Lightening Strikes Twice

Hello Healing Well Friends:

I posted from 2007 to 2013 when my husband, Greg, had prostate cancer. Sadly Greg died of a sudden heart attack about 2 years ago. He was still in the zero club, but his PSA was slowly rising and we were facing radiation therapy in the future. I posted about his sudden death and received many kind responses from many members here.

Greg's sudden death nearly killed me. It has been a very long hard journey to work my way through the grief. Two different grief counselors (very expensive and not helpful) and two different grief classes (affordable and helpful) were utilized.

Last fall I was facing my birthday, our anniversary and the holidays. I was pretty desperate with my grief and prayed for help. An innocent facebook message to a high school classmate turned into many messages, phone calls and a wonderful relationship. I NEVER thought I would date again or even be interested in a relationship.

I was hyper vigilant about being in a relationship and wanting to make sure my new friend was healthy - so we were comparing lab results. His PSA went from 3.0 to 4.0 to 4.2 You know what happened next. His primary care physician suggested he visit a urologist. The urologist did a biopsy and it came back positive.

My new friend is scheduled for Da Vinci prostectomy on 4/14. GEEZ - DaJavu! My heart is already committed to this new wonderful man in my life, but boy do I hate having to go through this surgery and the endless PSA's and possible effects that will follow.

I have to admit - it's easier for me the second time around because I know what to expect. The sad part is my new man doesn't understand medical issues very well and I knew he had cancer before he did. His first urologist was a lazy idiot. He has since changed physicians and I really like the new one.

My veterinarian had prostate cancer a few years ago and we were discussing his surgery and recovery. I told him about my new friend he said "You need to date younger men". He knew my late husband had had prostate cancer. I told him younger men were interested in much younger women.

My new friend's statistics are Gleason 6, 1 positive core on the left and right apex.

I drop into Healing Well every once in a while, but here I am again. With another man. Same song, different partner. Boy do I hate prostate cancer.

How many of us actually understand medical issues until we're in the thick of it.

Hello and "welcome back." I would simply echo what ChrisR stated - unless there are some other mitigating factors we don't know about? Family history? Positive DRE?

Hello Darcy, I'm glad you were able to find someone after Greg but I'm so sorry that you have to go through this prostate cancer thing again.

As the others have said, there are options for your friend and I would strongly suggest that you and he explore them before rushing headlong into surgery. First I would suggest that you share his full stats with us...you know the drill...age, % cancer in each core, etc. Then I would suggest that you get a second reading on the biopsy slides from Epstein or Bostwick so that you know exactly with what you are dealing.

Finally, he may be a good candidate for AS and you should visit a physician or program that has experience in managing AS patients. If you decide that treatment is needed, you should meet with experienced experts in LDR Brachy, HDR Brachy and SBRT. These are real options for cancer cure that may offer less onerous side effects than surgery.

Good luck.

Jim

Thanks for the comments guys, but I guess I want to clear a few things up.

My new friend has the same biopsy report that my late husband had. 2 positive cores out of 12. One on each side of the prostate. He is 57 years old - excellent health. No other medical problems except an arthritic knee. The biopsy was done in late November. Negative DRE - no family history.

Since I am NOT his wife, only his "friend" I don't get much say so in this situation. His sister is a pre/post op RN at a local hospital, she directed him to a board certified urologist she knew and trusted.

Greg had the exact same biopsy and gleason score in the beginning. Post op he upgraded to gleason 7. Margins were clear. Greg had the Da Vinci surgery at age 50 and had no bladder issues and no ED issues after about 3 months. Greg's PSA was slowing rising even after having the prostatectomy and was facing radiation in the future. He died at age 55.

I thought AS was only for men with a very advanced age Not for those in their 50's. Since Greg had few problems post op - I was hoping for the same with Tim. In some ways I am glad Tim isn't going to Greg's Dr., as I would feel responsible if he didn't have the same easy recovery with few/no side effects. I am also glad because going back in that office, seeing that same Dr. in those same rooms would just take me back to being there with Greg.

MrsGFM –

First, I'm certain that everyone here wants to express their sympathies on the loss of your husband, as well as sympathy for the very stressful situation you now seem to have found yourself in with your new friend. It truly does seem like déjà vu, at first glance.

However, and while this may not be all that comforting, it would still likely interest you to know, and you may well know it already, that prostate cancer is in reality rather common in men as they start to age.

The generally accepted rule of thumb is that the chance that a man has it is numerically about the same as his age. For example, a 50-year old man has about a 50 % chance of having it, a 60 year-old man a 60 % chance, etc. So the fact that these two men in your life have both come down with it is, while certainly not comforting, is, considering their ages, not all that unusual.

HOWEVER, as a Gleason 6 with low cancer volume, assuming that stays he case, the chances that your friend will ever die from this cancer are very unlikely. And, as has been pointed out, he may well be a good candidate for AS (Active Surveillance).

Another important point about this disease is that there are no "do-overs" as far as treatment goes. He needs to take his best shot first, which may well be AS in his case. It would be time well spent to try and make him aware of this point.

If AS eventually fails, he will likely still have the other standard treatment options available to him.

Darcy, many of the others have pointed out that your guy is the perfect candidate for AS and that treatment options abound for someone like him, if and when the need arises.

I would like to address your post from another point of view. You said;

"Since I am NOT his wife, only his "friend" I don't get much say so in this situation."

First, it sounds like this man is someone special to you and may be for a long time to come. If he is as in to the relationship as you appear, how can he not take council from you and involve you in his decisions that will no doubt affect your relationship.

Secondly, you have first hand experience with Pca and its treatments and the affects it can have on QoL and QoR (Quality of Relationship) for you both. You spent many long hours of research and travels through your journey with your late husband.

His sister means well and no doubt found him a great Dr. to consult with, but as it was said, she doesn't have to live with the side effects of any treatment, YOU AND HE DO.

I guess I come at this from a position not so different from you. I lost my wife to cancer 3 years after I was diagnosed with mine. She never had the chance to be involved in my cancer. She had her own battles to fight for 6 and half years and I was right there with her every step of the way.

I met someone who was very special after she had passed. She is now my wife. Her late husband passed away after a 12 year battle with Pca. Even before we married, I involved her in every aspect of my research, decision making and thought processes. How could I not if I thought for a minute that the relationship would be long term. I can never be cured of this crud, I just have to keep trying to keep it at bay for as long as I can.

Okay vent over.

I too am saddened that you lost your husband to this crap. I am also happy to hear that you have found someone that appears to be filling your life with joy. I hope that it turns into something special and goes on for many years to come.

Sonny

bigal said...
I'm with ChrisR -- steer away from the Da Vinci surgery. Greg sounded like he did ok but most of us are ruined for life. I would try the surgery last .

Here is yet another vote to run from the surgeon. (Lol! As though I have a vote ) indeed it sounds like your husband did great, he would be the envy of so many of us here. And how tragic about his sudden death after going through all of that! But please also notice that despite an apparently super successful surgery, he still was facing a rising psa and radiation. This reminds me of my friend who had the surgery, but plenty of side effects, including penile implant, and then died of a sudden stroke at age 51.

Anyway, maybe you can get him to read here and at other pc web sites? If AS is out of the question, what about brachytherapy with or without EBRT? I just hate to see any G6 volunteer for the probably permanent negative life changes that so many of us end up with after surgery without at least knowing all about all possible alternatives and the relative side effects of each. Considering how low the odds are of anyone dying from a G6. God bless both of you whichever route you choose!

MrsGFM,
How wonderful you've found happiness again!
I have only this to say in regard to your dear friends upcoming surgery. Please listen to these men who know what they're talking about. Now is the perfect time to talk to him openly about expanding his choices. Surgery is Not the only answer and certainly not even the best answer for him. Be strong and positive - you are in a position now that if you don't present him with the facts, well, I'm guessing you won't like the way that feels. I hope I haven't overstepped. I just think you both deserve the best future possible.
I wish you both a long and happy life,
Susan

Post Edited (myman) : 3/14/2015 4:01:52 AM (GMT-6)