IN DIRE NEED OF HELP

I'm not the most knowledgeable guy here, when it comes to the technical stuff, they'll be along soon. But my guess is he ruled out surgery because of the suspicion of Extra Prostatic Extension. But to my knowledge, that shouldn't rule out surgery. Might make it a less desirable option, but shouldn't rule it out. I don't think MRI can see that it exists, definitively. The Meri's are good, but not perfect.
With that said, there are other treatment options you should explore.

First thing you should do, is send the slides to Johns Hopkins pathology for a second opinion.
Second is to read the Sticky at the top of the forum for newly diagnosed (as well as other stickies of interest).
Third is educate yourself as much as possible. Read the book "Dr Patrick Walshes Guide to Surviving Prostate Cancer", 3rd edition. It's a bit dated, because PC treatments are advancing so fast. But for learning the basics in n easy to read format, it's excellent.
You might also read "invasion of the Prostate Snatchers" by DR Mark Scholz, which will give you a good but different perspective.

With your G6, YOUVE GOT YHE LEAST AGGRESSIVE GRADE you can hve, so that should provide some comfort. But with so many cores positive, you probably are not a great candidate for Active Surviellance.
Most important, try to relax. It's a shock to hear the words "your biopsy was positive for cancer". We've all been there. But education is power, and you will,soon learn, that for the most part, prostate cancer today, can usually be cured with first line treatment, and when it's not , it can be treated as a chronic disease with good quality of life, for decades. You aren't leaving this side of the ground anytime soon.

So try to take deep breaths. And wait for more responses, they will soon come fast and furious.''good luck, oh, and welcome to our reluctant brotherhood,

Hi lanky, Welcome.

Per the previous replies, if you do decide to get a nearby pathology second opinion, here's a link for that.

— Jonathan Epstein, M.D.

pathology.jhu.edu/department/services/secondopinion.cfm

Charles

Lanky,

I am yet another guy whose usual role is to say hello and keep a new member company until the smart guys show up to tell him what is going on. While we wait I might as well tell you what I think...

Your MRI and pathology reports are a bit of a mixed bag. The bad news is that the cancer seems to be in several different spots and it has grown out of the prostate capsule. The good news is that it all appears to be Gleason 6 disease which is very seldom particularly aggressive.

If you will forgive a metaphor, prostate cancer with a higher Gleason score, say Gleason 9 like mine, tends to spread like dandelions if you don't catch it in time. Like the fluffy white seeds that blow around in the wind, cells of high-Gleason cancer travel all over the body in the blood stream and can wind up anywhere. But you don't appear to have that kind. The kind you have -- Gleason 6 disease -- spreads like crabgrass. It sends out runners into nearby tissues. It can cause trouble and if there is a lot of it then it needs treatment but it doesn't pop up somewhere else far away.

The reason your uro doesn't like you as a candidate for surgery is that he probably suspects that the cancer has grown into nearby tissues that you will probably not want him to cut out. The guy with the backhoe can deal with your crabgrass as long as it stays in the lawn but he's not a good choice if it has grown under the azaleas and spread into your rose garden.

Hi Lanky, welcome to HW, sorry you have to be here. You got some great advice. You get to slow down and do your research. Peter gave you some great metaphors that should help calm your nerves some (not all your nerves as that is hard to do when you get the cancer call). Besides the items previous posters mentioned, a good support group will do you good. Cancer Support Community has groups through the U.S. A lot of hospitals do to. Best wishes to you and keep us posted. Take care. -JR

PeterDA - as always you crack me up!

Love the metaphor... word pictures like that help us take some of the emotion out of the situation and improve understanding.

Modesty? Dignity? Does none still have that? I didn't leave mine home when I was diagnosed. I threw it in the trash. LOL 😂

I will just add my welcome as well...you are received great advice. Stick with us and stay cool. We will help you thru this.

Jim

Lanky do all the stuff the above members suggest...just don't get on the treatment train until the con-doctors have had their say and have punched the impatient patient...and then when you are drunk with fear...submit...resistance is futile...

Oh and discern the difference twixt old and new wine...and that even new wine at some point becomes old as ages come and go...go and come....' same old story...fight for love and glory...case of do or die'...hey what else we got to do? it really is all about the train ride...final thought...beware the switchman...you will know him best in the dark and see the grin and the dark light that emanates from same.

I would be concerned with any doc who has issues with getting a second opinion on a biopsy.

The uro is not the one reading the slides, and should have no vested interest in your getting a second opinion. At least my insurance expected it.

My uro insisted that I go to Bostwick up front.

Island Time,

Nobody is "giving up" on curing his Gleason 6 disease. It's just that when it gets outside the capsule then radiation tends to do a better job of treating the surrounding tissues. Radiation is at least a likely a cure for him as surgery.

Thats life...let one bloke...that "offends" drive you away from a gaggle of others...that helped you...what is wrong with you?... adolescense teens 30 something's...and now the dreaded 50's...anybody have any skin on the bones to protect...that aint wafer thin...Lordy Lordyl ...Im not a diplomat...just another pca survivor...the Moxie must have been left in the "chevy by the levy"..."down by the river".......near the TVA...look around at the world today...my empathy is stuck in the mud...right next to my pomade...

Saw the RO and he recommended two treatment options: (1) IMRT - 40 x 2GY; (2) HDR Brachytherapy (Mono) hollow catheter placement technique - two treatments (12GY per treatment 6 weeks apart). A Polaris biopsy test result done showed a score of 3.1- intermediate risk.
I am researching both options but I am leaning more towards HDR Brachytherapy.
I would appreciate any input (experience, opinions, etc) from anyone who has either gone this route or decided not to, especially the HDR Brachytherapy (Mono) using hollow catheter placement technique.
Thanks,
Lanky