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Posted 6/11/2014 5:31 AM (GMT 0)
Just diagnosed two weeks ago with prostate cancer...T2c, gleason score is 7. I'm 57 and had no symptoms, just a routine PSA test led to a need for a biopsy. The biopsy was positive in 8 out of 12 samples.

I meet with my doctor this Friday (June 13, 2014) to discuss treatment options. Based on the literature I have read it seems that the best option is radical surgery.

Any and all comments welcomed.
Posted 6/11/2014 10:29 AM (GMT 0)
Welcome Jensen,

Lots of great information can be found here. I had robotic RP and I'm recovering well. My biopsy path report was a Gleason 7, but downgraded to a Gleason 6 on the surgery path report.
Some opt for brachytherapy (radioactive seeds). Do as much research on your options to make the best decision for you. I looked up the pros and cons for each and went to You-tube to hear real people talk about their experience. In the end I was very comfortable with my decision and have no regrets. Best of luck to you!
Posted 6/11/2014 11:31 AM (GMT 0)
There are a lot of ways to treat this and you owe it to yourself to get muptiple opinions before deciding. Surgery is effective for low and intermediate risk, but it comes with significant side effects for many. Radiation is equally effective with fewer and less severe side effects. External beam like IMRT and IGRT and Proton can be used alone or in conjunction with brachytherapy and provide excellent results. Brachytherapy comes in two forms, the permanent seed version and High Dose Rate that does not leave the seeds in the body. You can also choose SBRT, a concentrated version of external bealm that can greatly reduce the number of treatments.

The next thing is for your doctor to cover each of these in an unbiased way and then for you to get information froim other specialists before deciding. We have members here that have done all these and can help yopu based on their experiences.
Posted 6/11/2014 11:55 AM (GMT 0)
Jensen,

Sorry you need to be here, but glad you found us. You'll get lots of great support and guidance from the folks here.

Your description is very similar to my history: No symptoms. PSA was high. Biopsy showed Gleason 7. You can get more info from the "Intro" link below in my signature.

I don't think you should jump to the conclusion about surgery. (Note: I had surgery, it went fine, and I don't regret my decision one bit.) Brachytherapy (seeds) is another option you should explore.

My guidance to you:
1) Visit the links in my signature which provide good resources for anyone newly diagnosed with Prostate Cancer
2) Have consultation visits with the best PCa surgeon and the best PCa brachytherapy specialist you can find. In my signature below you will find a list of important questions to ask each of those folks.
3) Make the decision that you feel is best, and don't look back.
4) Read Dr. Mulhall's book (link below). Whatever treatment you choose, it will impact your erectile function - hopefully temporarily. Understanding why that happens, and the rehab options, will likely be helpful to you.

If you tell us where you live, folks here can recommend surgeon/brachytherapy docs near you.

-Gedman
Posted 6/11/2014 12:16 PM (GMT 0)
Welcome to our club that none of us wanted to join!

You know what they say about opinions, everybody has one. You need to take some time to learn all your options and decide what is best for you. All treatment plans have side effects, some right away, others develop over time. As my urologist told me right after he gave me my diagnosis, "From this point on, your life is going to change".

The good news is you have time, PCa is a very slow growing cancer so weeks or months will not effect you much. Talk to several doctors and get second opinions.

As far as your comment about "no symptoms", again welcome to the club.

Whatever treatment plan you choose, find the best doctor you can find. Many of us here know doctors all over the country to recommend so if you tell us what part of the country or what country you are in, maybe we can help.

My surgeon has done more Da Vinci surgeries than anyone in the world and he was located only 120 miles away. Many of us go across country to have the best we can get. Some travel to a different country. You only get one shot at this so take your time researching.

I had surgery and I was a Gleason 3+4=7 with 10 of 12 core positive. But that was my choice, you need to make your choice for you.

Good luck, we are here for you. As we say, "Knowledge is power!"

Bill from Florida cool
Posted 6/11/2014 12:29 PM (GMT 0)
Jensen
I agree with bedman re: brachytherapy . I did not qualify due to history of BPH so I had open RP which went fine. I played golf three weeks later! You're young and the worst thing about RP is ED. But I believe RP is the lowest risk treatment in terms of complications. Just my opinion. I also like the idea of getting out the source of the disease. Maybe you won't have ED or it will not last too long but it could last quite a while. Good luck with whatever you decide!
Bob
Posted 6/11/2014 1:03 PM (GMT 0)
Jensen,

I found this site to be a lifesaver for me. There's so much information available to help you make a decision. The guys on this site have a wealth of experience and information in fighting PCa.

I elected to have open RP to rid myself of the beast. I'm almost 7 months post surgery and I'm happy with the decision we made. I say "We" because my wife, being a retired RN, had a lot of influence in my decision. You'll go through a range of emotions in your decision but in the end, it's up to you to decide your best treatment option.

If you elect surgery, make sure the Surgeon has done lots of operations.

All the best to you in your decision making............Berk
Posted 6/11/2014 5:15 PM (GMT 0)
You need to find out if the PCa has penetrated the capsule through either a CDUS or 3T MRI with an endorectal coil. If it has, then you will likely have to undergo radiation and HT down the road. If it is contained, you have more options. Surgery will give you a more accurate pathology report but there is a good chance you will be dealing with short term if not lifelong ED and/or incontinence, and it is major surgery.

If the PCa is contained, you could look at HDR or LDR Brachytherapy. The HDR BT has the best cure rate with the least SEs if you have a good doctor. SBRT is also a good option if you are adventurous. And there is always PBRT or IMRT. All of these have equal if not better cure rates as surgery with less side effects if done correctly.

If the PCa has penetrated the capsule, then you may require a more aggressive treatment, usually a combo of BT, HT, and EBRT.

Listen to the guys here. Ask questions. Read the profiles. You should make sure your decision is the best one because oftentimes, the first attack can be the cure, especially with your numbers.
Posted 6/11/2014 6:04 PM (GMT 0)
Welcome to HW, sorry you need to be talking to us.

The hardest question you have to answer right now is how to treat. Surgery is a good option but as mentioned above, radiation would work just as well. There are trade offs in side effects but it would work as well.

In the end, it often comes down to what you feel most comfortable with. You should at least talk to a radiation oncologist and explore all your options. With your numbers you've got time to make an informed choice.

Keep us updated on your progress,
Andrew
Posted 6/12/2014 3:59 AM (GMT 0)
Thanks all, good advice from all of you. Many of you have asked about my location in terms of getting the best medical treatment.

I live in Port Coquitlam BC, Canada...near Vancouver.

I have very good support from my family doctor and the urologist. Just by coincidence my wife is undergoing radiation treatment for a brain tumour and the radiation oncologist has given me some council as well.

I have read a very good book...the intelligent patient guide to prostate cancer (revised 2014). I will also follow up on the links you have provided as well as additional dialogue with my doctors. I know I don't need to rush to a decision, but I will probably decide an a plan of treatment within three weeks.

Again thanks for the advice and further comments are always welcomed.
Posted 6/12/2014 9:52 AM (GMT 0)
Jensen,
I was your age at diagnosis. As you can see from my profile, I had at least one of the 60 samples at GL7. Surgery was the very last thing that I wanted, and I am very glad that I researched and then chose a different option. For me, it was LDR brachytherapy.
I am now living life precisely as I did before the one-day treatment, and my doc says that I am cured.
I strongly urge you to study your options before making any decisions. There is a reason that it is called 'radical surgery'.
Best wishes.
Posted 6/12/2014 11:13 AM (GMT 0)
the author to the Intelligent Patient Guide to Prostate Cancer is an excellent book worth reading for information about Pca. It was written by my brother-in law Dr. Larry Goldenberg. I am 58 and had the same history as you. I was by Larry and my Toronto uro-oncologist to have the robotic surgery which I had exactly 2 weeks ago. No regrets.

Good luck on whatever route you choose. That book, the doctor you choose and this site provides all the info you need. Just be careful about what you read on the internet about PCa. A lot of it is inaccurate and it may not be applicable to your specific situation.
Posted 6/12/2014 2:49 PM (GMT 0)
Everyone is correct. Look up the pros and cons for each treatment. YouTube can give you a visual of what to expect. You can find real talk here on Healing Wells. Good luck.
Posted 6/12/2014 10:57 PM (GMT 0)
And if you can, talk to the people who went through the various treatments. I was lucky to work with a lot of old farts like myself. Many had had prostate cancer, but not one of the ones who had chosen surgery had the results that I wanted...ie they were all impotent. That is what drove me to search for a different path. Others here have chided me before, but I've never wavered, my decision was based on maintaining my sexual function because I 'knew' that there was more than one way to eliminate the disease. I was and remain very fortunate...and for that I am very grateful.
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