just diagnosed with cancer

Hi All,

I have posted here in the past. This is a great forum with incredibly help for those of us in need. Long story short I have had high PSA numbers for the last year. My last bloodwork showed 4.8

After a watch and wait scenario my urologist suggested a prostate biopsy. I had that done about two weeks ago. The dr called me with the results. 3 out of twelve cores came back positive for cancer. I have no numbers yet on the samples so I don't have any idea how bad things are. I was immediately scheduled for their in house oncology team. My group is Urology of Va. I think one of the biggest in my area. They have their own cancer center.

As bad as cancer is I also have some other issues. I had a two level spine fusion about two years ago. I suffer from osteoporosis also. I fractured my T12 vertebra a year ago. Its about 30 percent gone now. I also managed to herniate my L4-L5 disc with moderate root nerve impingement. I will have to have another lumbar fusion in the near future. My last fusion left me in just as much pain as before surgery.

I would appreciate any advice from anyone as to what I should do about my cancer. I know I am not giving much info but will post more when I learn more. My oncology appointment is this Friday. I know there are many treatment plans available. Because I have pain and spine issues I need some help here. I am 60 years old. I am also in pain management.

Thanks for listening and any help is appreciated
dmo

Post Edited (oceanfisher58) : 8/20/2018 4:49:26 PM (GMT-6)

Their Oncology Team will go over your biopsy report in detail. All your treatment possibilities will be explained..You Gleason score will be very important in planning your journey....

Hi Ocean. Sorry for the news but hopefully it will be a curable cancer. You can wait until Friday or...you can call them back tomorrow and get the specifics. That's what I did. That way I was able to research my personal situation ahead of time and come prepared with direct questions. Just a thought.

Good luck and please don't make any decisions on Friday in any case. You'll need some time to figure out the right approach.

We are here to help you.

Jim

Good luck Oceanfisher!

Sorry to hear about the DX. Next step is to get the numbers. I won't even speculate until you know what they are. Depending on what your risk profile is, you'll have a dizzying array of options to sort through.

Low risk means you could do AS (active surveillance).

or you might need some treatment. Surgery might be too much for you so you might consider your radiation options, but that's all speculation until you see the numbers from the biopsy.

Andrew

You are heading in the right direction, be bold and get all your own data, physical copies, start a notebook, and start writing down questions. Data is king to decision making. I wish you well. Denis

I'm very sorry to hear about your diagnosis...but once you know the specifics you'll be able to figure out a plan of attack. Regarding AS, there are ongoing biopsies, but there's other monitoring that goes on as well. One person here who has been on AS for quite a while recently posted that his docs have had him go four years without a biopsy.

Best of luck with the back--dealing with more than one health issue can be rough. Hope we can help.

DMO,

Well, if you're going to have PC, two G6 cores is almost as good as it gets. At that level, it's generally asymptomatic--so your other aches and pains are about being your age and stage.

A few steps to take:

1. Have your slides sent up to Johns Hopkins for second opinion.
2. Seriously consider AS. Yes, it will require a follow up biopsy is 6 months to a year. The good news is, that you may never need to treat (about 1/2 the AS patients go 5 years or more before treatment), and the other good news is, that a long term study shows zero difference in long term outcome for AS vs immediate treatment. Except for the non-side effect outcome that goes with deferring treatment.

You're going to be OK.

I fully agree with the last two comments. And given what happened to your dad, I can see why you're quite attuned to the lower back pain and fatigue. Just know that there are probably a 1,000 reasons as to why you're feeling that and PCa probably makes up less than five of those possibilities.

While it sucks to have cancer no matter what, overall you have a low volume of a low-risk cancer. It's the textbook definition of the type of cancer that you can monitor (Active Surveillance) instead of treating, which brings a decent chance of side effects. Not everyone feels that way, but interestingly a lot of guys here that had had treatment think that AS makes sense for those that qualify. Everyone is different, but I'd lean toward AS first and if I somehow felt compelled to treat would very carefully consider all my options (surgery and radiation), which means talking to several very different types of doctors.

Good luck to you and I hope this community can help you navigate this!

You seem to be a great candidate for AS. A confirmatory mpMRI-targeted biopsy will tell you more.

The bone pain is most likely from your osteoporosis and your prostatitis. PC doesn't become painful until later. With your diagnosis, you can probably get Prolia.

Your father's prostate cancer may be a different type from yours. Inheritance plays a role, but it is not that big a role. You can ask your doctor to prescribe the Color Genomics test (cost=$250) which will check for germline (inherited) genetic aberrations.

One of our members (Paxton) actually had testosterone replacement therapy during his SBRT treatment. Chronic low testosterone is associated with PC.

oceanfisher58 said "Some days I can hardly get going."

With all you have going on, that is understandable. I am certainly no doctor but let's not ignore how our mental health is impacted by our physical health, especially when things are chronic. Some have shared on other threads how they have dealt with the depression and anxiety that comes along with these other problems and depression, in particular, is an energy and motivation zapper.