Just Starting My Journey

First, thanks to everyone on this board. You have helped ease my anxiety. I’m 52 and have had a weak urine stream for at least 7 yrs but didn’t have a doctor so didn’t worry about it. My dad died of colon cancer a few years ago so finally got brave and found a doctor. During my wellness check the PSA was 6.2 so he got me into the Urologist in three days where he found a 2cm nodule on the left side of my prostate during the DRE. The urine test was clean so he scheduled a biopsy which is in a few weeks. Over the weekend I read up on everything I could find aboutPC and noticed many recommendations to have a 4K score before a biopsy. I called the doctor and he said regardless of the results based on the size of the nodule he would recommend biopsy anyway. So now I wait for the biopsy.

I’m uncertain of what comes next. I’m assuming the worst and fully expect to find cancer. I think I can handle G6 don’t want G7 and am scared to death of G8 or higher. I’m just getting started on understanding staging but my questions are about what happens after I get the dreaded call and what to expect at that appointment. Does he run tests and scans or just tell me his recommendation of treatment? Is this when I ask for a second opinion(I’m 2 hr from Barnes Jewish and the Siteman center)? Any information you can provide to help me prepare myself wouldn’t be greatly appreciated.

One other thing I want to hear about is the Viewray MRIdian Linac. Last summer, ironically, I bought stock in the company because I heard third hand about how it offers a better side effects profile and thought maybe it would help a lot of men never dreaming in under a year I might be one of them. Has anyone’s done treatment at Siteman using it? If so, please share your experience with me. Thank you so much for listening to me.

Be sure to read the "newly diagnoised" sticky thread at the top of the forum. Plenty of good info there.

Even if you get a call that some cancer was found, you may never need treatment, or can safely delay it for years.

As Alephnull advised, "breathe", and don't run down a road of possible treatment (or not), until you know that you actually have PCa, and what risk classification it is.

Everyone's situation is a bit different in terms of how we get the news. First off, let's hope you get good news! In the event you don't, you do want to find about the Gleason scores, # of positive cores and percentages. The general advice here is to have the slides sent to Johns Hopkins for a second opinion.

The need for scans depends on your diagnosis, but with a PSA of 6, even if you did have scans I'd be surprised if they would show anything.

Re your comments about Gleason scores...I was prepared to be told I had cancer, but I wasn't prepared to be a Gleason 8. (Which was later upgraded to a Gleason 9.) But you know...even then I was fine and have been so since finishing treatment four years ago. I guess I just bring that up to say that no matter what's ahead for you, you can do it. The vast, vast majority of us do well.

Good luck...the waiting is the hard part.

We all understand the anxiety factor - it's very stressful and very alarming when facing the unknown about possible prostate cancer. Like the guys said, take a deep breath and relax - just give yourself some time to soak this situation in, it will take a few days. Check back in when you get your biopsy report.

And at 50 years old, it's time for the hose up the rear end for your colonoscopy - this is especially important since there's colon cancer in your family. There are some very good preps out there, it's not that much of an ordeal nowadays.

Welcome to the site.
As others have told you, slow down and take a breath. Take the time to read and learn all you can. There is a wealth of knowledge here and you will learn a lot reading as many of the messages posted here that you can.

Get the biopsy and your results, then let the folks here know what they are. You will get great advice from those who have gone down the path before you.

Convertible68,

Welcome to the site, it is a great place to get information, advice, and support. we have all been right where you think you are or might soon be. Right now you have some concern and questions but do not know that you have cancer so relax and take a nice calming breath. With a PSA of 6.2 you need to investigate to see what is causing that. there are several things that can affect PSA. If you have an enlarged prostate (BPH), Medications, or having sex prior to the PSA test (24 -48 hrs). As mention by others not all nodules are cancerous either so again, relax.

Take some time now to read. Do your research but start with the basics and learn about each step in the process.

The biopsy is no big deal, a little uncomfortable and you will have some blood in your urine and seamen for a short time afterwards but nothing too bad. Talk to your Urologist about any pain meds before and some antibiotics to prevent infection. Most of the guys here have no real issues with the Biopsy and report only minor discomfort but everyone is different. after the biopsy it usually takes about 10 days to get the result. My Uro had me come in for an appointment to give me the results and discuss the findings and what it meant. I have heard other guys report that they got the news over the phone so you might discuss that with your Uro at the biopsy. Start making a list of questions. I actually bring a notebook with me to appointments so that I remember my questions and to take notes. it is surprising how much information you forget driving home from the Dr's. I recommend bringing your spouse or partner with you to help you remember things and so they can get answers to their questions too.

Once you have your results comeback to the site and post them in detail so the guys have as much information as you have and they will be able to help you get the information and advice you need to make an informed decision on how to proceed. If the results are positive for PCa the basic steps will be to have the slides read by Dr. Epstein @ John's Hopkins to confirm the staging as it is important to know exactly what you. then you can look at the treatment options available and determine what treatment fits you and your specific case. PCa is typically a slow growing cancer so you have time to gather information and evaluate what is best for you.

Good luck with your journey,

I know how you feel, Do some research lots of great information on this site and read Invasion of the prostate snatchers. I was diagnosed within the last 2 months. Age 52 psa 5.8 and 1 core 5% gleason 6. I started active surveillance with Memorial Sloan Kettering.. If at all possible have an MRI first before the biopsy. This way they can pinpoint any suspicious areas and sample them when doing the biopsy.

Welcome to the board, and sorry you have to be here. I can understand your anxiety about the process as I was there not too long ago. If you have a Urologist like mine, if the biopsy confirms P-ca, he will likely recommend surgery. My advice would be to not rush into your decision about the kind of treatment. Instead research as much as you can, there are so many different kinds of treatment available and each has it's pros/cons. Getting a second opinion is always a good idea. In addition there are tests out there that help you gauge the aggressiveness of the P-ca (if revealed by the biopsy)--this might give you an idea of how urgent your treatment decision needs to be. Your Urologist may or may not provide you with these options. Also I would suggest you seek out a treatment facility (again, if necessary) which specializes in treating P-ca and has a good track history of performing the kind of treatment you have decided upon. Lastly, keep in touch, this board is a good resource both for information and support.

Well, now the wait begins. The 6.2 PSA right after sex may be somewhat elevated. Are you sure the volume was 335???? That would be record breaking huge. More likely it's 33.5.

low blood in the urine is good. Hopefully you won't have any unpleasant clots to pass. Do be aware that there will be blood in your semen for a week or two--it will start off bright red and gradually turn dark red to almost black. It looks awful. Drink lots of water to keep things flushed out.

Let us know when the report comes back. You might read up on gleason scores. The main questions to ask when the report comes back are:

1. How many positive cores?
2. What are the G scores for each positive core?
3. Which cores are positive (they will say things like upper right, lower left, etc)?
4. Can I please get a written copy of my pathology report?
5. Can I have my slides sent to Johns Hopkins for second opinion?

Then, come in here and tell us what you found out. You can keep adding to this thread, or start a new one. Either way works.