Recently diagnosed - PSA 15.1 with only 1 core positive @ 3+3. At 44yrs old - any thoughts?

Thanks halberd and all the others who have helped me.

I had my PSA tested Monday, it's now 15.5 .. and that's after a low dose of cialis and another round of antibodotics...

I met with a another radiation oncologist today and he recommended surgery...

I have a weird pressure down by my anus that has me worried.. so all this has me back to the surgery path.

I fly to NYC Friday morning. Consult next Monday then surgery Tuesday. I'll head overy to Boston area afterwards to see (and break the news) to my parents.

Thank's all!

Zzarth

Hi Paulmerc

Yes I had a 3T MRI of Prostate w/ Perfusion w and without contrast on 9/13

Apprecaite your view, I bet that might be happening to me... it's a weird sensation that I have "down there" that feels like pressure... and it sometimes extends to the back top of my legs... is it in my mind or is it real? ... (kinda like that old Memorex commercial? .. is it real? or is it Memorex) ... ok I digress :)

Here is my MRI Report said...
The prostate gland measures 3.9x2.9x4.2 cm for a volume of 31cc. Along the anterior gland near the apex there is a 16 mm focal area of low T2 signal which is somewhat lentiform in shape and it is not entirely clear whether this represents a primary focal tumor or stromal hyperplasia. Slightly heterogeneous signal is identifed throughout the remainder of the gland however no other definite focal tumor is seen. The prostatic capsule is intact and seminal vesicles are normal.
Lymph Nodes: No lymphadenopathy.
Bladder: Normal
GI Tract: Visualized aspects are grossly unremarkable.

I have 2 routes I've been debating:

Plan A - go forward with surgery with Tewari next week
Plan B - go forward with a MRI guided biopsy next week.

I took time off before I start my new job for Plan A... so there is the cadence/timing aspect of this whole thing, not sure i can take more time off until next year if I don't get this surgery done now, esp. if I decide to do it in NYC ...

Also, I don't think any result from the biopsy matters for FLA with a PSA over 10 .... in fact, Uchicago FLA team didn't even call me back after I emailed them and sent them my CD --- their FAQ for FLA states that a PSA < 10 is a prerequisite. Dr Walsner said he would "ablate the entire R-APEX for me if I wanted", but a lot of surgeons have told me that savage RP after FLA is harder than if I didn't have FLA because of the damage FLA does.

That said, I don't know if a biopsy would change my treatment course at this time.. and right now it looks like I'll keep walking towards plan A ...

Regarding RT including BT -- I had 4 chest CT's w/ contrast in 2013, which I believe is equal to 700 chest XRAYs (each) ... so I don't think I want any more radiation ... actually, maybe that is what caused my cancer i the first place...

Anyways, that said, it seems all roads end with Surgery for me... I got the stage set with Tewari next Monday and Tuesday, so maybe it's time to pull da trigger and stop changing my mind ... as some of you can already time I'm going totally insane & as some other members here have suggested regarding Surgery:

"GET ER DONE!" -- (in the voice of Larry the Cable guy) :)


Zzarth

Best of luck to you, Zzarth! I was going to ask when you would be in Boston, as I'm going there this Thursday (10/27) for a consult. Guess you're "busy." Get busy healing so you can get your life back, brother!

Go Class of 2016!

Good luck man.. I meant to respond earlier but my last thoughts to try and help you decide were - IF for some reason the PSA came down, would you really just want to start with FLA? I never got the sense that that was your preferred choice.

Anyway.. you're young, you've picked a great surgeon, who does an advance procedure and you're at a great facility. You've played all the best cards.

Good luck with surgery. Recovery takes time, don't rush anything.. get up, move around, lie back down REST. TAKE THIS TIME to just focus on the one thing you have to focus on and that is HEALING and RECOVERY. If you're not needed at work, don't think about it. There is ONE mission at the moment. coming out the other side as best as you possibly can and that will take ALL your mental and physical energy to get the best result.

DRINK A TON OF FLUIDS..just keep drinking and FILLING THE BAG. FILLE THE BAG.. flush the system. Get up, move around walk, no stairs, but move the body.. sit back down and rest.. TRY and eat.. healing takes energy and food is energy.

Try and avoid caffeine if you can - no tea or coffee. It irritates the bladder and makes recovery of the bladder more difficult and can lead to more bladder spasms. Green tea tastes like ass, but it's a good substitute and has some healing properties - apparently.

catch up on old movies or new movies and read those books you never get to. Don't rush dinner or lunch, enjoy it. LET people dote on you for a few days..you'll need it and they WANT to do it. Enjoy this moment of freedom from anything else, there are few of them in life.

your on the path

pm

Glad you've landed on a treatment. Good luck and make us proud!

Best of luck and see you on the other side, you picked a great surgeon, you are in good hands

Well ... I'm in the recover room... so I made it.

Tewari meeting tomorrow but he told my Fiancé it appears cancer was contained and no ECE.

Yesterday I asked a single question for Tewari, I asked him "promise you'll take care of me?"

The next thing Tewari did was .. he got up, walked over to me and gave me a Hug. AMAZING.

Just wanted to make a quick call out to you Tall Allen. I wouldn't have found Tewari without you. So many people rely, respect and benefit from you insights, your Karma level must be up there.

Also thanks to everyone else on this thread who took the time to post advice and view points... they were all super helpful.

My cath is my only nightmare. But I'm doing better and better already.

Let's hope for a good path report!!

Zzarth

OK so had my after surgery consult with Dr Tewari.

So I had both nerves spared, no ECE.

So not only did I have cancer in APEX, but they pathology lab found what Dr Tewari called a "booby trap" of cancer near the rectum..

Also I said I had a very inflamed prostate...

Looking forward to the full pathology next week. But it looks like if I did FLA it would not have gotten it all and probably would have been a bad decision.

Zzarth

Zzarth,
Sorry to hear about your diagnosis. While I'm no expert, I'm in the relatively same boat as you. Diagnosed with PCa last month at the age of 44. My biopsy, returned 4 g6 and 1 g7 (3+4). Based in part of g7 and rise in PSA 2X over 2 years, the MDs didn't believe AS was in my best interest. However, if my cores came back with just G6 - AS would have been my course of action.

I'm in the Dallas area and there are some great dr's at UT Southwestern and USMD that I've met with for consults.

I've elected for surgery vs radiation. I will also have an MRI in a few weeks prior to the surgery to determine if the nerves can be spared - praying this will be the case.

Good luck!

So just have to vent. Flying from NYC to Boston ... and my cath bag pops and leaks all over my foot. During to confusion, someone stole my android tablet.

Where is my karma!!

Besides that I feel ok.

Hey Paxton
Luckily the tablet was not that expensive. It was a nice dual boot android windows 8 inch..... What bothers me is the content I had... I had loaded it up with all the seasons and episodes of walking dead to watch during recovery... Plus I'm concerned about security... Oh well..

So 3 days after surgery, my girl friend and I made it to my parents house in Boston.... I had been holding off talking them that I had been diagnosed with prostate cancer and subsequently was fired from my new job... But when I finally told them they were supper supportive and were grateful I didn't tell them... My dad is 79.... But it sure was a huge weight off my shoulders to tell them.

So I have 1 more day until I fly back to New York to have my new friend (Mr. Cathedar bag) removed and my pathology report...

In feeling good... And staying confident that mentally ill be able to accept and actually enjoy the new type of non_ejaculant sexual experience that is in store for me. I'm feeling positive that ultimately be one of the rare guys who actually have a heightened experience... (fingers crossed)

By the way, my cath bag was completely blood free until today... Today it was definitely blood and looked like a few pieces if dried blood (scabs) floating around in there... That happen to Anyone else??

Omg Paxton I think we did!!!

I'm up in the BoxFord Massachusetts area... Staying with parents and relaxing it up.

After doing a walk around the neighborhood my cath bag today had so much blood in it, it looked like watermelon water. Anyone else experience this?

Zzarth

My bag was pink first few days with some floaters. Toward the end of the week it cleared up. I drank lots of water to flush the system out.