Diagnosed with Prostate cancer 4 weeks ago

Welcome Chaplain! Lots of knowledgeable guys and gals here to help you along. First of all you don't seem to be panicking and that's great, no need to! It's been a month so I'm sure you have a few questions, spit 'em out and we'll try and answer them.

Cheers, Doug

Sorry to hear that. I got the news a month before turning 53. If there's a silver lining here, it's the G6 diagnosis, which is low risk. Pretty much any treatment will cure you and there's a good chance that you're eligible for Active Surveillance, where you're closely monitored to see if you even need treatment.

But first...as Pratoman said, get a second reading on your biopsy slides from an expert. Surprisingly easy to do. And then start learning all you can...another benefit of the G6 diagnosis is you have plenty of time to make your decision. Learn as much as you can, talk to experts and ask us here whatever questions you have. Some amazingly knowledge folks here.

Good luck to you! Oh, and please put the specifics of your biopsy in your signature...

Thank you for the input. I have a second opinion appointment with the chief of Urology at Emory Hospital in Atlanta on 4/8/15. His name is Dr. Sanda. I did edit my signature with the info I know hopefully it gives you a better picture of me

Ok updated signature with alot more info I hope this is a better picture of me

Chaplain 1 said...
Ok updated signature with alot more info I hope this is a better picture of me

Thanks! It does help us.

Do keep us updated. The waiting for appointments was a killer for me at this stage.

Ask any questions you have.
We're here most days,
Andrew

Chappy, While I would normally suggest Active Surveillance to someone with a G 3+3 score, the fact that your biopsy shows bilateral involvement makes me hesitate to do so in your case.

Recent research at Johns Hopkins indicates that having positive cores on both sides of the prostate increases the seriousness of the case.

That, plus your young age, would lead me to think that you will need to choose surgery, radiation, or another form of intervention. Of course, you can take some months to review and decide which you are most comfortable and confident with. Good luck, your chances of beating a G6 cancer are very, very high.

Chap,
I too was caught off guard when my original uro suggested surgery...devastated may be a more accurate description. I chose to do AS for as long as I could (2 years in my case) until the disease progressed to the point where it needed to be addressed. At that time, I visited a radiation oncologist. That opened up a whole new world for me. I hope that you will take the advice given here and do yourself that same favor before making any treatment decisions.
Best to you.

I was in your shoes about a year ago when I found out. I know how you feel. This forum gave me the information I needed to make the decision I was comfortable with. I chose surgery and I am happy with my decision. The only side effect so far is ED and I am now taking injections to help with it. I have a loving and caring wife that supported me through it all and my main concern through it all was being alive with her for a long long time.

The best advice I can give you is that no matter what you decide to do get your body in the best physical condition you can and you will see the benefits after your treatment

I found a long walk every night with my wife gave me the time to think and clear my head. Sorry to hear this with anybody but you will find out in here that it is a very manageable and you will deal with it and it will just become a bad memory.

Good luck with any decision you chose and contact me anytime my email is in my profile

Thanks for all the information. My wife and I have talked a lot we both agree that surgery is what we want. I have a very high cancer family history on both sides. The Dr. suggests surgery so that if there is a recurrence I still have the radiation option available. I know there are surgical risks. My main concern is I understand what statistics say but that is numbers on a piece of paper. How do I know that surgery will take care of the cancer. How does the surgeon know nothing has spread. I am one who needs proof of what you tell me. A Dr. saying that based on my scores this should be encapsulated and removing it fixes everything is just words Prove it is encapsulated. What I don't want is a Dr. saying we were successful and removed it and you are good just to be told 6 months later oh we were wrong it has spread and you have 6 month to live. Been there with family and that just puts me in a very bad mood. Maybe I have overly high expectation. Someone said to me Chappy where is your faith? My faith is in God, He is faithful and I know He is never wrong. Dr.'s on the other hand I need some proof.

Chaplain 1-

You are jumping way too quickly to a decision here. You have a diagnosis that allows you to take your time, and I suggest you do just that. You may, on learning more, decide that surgery is the right treatment for you, but please do yourself a favor and make that decision while you are not in a state of cancer panic. Give it at least a few months.

Your comments reflect the typical misinformation one gets from meeting with only urologists. It's not their fault - they are specialists in their field only, and you cannot expect them to know much outside their own field. 30% of RPs fail because cancer was left behind. That's partly because of the surgeon, and partly because cells have already escaped the capsule. You have a lot of cancer at the apex (the bottom end near the pelvic wall and urinary sphincter), and if your prostate is small, the surgeon may have difficulty getting a clean margin. It's not a reason not to have surgery, but is a thing worth discussing. You want a surgeon with the highest number of RPs (open or robotic), and the lowest positive margin rate.

There are many salvage options after radiation, although they are very seldom needed. Radiation treats a margin outside the prostate that surgery can't, so recurrences are seldom local. The side effects are very different as well (incontinence and ED are much less of a problem).

I think you owe it to yourself to talk to a specialist in SBRT (see link in my signature), and specialists in both kinds of brachytherapy.

Take your time.

I'll third what Tall Allen said. I left my original appointment with my urologist completely ready to move down the surgical path. It was only after I got my head screwed on straight and sought out some specialists that I learned that surgery really wasn't the best choice given my diagnosis.

That said, unlike my situation surgery *can* make sense since you have every reason to believe it's all contained given your G6 diagnosis. But I do think you owe it yourself to hear from more than one specialist so you actually know for sure. If you had a room added onto your house, I'd bet that you'd probably get more than one bid and this is certainly a lot more important. If three things can cure you, why wouldn't you want to investigate all three? If you still decide to have surgery, you'll be going into that from a position of strength.

Good luck to you regardless of the path you follow--we're all on the same team here!

Thank you gentlemen for your candor. believe me I am seeking second opinions on everything. I have sent my entire urological history to the chief of Urology at Emory. and have requested that a Radiation Oncologist be in on my consultation on 4/8/15. My position of surgery if my first option but not my only option. Tall Allen thanks for explaining the difficulty that getting a clear margin might be that is a definite discussion point. I will continue to research information on all of this. Please continue to share with me candidly. I do not like sugar coated fluff.