First post

Hi all,
I have been reading the forum for some time now and was just diagnosed 3/24/2016. I just turned 55
I mentioned the fact I was having to urinate a lot to the doctor when I went for a check up and figured it was due to high blood pressure medication I was on. Thought I could just change pills. She did not think it was that and ordered blood test. The first test was 7/15/2015 and the PSA was 4.7 she had me come back in a few months and on 11/17/2015 the PSA rose to 6.0 DRE was also done with some enlargement but no bumps or anything. Went and seen a urologist 2/11/2016 and he ordered a biopsy to be done. That was done on 3/15/2016.
I got the results on 3/24/2016 and was positive for cancer. He is recommending prostate removal and I am to see another urologist on 4/11/2016 who would be the one doing the surgery. He wanted to have the surgery done in a couple of months from now so that the biopsy would have time to heal.
I know everyone has to make their own decisions but I would love to hear some feedback.
He did start me on tamsulosin (FLOMAX) 0.4 MG Capsule on 2/11 but it has not helped.

Thanks

Greetings from another 55-year-old and I'm very sorry to hear your diagnosis. We always hate to see new guys here, but when it happens you'll find that we snap to action. If you just found out yesterday, you're probably not in action mode yet, which is fine and understandable. That said, here's my recommendations on how to get started.

First off, we could give you more direction if you can give us the specifics from your biopsy. When you have a positive core (they probably took 12 samples), its anywhere from a Gleason 6 (unaggressive) to a Gleason 10 (yikes). Knowing that is important. Next is how many of your cores were positive and what the volume was. If you could post that info that would be helpful--you should be able to put it in your signature.

Regardless of what your Gleason scores were, you should get a second opinion on your biopsy slides since reading them is a subjective process. In the newly diagnosed sticky (definitely read!) on this site, it explains how to send them to Bostwick or Epstein for a second opinion. It's easy, cheap and something you should really do.

With that info in hand, you need to decide how you'll treat this. Almost everyone gets surgery as an initial recommendation since we're diagnosed by urologists and by training they are surgeons. Surgery may or may not sense for you, but you should also investigate over radiation options, specifically brachytherapy and SBRT. A urologist can't explain those to you--you'll need to find an expert that practices these specialities.

To that end, if you let us know where you're located, we can probably give you the names of different specialists, including surgeons. (Maybe someone here has even used the surgeon you'll meet with next month.)

Last point: no one wants a cancer diagnosis. But most guys with PC do very well. We'd like to know more about your specific diagnosis, but the odds are that you will do well. Good luck to you and let us know how we can help!

Michael_T, I am in Illinois and have been going to OSF Saint Francis in Peoria. I am limited by my insurance, it's through the state.

Zauberer, welcome from another non-Chicago Illinoisan. I'm south and east of you. With one positive G6 core, quite seriously, you may not need to do anything for a very long time. Which would be the ideal situation. Do not allow a surgeon to railroad you into immediate surgery.

I don't know anything about St Francis, or who might be there.

I'll tell you what my Urologist told me after diagnosis: With 3 G6 cores, he told me I had at least 6 months to decide what my course of action would be. With one, you don't need to decide today...or even next month.

In other words. SLOW DOWN.

With a unilateral G 3+3 in two cores. you are in a position to take your time and read up on the possibilities available to you. As Sr Sailor wrote, every option in the book, from active surveillance to focal therapies, to various types of radiation, to surgery, are all possibly appropriate for you.

My humble advice is that you do not rush into surgery, but spend a few months learning about the implications of the various forms of treatment, their long term success rates, and common side effects. There is a lot of great introductory information on this site, and other places on the internet.

Thanks every one for all of the advice, I have been reading all I can about it now and I think will reread it again later as well. The brain is just not soaking up much today. It's good to know I have some time to research and make a decision down the road. I guess everybody freaks a little the first day.

Hell Zambauer and welcome. You have received some great advice already namely, slow down, recognize that you have lots of options and get another reading on your slides.

Now is also the time to get yourself educated on our disease. I suggest reading the sticky thread at the top of our forum that is designed for newly diagnosed men and their families. Also there are tons of books you can read. I personally recommend Dr. Walsh's, "Guide to Surviving Prostate Cancer" and Dr. Scholz', "Invasion of the Prostate Snatchers."

So, don't be railroaded into anything and ask lots of questions. Once your diagnosis is confirmed (or changed) by Epstein or Bostwick then you can really get down to decision time which very well might be active surveillance of your disease and treating it like a chronic issue that might or might not need other treatment.

We are here to help so please take advantage of our great and knowledgeable membership.

Jim

Zauberer,

Welcome. Be assured that with your low risk prostate cancer, you have plenty of time (probably years, if you choose active surveillance) to collect info, interview lots of specialists, and decide which is right for you, be it active surveillance, focal therapy or radical therapy.

Your PSA density is 0.24, which is just over the limit for "very low risk," and I don't know the % cancer in the two positive cores, but you are comfortably in the NCCN "low risk" category.

I'm a bit surprised that you are experiencing urinary frequency with a prostate that small and so little cancer in it. Perhaps you are having bladder spasms - ask your Uro if you can try samples of a bladder antispasmotic (e.g., Myrbetriq, Oxybutynin, Vesicare, Toviaz, etc.). You can also try switching to a different alpha-blocker (e.g., Rapaflo). Cialis, the same medicine used for ED, has also been found to alleviate lower urinary tract symptoms (LUTS).

Tall Allen, thanks for the input. I never thought about asking about bladder spasms. I will bring this up when I go to my next visit.