prostate cancer spread

I have been diagnosed with prostate cancer 2 days ago. total score 7. 12 samples done . 6 on left side and 6 on right side. 3 positive on left and 1 positive on right.
I am 43 years old. The recomendation is removal of prostate. I am still deciding between robot or surgery.
Before I was diagnosed I experienced pain in prostate and early ejaculation urin leakeage.
My biggest concern is obviously spreading . do they still remove the prostate even if they find that cancer did spread. ?

Devon, sorry you have to be here, and have been diagnosed, at such a young age..
Generally speaking, unless you have a very aggressive form , I.e. High Gleason score, PC spreads very slowly. Can you post your Gleason score, % of cores positive? And other details of your biopsy? It would help us know more about your diagnosis.

There are differing opinions regarding surgery after spread. But you are not there yet.
A few thinks to understand....
Most urologists are surgeons. You say surgery is the recommended treatment? Recommended by who ? A urologist, who is a surgeon?
You should get different opinions, see a radiation oncologist, actually a few of them, as they specialize in different types of radiation. HDR and LDR Brachytherapy (commonly known as seeds), SBRT, also known by the brand name Cyberknife, etc.

Also, I would want to get a 3Tesla MRI, which would show with a high degree of accuracy, (not 100% certainty, but high) what are the chances that the cancer has spread outside the prostate capsule.

There is no one right way to treat this disease. Get educated on ALL of your options. And depending on your Gleason score and details,of your case, you probably have some time to decide which way to go.

Welcome to HW, sorry you need to be here.

First, I realize this is like getting a kick in the head and likely your emotions likely are flying everywhere, but relax it's not as bad as you think. Okay, having your prostate ripped out isn't going to be fun, but you're going to be fine. You numbers suggest an intermediate risk PC and with your PSA number, it's unlikely to have spread. It's possible, but even then, there is a lot of things the doctors can do in that case. There are scans they can do but at lower PSAs like yours they often show nothing.

Second, look into your treatment options and get a second opinion on the biopsy and what to do. There are a number of possible treatments that might work as well (radiation) but at your age surgery might be the way to go. PC is generally a slow growing cancer, so you have a little while to make an informed decision. Don't wait for months, but a few weeks won't matter much.

Check out the sticky threads at the top of the forum for newcomers for a lot of good info and ask all the questions you have. We're most days.

Hang in there and keep us updated on your progress,
Andrew

Deon124,

Welcome. We've all been through the shock of the initial diagnosis that you are going through now, but at 43, that had to be totally out of left field. When one's mind is reeling like that, one is not in a good state of mind to make an important decision like this. And the good news is that there's no rush - you have enough time to get into a better headspace, to meet with specialists, to gather info, and make a decision that's right for you.

Most of what you know about other cancers does not apply here, and the differences are important. One is the way we work with doctors. With other cancers, one goes to an oncologist who brings in specialists as needed. Not so with PC. All of us started with a urologist, but then many of us saw a variety of specialists on our own. I met with 6 specialists before deciding, including 3 urologists and 3 different kinds of radiation oncologists.

This site has a good explanation of what one should learn at the start of this journey:

Newly diagnosed with PC? – read this thread first

In there, you'll see a recommendation that you have your biopsy slides re-read by Bostwick Labs or Epstein's Lab at Johns Hopkins. The reason they are recommended is because their pathologists are devoted to reading prostate biopsies only. They are the gold standard. Getting a good Gleason score is vital, and it matters if your Gleason 7 was 3+4 or 4+3.

I don't think there's any other diagnostic info (e.g., imaging) you'll need to get started. Each specialist you visit with may have his own recommendations, so your best bet is to follow their requirements.

If you tell us where you are, we may have recommendations for specialists in your area.

Thank you for the replys to date. It does help talking about it. At this point in time I am waiting for the week to gather more info.

I stay in South Africa. Cape Town

Cape Town has me stumped. There was a woman on here last year, from Holland, whose father was being treated in South Africa. You might try posting onto her thread (link below) to see if she has any recommendations for you:

www.healingwell.com/community/default.aspx?f=35&m=3332236

Hi Deon. Sorry you have to be here, but Welcome to a great group!

For what it's worth 3+4 is the GOOD 7 to have.

I know that "Take your Time" is not what you want to hear in amongst the inner panic you must be experiencing, but it is absolutely the best advice anyone can give you at this point.

Do your research, stay ahead of the data and information curve, and make the Best-For-You decision based on your available options.

After you read the rather loooooong sticky post at the top of the page, the well educated individuals who frequent this forum will help you with any and all questions about any aspect of having and beating PCa.

Not sure if anyone saidf this already or not but.

But in general they only recommend surgery if it is contained, IE not spread.

"All aches and pains I now link to cancer.I know I should not but I suppose its normal." That statement alone tells me you will have little problem handling this disease. Your bit of fear is well covered by wisdom… That plus when you said I "stay" in South Africa…I thought I was hearing one local bruddah speak from Hawaii. Dats where I stay…I also stay glad you found us. I have met many South Africana's here on Maui….Sawabona and Aloha...

I am back, read a book, looked at various options. Its obvious that every PC depending to each individual's pc is different. I spend hours reading blogs, individual storys and outcomes, etc.

Taking everything into account and all the information I have gathered, for me I end every tim at the same answer.
Surgical removal
Booked robotic surgery for 30 June 2016

my age 43
4 of 11 positive
gleason score 7 ( he said it a 3+4)

The additional info is that my urin flow rate is slower than normal and somtimes retension, not emtying my bladder completely?
I am getting mixed information in regards this. Its obvious the prostate but does this mean anything specific. Orriginally I went to the doctor because I had lower back stifness I thought. It was just strange. After I had the biopsi I realise the feeling was my prostate. The tenderness after the biopsi was simmilar to my orriginal feeling.
I felt my prostate? I still remeber telling the doctor it is not pain like I hit my finger with a hammer, it was just I feel there is something.

That feeling is now gone.

Any thoughts on this?

With only 4 of 11 cores positive, and a 3+4 = 7 Gleason, there's no rush, i.e. DON'T PANIC.

I've had guys here tell me I could do ACTIVE MONITORING. My vitals are below and much worse than yours.

Did you have an MRI done? What were your PSA test results? Have you seen a radiation specialist?

Hi Dion,
It sounds like your GP treated you for pleurasy. I had it once. VERY painful. I hope it is better.
I don't think your GP is sending you on a goose chase with the referral. It is not for an xray, I'm guessing, but to discuss another option for treating your PC. Surgery could have a lot of life changing side effects. So irradiation. But don't you think you owe it to yourself to check out all your options and decide with full knowledge what will be the best course of action?
Good luck and let us know what you decide!
Beth