Looks like I will be crossing over to the "dark" side.

I got the results back from my latest biopsy. My last MRI showed a nodule which was targeted by the biopsy. Unfortunately the nodule showed a small amount of Gleason 7 (3+4) at about 5%. Before starting active surveillance I set up prerequisites to continue and one of them was to remain at Gleason 6. If I was 10 years older I would continue under active surveillance but at my age (55) it seems like too much of a risk. The biopsy was sent for a second opinion which conferred with the first.

I'm going to take a little time to ponder everything but I will likely have robotic surgery in February. One thing that worries me about treatment is that it sort of reminds me of the movie "The Fly" where they find a way to transport a human through space. You never quite know what kind of strange transformations might have taken place when you arrive at the other side. One thing that does give me courage is hearing how some of you have gotten through it. Even some of the bad stories are helpful because I tend to think, "Well if he can deal with it, so can I".

I don't regret my AS path in the slightest and I was no where near ready for surgery when I was first diagnosed. Sometimes you give something your "best shot" but your best shot is not good enough. C'est la vie.

DB,

Good for you sticking with AS for so long..
I had my surgery last Feb and the whole thing is becoming a distant memory.. Best to you with the whole process and getting through it with a speedy recovery.

DB,

We do what we have to do when the time comes. And then we take the hits, if there are any.

I'm glad you got what you did from AS.

Surgery gave me less to lament than Adjuvant RT. I'll have a post on that here shortly.

Consider your options, make an educated choice, and go for it.

Thanks all for the kind words.

I hope I'm in the mood to have an empty prostate in the days approaching surgery. I am trying to keep up my general fitness, kegels, etc. but it takes motivation as I'm a little down about the whole thing. I suppose that's natural.

Hi DB,

Just wanting to weigh in with emotional support. I cannot speak to what's best for another person. We are all different and unique. Good that you had awhile with the Active Surveillance. And now are looking at going with some surgery.

For myself, even with the presence of a known tumor, I've persuaded myself, not that I needed much persuading, that prostate surgery of any type, along with radiation, chemo, hormones, etc., is just not for me. I'm going to roll the dice and go for a natural cure.

That said, I'm keeping the communication lines open and have an appointment to discuss things with Dr. Ballentine Carter at Johns Hopkins this Wednesday, 10/29, two days away. I intend to go through Hopkins' whole evaluation and assessment and team consensus advice/opinion what is the best course forward (I'll have a seat at that table), and THEN make up my mind (even though it's already made up). I want to stay open to all .... ALL possible avenues, but for reasons I cannot even explain fully to myself, much less to others, I just know going the 100 percent natural alternative route is the right path for me. I'm going to be eating and juicing so much lettuce and cauliflower and garlic and onions and kale etc I should buy some stock in Dole. I could say it's my own little personal experiment.

I'm convinced my mind is unbelievably powerful, as powerful as EXISTENCE itself, and that we could say my mind IS EXISTENCE itself -- the drop in the ocean also IS the ocean idea -- and that nothing can stop my prostate cancer from breaking up and dissolving and my body excreting the waste products of that.

I'm totally supportive of your own journey, your own path too. I believe what I choose to believe in, that's what is going to happen, nothing can stop it. I create my own reality with my thoughts.

Best to you, DreamerBoy,
Bill

Good luck with that, DB.

You gotta do what you gotta do. But, since you were previously G6, and now they say G7, has it occurred to you to get a 2nd opinion? They don't all agree, it's part science, part art, or so it seems to me, since a reading by one doc is not necessarily definitive, and another may read it differently. And it makes all the difference, as you know.

JB

Hi Dreamerboy, Hi JB --

Dreamerboy wrote, in part,
"Unfortunately the nodule showed a small amount of Gleason 7 (3+4) at about 5%. Before starting active surveillance I set up prerequisites to continue and one of them was to remain at Gleason 6. If I was 10 years older I would continue under active surveillance but at my age (55) it seems like too much of a risk. The biopsy was sent for a second opinion which conferred with the first."

JB has suggested a second opinion. Maybe he means get a second opinion on the second opinion that you got.

With these Gleason scores carrying so much weight in the decision-making process, in these matters there is no such thing as being too thorough. The original pathologist report I got on the original biopsy gave me 4 biopsy cores with Gleason 6 (3+3) and two biopsy cores with Gleason 7 (3+4). I immediately had the local hospital's #2 pathologist look at the same biopsy slides and he said I was Gleason 6 (3+3) in six cores. Faced with that difference of opinion, I asked Dr. Jonathan Epstein at Hopkins to review the slides. Dr. Epstein's pathology report, which could be called either a Third Opinion, or a Second Opinion on the Second Opinion, confirmed the Second Opinion pathologist's report of six biopsy cores at Gleason 6 (3+3). We all know the expression, "Trust, but verify."

My skepticism has great compassion to it too -- hey, people make mistakes. I second JB urging you to get another opinion on the second opinion you got.

Tempering and dampening my enthusiasm about in my own case having Gleason 6s all around, my original pathologist said, not an exact quote, "Feeling a palpable tumor or nodule on Digital Rectal Exam (DRE) outweighs Gleason scores, outweighs PSA scores. Forget all that stuff! When you've got a palpable tumor, it's time to get it out." Well, maybe, in my book . . . just a hunch, if it's slow-growing and non-aggressive prostate cancer.

Even with this new Gleason 7 (3+4) score (perhaps more accurately, the pathologist's opinion), take your time getting a third opinion. Who knows, maybe the first two pathologists are mistaken?

Probably the best way to see things is that whatever you decide, that's the right choice (for you). I'm on your side. Everybody here is. Pick a door and go through it. We'll support you every step of the way.

Bill