Prostate cancer with lynph nodes

Jenny,
Unfortunately, my experience with this disease is limited. When I was first diagnosed in 2011, I think every time I had an ache or pain, I thought the cancer was responsible. After several trips to the hospital and doctor, I learned many of those aches and pains are due to age. My wife and I discussed a second opinion with another doctor and we were glad we did. We had nothing against the first doc, in fact, we based our decision on the fact that the original diagnosis was at hospital and we felt more comfortable at a cancer center. We feel we made the right decision. I have learned a lot from this forum, others will share their thoughts. You are in our thoughts and prayers.

jennysdesigns

I was recently diagnosed and had surgery on February 19,2014. My first visit to a urologist after a complete urinary shutdown diagnosed me with cancer after doing a digital rectal exam (DRE). I was recently unemployed and had no insurance at the time so the news was devastating. Fortunately that resolved and since had a multitude of CT scans, ultrasounds, cystoscopies, Bone Scan, MRI, Bone biopsy, Prostate biopsy along with a multitude of blood tests and urine samples. The point I am trying to make is that your husband complained of back pain for which an MRI was done. The MRI must have revealed something in order for them to prescribe treatment right away. If the doctor wants to start treatment, then they must believe that your husband has cancer and they want to slow the progression down immediately. Once I was diagnosed with hot spots on my spine my doctor prescribed lupron and casodex. The goal was to stop the progression of my disease in its tracks which it must have done, because at the time of my surgery, my prostate had shrunk to less than 1/2 of its size when I was diagnosed. I may not be cured but the treatments with the surgery seem to be working for me. My latest psa score was <.01 where prior to surgery it measured at 243 ng/ml.

Treatment will help your husband too and he may respond remarkably to it. Last, despite how bad you think his cancer is, he may already be there but does not want to alarm you. I am both a realist and an optimist. I hope that the treatment I am receiving together with my surgery and a change in lifestyle will help me beat this thing but the reality part of me says I am buying time. I will buy as much time as I can just so I can see another day and the ones I love.

I wish you and your husband the best. Cherish each day.

DX 10/04/2013 PSA 187.5
07/11/2013 psa 3.31
3/10/2010 psa 1.87
1/24/2006 psa .87
Biopsy 10/28/2013 4 cores positive gs 9 (4+5)
Bone Scan 12/09/2013 2 hot spots in spine
Hormone Therapy started 12/17/2013 22mg lupron, 50 mg Casodex
Bone biopsy 01/09/2013 negative
RALP 2/19/2014 Non Nerve sparing, Lymphovascular invasion
Pathology T3B NX, MX
Bilateral cancer found involving 6% of prostate
03/07/2013 PSA .6
05/29/2014 psa <.01

Hi Jenny, - With a HIGHLY elevated PSA of 447, it is ALMOST certain that your husband has PCa and the MRI evidently showed likely lymph node involvement sufficient to suggest metastatic spread to the lymph system. A Urologist (MD) is almost always the initial referral for Prostate Cancer (PCa). ADVANCED PCa is, most often, more the purview of Medical Oncologists (MD's) whose specialty is the manipulation of Drugs to treat Cancer that has already become "systemic" rather than remaining localized at the time of treatment.

There are numerous variations under the heading of MRI and if by chance he had an mpMRI (multi-parametric) and the PCa is advanced enough, it may have supplied enough information so that they feel that they can proceed to treat on those findings. By today's Standards, the only widely accepted
method to confirm a PCa diagnosis is by a Pathologist (MD) directly examining Prostate tissue samples, usually obtained by Biopsy, under the microscope. Early results suggest that mpMRI MAY be able to change some thinking in this respect, but much more sophisticated data is needed to adopt such results as a satisfactory replacement for Biopsy Findings.

Where is he being treated and by what Medical Specialist(s). Today's HIPPA Laws can prevent meaningful dialogue between the spouse and the patient's Doctor, UNLESS specific authorization is given and displayed in the medical record. Be sure your access to his medical information is properly documented and formally authorized by your Husband.

The choice of Doctors involved in his care is your Husband's prerogative, his case is likely serious and treatment may be prolonged. Effective communications between ALL parties, including husband and wife, is going to be important, so address it now, I would suggest.

Good luck to you both! - [email protected] (aka) az4peaks.

I am surprised they do not do a biopsy to get more definitive information

Mel

Jenny,
You sure landed in the right place. IMHO, I think the doc made the right call. Why do something more invasive when you already know at least some of the answers. The HT should bring down your husbands PSA. I'm not sure who recommended getting to a good medical oncologist, but I second that. They will know how to treat your husband's disease the best. I'm sorry you need to be here, but right now it's the best place to be.

He started the hormone treatment on the 1st visit this is his 2 month check up

Jim:

 

Keep us informed. I see Lam on Tuesday.

As you probably read, my PSA has jumped from undetectable to 0.04.

I have been on HT vacation.

 

Also, my T has jumped from 10 to 140.

I think that's good news as it means my PC is probably still hormone sensitive. Anyway, I suspect we will stay the course and watch the PSA. Once it gets above 2, he will recommend a C-11 scan at Mayo.

 

That's just my guess.

 

I gather you were impressed with Turner?

 

Mel

Jim,

We saw both Scholz and Lam on previous visits. Only the last visit was with Turner and he just turned out to be our favorite. All three of them are awesome to deal with.

Gotta love Father Joe, eh? Such a sweet man!