (GMT 0)
A second opinion on the biopsy can be valuable to determine whether you are intermediate or high risk. You appear to be borderline to me. If the gleason comes back 4+3 or 4+4 it could indicate more aggressive initial treatment or a greater probability that surgery will fail and then radiation will be required also. In about 35% of surgeries the Gleason is upgraded.

Since you are a high PSA (20 is High Risk) and a significant tumor volume shown by 9 of 12 cores positive, it may increase the probability that the cancer is not contained. Has your doctor illustrated the nomograms? These are forecasters of the probability of recurrance and and the cancer being out oif the capsule. For instance, mine were significant enough that my urologist/surgeon said no surgery (as did a second surgical opinion and one from a medical oncologist). The reasoning was they didn't want to subject me to the significantly additional risk and side effects of surgery followed by radiation.

Thankfully radiation is as effective as surgery and can be more so in intermediate and high risk cases. This is why so many with experience are stressing that you seriously consider all treatment posibilities before making the deciscion. Now is the time to be considering all the options available to make the best possible choices. Killing cells by radiation is just as effective as removing them. I encourage you to fully consider the probability of surgery being curative and the side effects if it isn't, before deciding on the treatment direction. As Peter Disabled said, the members here will respect any dscisions you make and be as supportive as we can based on our knowledge and experience. The number of people advising that you seek multiple opinions as to treatment choices and specific practioners indicates that based on their actual experience it is vitally important to do so.

You only get one chance to determine the initial treatment. In my case, my urologist would not take me on as a patient until I sought out second and third opinions and returned to him with the information. I think it was the single best thing he did for me and I wish more doctors would do so.
Posted 3/28/2014 2:47 AM (GMT 0)
Kat, hello from Boone, NC!

My husband got PC over a year ago. I, especially, was pretty freaked out, but once I found this forum and we explored all our options, we ended up with what we feel was the right approach and the right doctor. We, too, started with Dr. Hamal. He performed my husband's biopsy and had the MRIs, etc done. Wake read the Gleason at 7 (4+3). Dr. Hamal is a fine man and from all reports a very good surgeon, but frankly we felt pushed towards surgery by him. This is not uncommon, of course--most surgeons push surgery, and most radiation oncologists tend to push radiation, but we felt strongly, based on feedback from this forum, that it would be most advantageous with a G7 to consult with both a radiation oncologist and another surgeon. So we went to Duke and met with both a radiation oncologist (Dr. Lee) and an an excellent surgeon there (recommended by this board)--Dr. Moul. Duke read my husband's results as Gleason 7 (3+4). In the end we opted for radiation with Dr. Lee, and so far so good. We did not feel pushed at Duke towards any treatment bias.

Whatever treatment you decide will most likely work for you. But I would like to echo others on this board who encourage you to explore other options. I hope I haven't broken any rules or regs here by talking about specific doctors. If I have, my apologies in advance.
Posted 3/28/2014 2:12 PM (GMT 0)
Kat,

Good luck with the scans today!

Lisa
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