New to forum

First I would like to say this is really great to find this forum. I read the "Recently diagnosed" thread and it was very informative. I'm a 57 year-old who was just last week diagnosed with prostate cancer. My PSA score was 4.4 (up from 2.9 two years ago - my former doctor did not repeat the test last year) and a free ratio of 11. Had the 12 core biopsies a couple of weeks ago - three came back with a Gleason score of 5 (or what my urologist said they would consider a 5), two came back benign and one came back with a Gleason of 7 (3+4). The exact reading from my pathology report on the Gleason 7 states -

Prostate, Left Base, Needle Biopsy: Adenocarcinoma, Gleason's core of 3+4 =7. Quantity: Carcinoma involves 1 of 2 cores with area of involvement measuring 2 mm, representing 7% of the tissue. Perineural invasion: not identified. Additional findings: None.

Now, I am just trying to decide which treatment option is best for me - brachytherapy or surgery, but at this point I am leaning toward brachytherapy as it appears to have the least amount of side effects.

Two days ago I went to a support group with a group of really nice men and, maybe I'm just kidding myself at this point, but they were all surprised how well I was handling everything and also that I wanted to wait three months until the end of the summer to make my final decision. My theory is that freaking out or worrying is not going to make it any better and I want to be sure I make an informed decision and that's why I am going for a second opinion on treatment at Seattle Cancer Care Alliance and, perhaps, I will go for even a third at Swedish or Virginia Mason (here in Seattle).

Anyway, I am thankful to discover this forum and please feel free to give me any advice or share any of your experiences as you would like

Thanks!

The prostate cancer center in SEA is one of the best in the country for BT. When you say second or third opinion, what do you mean? Severity of disease or treatment options.Another way tp put it is what is the first opinion.The biopsy report or BT. There is a distinction between the two.Where was the biopsy done? some folks get 2nd opinions on them from medical centers with pathology depts that read a lot of pca slides. Anyway glad you like the forum. good luck in the months ahead…your treatment options are many.

SG, it sounds like you're making all the right moves. If you've found a local support group, you can get suggestions for where to go in the area for the best care.

My experience was that I wanted the best team around me I could find. Sure, the lead surgeon/RO is important, but how good is the whole team? That was important to me. Even the guy who brought food around at the hospital was part of it.

I also know that when I met with the surgeon, I knew in my gut that 'this is the guy'. It's just something that happened for me. It may be the same for you. What I also know is that going into treatment with a good attitude makes a huge difference in the outcome.

Hi - Been offline for a couple of days. First, thank you all for the words of encouragement and support - very much appreciated! Secondly, I made an appointment today for Monday, June 1st with Peter Grimm. I was very happy to be able to get in and see him so soon and I'm already impressed as his nurse asked a lot of pertinent questions and sent me a questionnaire and a PowerPoint presentation. I will also call Meier and Chapman to see if I can get in to see them. My theory is that I want to have all the information I can before I make a final decision as to treatment options. Grimm's office said that they would be sending my slides to another another person to read (someone at Johns Hopkins) so I feel good about that and I also ordered Grimm's book from Amazon. At this point I am leaning toward brachytherapy, but I still want to leave all of my options open. Again, thank you so much for your advice and also for the referrals on these doctors! I'll keep you posted.

Welcome aboard Seattle Guy!

You sound pretty level headed and you are doing all the right things so far so I wish you the best.

Unfortunately you appear to qualify to be a member of the club that nobody wants to join. Membership accepted!

Bill from Florida

Dr. Grimm is one of the best in the world at brachytherapy. I had his ex-partner, John Sylvestor do my brachytherapy. I would put my life in either of their hands for prostate cancer.

Thanks
Paul

Seattle,
I concur with your inclination towards brachy. Many on this site have had great success with LDR and HDR brachy. My choice was stand alone LDR brachy. It involved only a one night hospital stay, and the recovery time was minimal. Within one week I was back at work and the gym.
More importantly, my oncologist says that I'm cured. I cringed when he first said it because I didn't expect to be cured...just treated. But he is the doctor, and I don't argue. I'm five years out with a psa of less than 0.1, and my quality of life is excellent. I wish you the very best.

Thought I would update to let everyone know that I had my visit with Dr. Grimm on Monday.  Dr. Grimm spent almost two hours with me going over the procedure, showing me the graphs from different studies, performed a physical on me and answered all of my questions.  His office should also have the results from the pathologist (Dr. Epstein) on his opinion of my biopsies by the end of this week.  I have decided that I will go with the brachytherapy and with Dr. Grimm.  For me brachytherapy is the best option.  I live alone and the quality of my life (without the help of someone there with me) is far more important to me than anything else.  Because I had my biopsies taken on May 6th I will have an MRI and another PSA test done on July 7th.  If nothing has changed I will have the procedure done the first of September. 

I really want to thank everyone who recommended Dr. Grimm.  I had no idea of his practice and, even though I have been researching everything I can, I may have missed him.  I really feel I am in good hands.

SG, I'm sure you feel good about making a decision and Dr. Grimm is an excellent choice. He is one of the best (if not THE best) at LDR Brachy. Yeah, get the final tests then enjoy your summer. Soon this will all be a distant memory.

Jim

P.S. Feel free to read my long winded LDR Brachy journey by copying and pasting the info in my signature. I have been VERY happy with the choice as have most members here who have made the same choice.