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Posted 9/21/2021 12:44 PM (GMT 0)
Ok well let see I had my biopsy 9/16/21 came back with adenocarcinoma Gleason 4+4= 8, grade group 4, 90 % on a couple and the others were 4+3=7 grade group 4 pattern 4 90% on all six cores out of 12 that had cancer. Oh yes my PSA was only 4.8 which I thought would have been much higher. My age is 59. It is thought that removal of the prostate is the best option and surgery would be the end of October.
Posted 9/21/2021 1:17 PM (GMT 0)
Hi Jeffrey, welcome to HW and to the club to which none of us ever desired an invitation. You have come to a great place for information and support.

I am sure this news has come as quite a shock and that your head is spinning with all the information about your condition and treatment options and what to expect. My first advice - DON'T PANIC! take a deep breath, and prepare yourself for a journey. No question GG 4 is serious, but generally prostate cancer is slow growing, you have some time to review all your treatment options. The best option is the the well-informed and researched one, that considers all of you - your current health, the details of your cancer, and your tolerance of different sets of side effects.

When you say, "It is thought that...", who is doing the thinking? From your timeline I would guess that you have only consulted your urologist. Keep in mind that Urologists are surgeons, and so they will recommend surgery, because that is what they do. You should seek out Radiation Oncologists to consult regarding various radiation therapies. There are different kinds of therapy (external beam, Proton, brachytherapy) and most ROs specialize, so you may need to consult more than one.

In the end, you may well decide that surgery is the right choice for you, but you owe it to yourself to make sure that it is before you jump in.
Posted 9/21/2021 1:43 PM (GMT 0)
Jeffrey,
I was diagnosed at 59yo with a gleason 8. While I chose robotic surgery, you might have other options. Welcome to HW as you research what those options might be.
Michael
Posted 9/21/2021 4:04 PM (GMT 0)
Hello Jeffrey...I'm sorry to hear that you're the newest member of our club. It's a real kick in the teeth to get that news. I was also a G8 diagnosis in September. And nine Septembers later, I'm doing really well. (BTW, a second opinion on the biopsy slide upgraded me to a G9. You should also consider getting a second opinion on your biopsy slides--specifically from Johns Hopkins, which is considered the gold standard.)

Presumably there are plans for scans and an MRI to help stage your diagnosis? You certainly want to make sure that everything is contained to the prostate before deciding on surgery. In my case, surgery seemed likely to fail and that I would need radiation as a backup, so I jumped right to radiation rather than risk the side effects of two different procedures. But obviously every case is different--my best advice is that to sort through all your options prior to making any final decision.

I hope we can help you through this. Most of us--even the higher risk guys that are G8 and above--do pretty well.
Posted 9/21/2021 5:30 PM (GMT 0)
Jeffrey,
When you find out you have a big problem like prostate cancer it feels good to decide what you are doing right away so you can start to get it behind you. That's perfectly natural, but it's not always a good idea. As others have mentioned here, urologists are surgeons. If you go to a Cadillac car lot the salesman will think you need a Cadillac. It's not so much that he is greedy as that he thinks Cadillacs are swell cars. That's probably why he works there. Urologist spend a lot of time studying prostate surgery -- the latest advances and how it can be done better -- and they are generally sold on it and their advice to seek surgery is generally honest and well-intended. Your cancer is a problem they know how to fix. But before you commit its a good idea to cross the street to the Lexus dealer and let the salesman there tell you about his favorite car.
You really need to talk to a radiation oncologist or two before you make a firm commitment. Surgery and radiation have similar disease control results but they have different side effect burdens.
If you tell us where you live -- nearest big city is enough information -- then maybe some of our members from your area can tell you who they consulted when they were seeking treatment.
Posted 9/21/2021 8:56 PM (GMT 0)
Thanks for the replies it's much appreciated. I reread my initial post and yeah I can see where you would think we're still on the fence about what to do but now we just have to get it all scheduled. After talking with other doctor's and reading and watching you tube videos for days now my wife and I have decided to go ahead with surgery which is what was first suggested I'm glad there's options and for very many it looks like they all work.
What's strange about all this is I thought I was ok a couple years ago I started getting yearly physicals and since then I've had colonoscopys with polyps removed and then diagnosed with Barettes esophogus and now this, I wonder whats next?
Oh we're from Spartanburg, SC.
Posted 9/21/2021 10:12 PM (GMT 0)
JefferyT

G8 is aggressive and means business!!

There is a new scan you may want to talk to your dr about.

psma pet

In your case you are looking to make sure the cancer is prostate confined and has not snuck into a nearby lymph node, in which case your best bet at eradicating the problem may not be surgery.

Also, and take this from a guy who had surgery and is overweight (by alot), if your bmi is up there, and the surgeon is going to poke holes in your abdomen, incisional hernias happen afterwards and can be stubborn things.

If surgery remains in your future get a good recliner…..they are rentable!!

Good luck eradicating the critters!
Posted 9/22/2021 4:16 AM (GMT 0)
Jeffrey,
It is in his late 50s when a man's interactions with his doctors starts to change. When he was younger the doctor would do some tests for his annual physical and run through the checklist -- "Fine... Fine... OK... You could lose some weight, but fine... Great... Fine..." etc. -- but as you approach 60 it's more like -- "Ok... Ok... Huh... That ain't right... And that's not so good either..." and so forth. I have Barrett's, too. I'm sure your doctor told you that it can mostly be managed; mostly it means you have another doctor to pester you from time to time.
Actually, we weren't worried that you were on the fence; we worried that you had fallen off of that fence before you had time to get a good look around. I'm still a bit worried about that. It's been less than a week since your biopsy and you've made your decision. That's OK but it's fast work.
Oh, and Stephen's right about needing a recliner. Make sure you can see the television and have a side table for a beverage and the remote.
Posted 9/22/2021 9:16 AM (GMT 0)
Hi Jeffery,
Wish you the best. Not an easy decision with so many options.
My first urologist only gave surgery as an option. Never once mentioned any other options. The second urologist gave me options and let me decide. With surgery and radiation having practically the same outcome, I felt radiation was best for me.
The main thing in my opinion is that one is comfortable with the choices made.

By the way I’m from Upstate SC as well. A little town called Liberty near Clemson University. Lived in Spartanburg for four years in the late 90’s while attending Sherman College.
Posted 9/22/2021 9:42 AM (GMT 0)
Jeffrey:

Welcome, and yea, it's a kick in the teeth, we've all been there.

I'd like to say somethng a bit more forcefully: You're G8, which is aggressive. However, do NOT immediately opt for surgery until you have had, at the very least, an MRI, CT, and bone scans. Here's why: If you cancer has escaped the prostate, surgery will not be enough. You will need post surgery radiation plus lupron hormone therapy.

You owe it to yourself to investigate the primary radiation treatment options, if you have not done so. They also have an excellent chance of curing you, and because of how they work, they can treat a larger area with potentially fewer ugly side effects.

If there is anything we have seen here, over and over, it is men who move from diagnosis to surgical treatment without even being told to look into the other options, particularly with aggressive disease, and regret the decision for the rest of their lives. As Peter said above, a urologist is a surgeon. They do surgery, they know surgery, and so they recommend it. Many will even bad mouth radiation therapy. Take an extra week and at least talk to a radiation oncologist--and make sure you get those scans done!

(By the way, I am a surgery veteran who has had a really good outcome)
Posted 9/22/2021 10:55 AM (GMT 0)
Hello Jeffrey. Usually when a man says he has made a decision and is unwavering most of us wish him luck and give him whatever advice we can re that particular decision. But as you can see from the recent posts we have veered from that course in your case. I'm with those guys...assuming the dates you provided are correct, you have made a treatment decision 5 days after your biopsy. Frankly that's way too soon to have had the proper battery of tests, to get properly educated and to process all of the info to make a sound decision.

I've been on this site for 13 years. The biggest regret that I have seen is from men who didn't do their homework and rushed into treatment without properly considering the options. I'll implore you - as Halbert did - to take some more time to get the proper tests/scans and to visit with other doctors who may have a different view than your uro/surgeon. Most of us would also suggest that you get your biopsy slides read by Dr. Epstein at Johns Hopkins so you have a true expert opinion on the pathology.

In summary, we feel you are moving way too fast and have not done your homework. If you still decide to move ahead w/o taking the proper steps we will still help you however we can.

Jim
Posted 9/22/2021 12:09 PM (GMT 0)
Good luck with you decision. Most of us pull that trigger when we hear the C word. Get it out! That’s what I did years ago. I wish I had done more investigating. I know way more now that what I knew then. The surgery went well and I have been clear after that. Other issues may have been less if I went with a form of radiation.

That is why I say I wish I had investigated more.

Best of luck with your decision and healing. Feel free to ask any questions here.
Posted 9/22/2021 4:28 PM (GMT 0)
Hello and welcome. I can say that one great decision you've made so far is to join this group. The knowledge, compassion, and good will you'll find here is second to none. Best wishes with whatever treatment option you go with, and for the journey ahead.
Posted 9/22/2021 5:07 PM (GMT 0)

PeterDisAbelard. said...
Jeffrey,
It is in his late 50s when a man's interactions with his doctors starts to change...

Hopefully, part of the change in these interactions is our life experiences leading us to know that doctors aren't the omniscient gods we may have once believed they were. It's always wise to get second opinions and opinions on our options.

Good luck with your treatment!
Posted 9/22/2021 6:28 PM (GMT 0)
Hey Jeff, sorry to hear your news. I was in a similar situation at the end of last year/beginning of this year. I had a RALP in February. I didn't discover this forum until after my surgery, but found the information shared within it quite helpful. You might read some of the older posts about what to expect from surgery, tips for recovering from it, how to deal with the catheter, what type of clothes to wear, etc. I found all that type of information very helpful.

I also found this blog informative: https://totallyuniquelife.com/prostate-cancer-dealing-with-the-diagnosis/
The details of his experience varied slightly from mine ( I was in and out the same day, had one less incision, etc), but gives a good idea as to what to expect.

best of luck!
Posted 9/22/2021 8:15 PM (GMT 0)
Wow thanks for everyone's responses, it means a lot. I can't wait to get home and spend some time checking out the links suggested and all, being at work I've not got the time I want to spend on them.
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