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Posted 6/18/2007 5:56 PM (GMT 0)
I'm newly diagnosed with prostate cancer, and I realize from reading some postings that I should have more of my own information, starting with a copy of my biosy report. The urologist said their were small areas of cancer presen in 3 of 12 sticks, something like 4 mm. The Gleason, I understand, was 3 + 3. I'm 56 years old, and my first quetion is this: Do any men my age adopt a program of monitoring the cancer over time rather than going for immediate intervention? So much of what I read describes prostate cancer being quiescent sometimes for decades. Is it completely unreasonable to even consider this? Thank you.
Posted 6/18/2007 6:21 PM (GMT 0)
Hi KMC51,

Your numbers are pretty similar to mine. The monitoring you talk about is commonly referred to as "watchful waiting". Watchful waiting was one of the options my doctor mentioned but did not recommend. If I was much older I might have considered it but the cancer would have many years to grow at my age. Also, I thought that I would respond to surgery better at my younger age and might as well deal with it now.

I have read stories of men who tried watchful waiting and later regretted it because the cancer grew to an advanced stage before they caught it. I'm sure some who wait never have a problem but I was not willing to roll the dice like that.

Joe
Posted 6/18/2007 7:36 PM (GMT 0)
Hi KM,

So sorry you had to find our little forum out of necessity. We're glad to have ya anyway.

Let's see, 56 and 3 of 12 cores positive....small areas but were they on one side? 3+3 and 3/12 is good so far!
How about your PSA? It's low I take it?

Of course you can adopt the watchful waiting approach and yeah, you may get a few years out of it before the cancer grows to a point where it needs to be addressed. Fact is, unless your PSA flew from 0 to whatever in the last 12 months all of a sudden, you probably have several months+ to do whatever you decided to do. Take your time. In the mean time, ask for a second biopsy opinion, which insurance usually covers and read up on the different choices and maybe talk to some folks who have had each of the treatments. The one thing we do know for certain about cancer...give it enough time and it will grow. 56 is still considered rather young for PCa so eventually, plan on a primary treatment mode.

My DH will be the first to admit that had Proton been a choice, he would have chosen that route. He chose a robotic assisted lap instead. All is well by the way. Good Luck to you. Keep in touch.

Swim
Posted 6/18/2007 7:47 PM (GMT 0)
Hi KMC,
Watchful waiting is sometimes a good option. My opinion about it is, If I have a bad heart, multiple ailments and I'm 80, then I might choose to wait. You sound healthy, you are young still by terms of this disease, and need more information. The folks here have a wealth of knowledge. And very few, if any at all, stayed with a watchful waiting approach. Prostate Cancer is one of the more curable cancers when caught early and treated. Watchful waiting is not treatment at all. Good luck in your research, but you should consider all options now as opposed to waiting for symptoms to arise.

Tony
Posted 6/18/2007 8:09 PM (GMT 0)
KMC,

Swim always gives good advice on the forum and she is right on with her reply to your post. For additional information on watchful waiting go to www.yananow.net and go to Mentor Experiences. There is a topic under this listing for stories of men that are following a watchful waiting approach. I was 56 when diagnosed and considered briefly the watchful waiting but I just could not handle mentally knowing that I had cancer in me and not doing something about it. But you are right on about taking control yourself and researching all options before choosing a path to follow. Stay with us through your journey as we all learn together.

Tamu
Posted 6/18/2007 8:17 PM (GMT 0)
I'm really grateful for this range of advice. My urologist, a surgeon who practices the Da Vinci, recommends surgery but agreed to wait until December. I'm having hipi resurfacing surgery this summer. I'm sure my dilemma , though new to me, is old to you. The surgery seems so drastic and irrevocable. But not as much as death, of course. What is the Proton that Sim referred to? Thanks again.
Posted 6/18/2007 9:31 PM (GMT 0)

KMC:

I must agree with all of the above - your stats look like you have caught it early (would be good to have your PSA), but at 56 you will probably have to deal with the Pca in your lifetime.  Meanwhile, it isn't just sitting there doing nothing - it may be slow growing, but it is growing. 

Proton therapy is a noninvasive treatment using proton beams - it differs from regular radiation (IMRT, IGRT, etc) which uses XRay.  Proton has no exit energy, the bulk of the beam being deposited at the tumor site, so the damage to healthy cells is minimal.  There are several threads on proton on Bluebird's "Helpful Hints" thread.  Also, can get info at www.protonbob.com.

This forum is a wealth of info and help, so continue to research and good luck to you.  Keep us updated.

Dutch


Posted 6/18/2007 10:08 PM (GMT 0)
Hello KMC51,

All have given sage advice, and the only thing I have left to add is that doctors will promote the treatment method that is their specialty, and of coarse so would I because it would be the one that I believed was the best. The fact is all the main stream theropies yeild excellent results; the various radiation treatments, and all of the surgical techniques show cure rates as high as 95% depending on the severity of the PCa. It sounds like you have been diagnosed very early so all choices are open. What will matter most then is which doctor will perform you procedure.

My feeling is that the longer you wait the greater the risk is that you will lose those options. Good luck on you search, and we'll be here for you.

Glen
Posted 6/18/2007 10:28 PM (GMT 0)
Hi   ~ KMC 51 &   Loved Ones,   A    “Special”   Warm Welcome   to   You!         We know ~ we can “all” make “Your Journey” smoother just by being here for you!   This is truly a great forum!!! ~ You have joined!  You are now part our forum family ~ a group of wonderful individuals who are so willing to share...   It helps “all of us” ~ to help you ~ if we know where you are on your path. So ~ Please stay with us and take our hand when you need it!   Keep posting.... OKAY!!     KNOWLEDGE     IS     POWER   ...   and   POWER conquers   fear   YOU MAKE THE DECISIONS… YOU HAVE OPTIONS… ~ and ~ Your decision will be the right decision for you!!!   Keeping you close in thoughts and prayers as you move forward in your search for answers…   In Friendship ~ Lee & Buddy   “God Bless You” It's a little prayer   ~   "God Bless You" ...but it means so much each day, It means may angels guard you and guide you on your   way.   (Direct Links ~ just clicks on the title below and a new window will open!   Reminder … click on the REFRESH icon once you get there) Helpful Hints ~ & ~ Direct Links to Important Topic Threads ~ Hope this helps you!! :)
Posted 6/18/2007 10:29 PM (GMT 0)
Hi kmc51. Sorry you have to be here, but you are in a good place with caring people. Find out all you can about your treatment options. Go to a cancer center that has a multidiciplinary approach to treating your cancer. Make an informed decision and don't look back. We are all here to support you.

Mika mvesr
Posted 6/18/2007 11:40 PM (GMT 0)
Hi KMC,   Isn’t this place awesome!!!       You’ve hit on the right forum to help you have a smoother journey…   Buddy & I invite you to visit our personal thread "Our Journey ~ Sharing is Caring".   Continue reading and learning….   You will be amazed at how many options there are.   If you find your mind reeling from all the “info” coming in… Stop ~ Take a deep breath …. And continue on.   It is your decision and we can share our experiences.   You can pull from many different journeys ~ which will make your Journey Yours!!… then it is ultimately “your decision”…   We hope the Helpful Hints page will help you!! (direct link above in Welcome Letter) Keeping you close as you continue to move forward in search of your answers. Always remember…   Knowledge is Power and Power takes away the fear!!! In New Friendship ~ Lee & Buddy «   bluebird ~   Moderator for Prostate Cancer Forum  
Posted 6/18/2007 11:45 PM (GMT 0)
KMC51,

A 2nd biopsy reading  is a good suggestion: biopsy readings are subjective, and you will be basing your decisions on them.

Regarding your questions about any men opting for watchful waiting  or whether it's completely unreasonable to consider it, active surveillance is often suggested depending on the situation.

Johns Hopkins have undertaken extensive research into active surveillance, and Dr Epstein has developed criteria to predict which men should consider the option. Some of his material is included in the Johns Hopkins winter 2003 newsletter. WWW.urology.jhu.edu/newsletter

Other information on the subject is available at www.prostate-cancer.org in their nov 06 newsletter, and www.prostatecancerwatchfulwaiting.co.za

John

Posted 6/19/2007 1:59 PM (GMT 0)
KMC51

A 2nd opinion would be a good choice, my first doctor recomended surgery as did my 2nd opinion. My second doctor and the one I ulitmatly chose to do the surgery said I could wait but it appeared I had caught it early and I was of a young age to recover fully. He told me the one thing that would not change is the fact I have cancer and at some point I would need to deal with it. In my case and this is only what happened to me and is different for everyone and your decision to make is after surgery and the Pathogly report came back my PCa was more advanced then the biopsy indicated and in fact I had some of the most agressive cells possible. Again in my case had I waited a year or so he told me it most likely would have spread outside my prostate and would have made for a much more dificult situation to treat. I am 6 months out from surgery and feel more and more lkie my old self everyday and the time goes by quickly and to date my first post surgery PSA was 0 so far so good and my next one is in July. I share my story only as information and not a recomedation and it truly will be for you to decide what action to take. You can see all of my stats in my signature and I wish you the best in what ever path you decide to take. I gathered a lot of great information and support from these fine folks as my journey progressed, this is a great forum.

Norskie
Posted 6/19/2007 2:48 PM (GMT 0)
Hi KMC 51

I am not personally in favor of "watchful waiting" especially at your young age. There is no test today that will tell you with certainly the stage of your cancer. This forum has demonstrated that point (i.e., some PCa patients who elected surgery and were found to have a more advanced stage of cancer based on their pathology after the prostate was removed). Another important factor to consider is the history of your PSA readings if you have such a history for a few years (i.e., the velocity or how fast has your PSA been rising). The faster it has been rising the more concerned you should be about undertaking some form of treatment.

Because I was foolish, I ended up in a "watchful waiting" category for close to four years before I was treated. I ignored my primary care physician's advice to have a prostate biopsy when my PSA jumped from below 4 to over 5 (it was 7.1 when diagnosed with PCa about 3.5 years late). Because I was still in an earlier stage of PCa when I was finally diagnosed (but certainly not the earliest), I can only conclude that I was lucky and that my cancer was not growing rapidy. I won't know for a long time whether my so called unintended "watchful waiting" may have cost me dearly if my proton treatment has not eradicated my cancer. The bottom line is that we really don't know with certainty how much cancer we have and how fast it is growing once we have been diagnosed with PCa. In conclusion, I am not a fan of watchful waiting, especially for younger men who should have a long life ahead of them. I started my treatment about 5 months after I was diagnosed. A waiting period of up to 6 months is generally considered to be acceptable unless you appear to be in a more advanced stage of cancer.

Dave
Posted 6/19/2007 4:56 PM (GMT 0)
Hi KMC 51

Everyone is "wired differently" and therefore different people will make different decisions given the exact same data.

For me, I am very analytical and looked at the probabilities. I estimated there was probaly about a 10% chance that watchful waiting would be the wrong decision. I "got it out" and my recovery has been excellent (playing golf in week 5 etc.,). Catching the cancer early definitely was one reason for the quick recovery. (quality of surgeon and physical condition were also very important)

Another person could say a 90% probability watchful waiting is the right decision. For me this was not an acceptable bet on my life but as I said, we are all wired differently.

Get as much data as you can and then make your decision. However, do not wait too long to make your decision (watchful decision is a decision) since the cancer is still there and growing.

Ed

Posted 6/19/2007 5:26 PM (GMT 0)
tongue  Hi KM

Getting RP surgery on Thursday.  Your numbers are very good, which indicates it is in the early stahes.  As most have posted on this subject, NOTHING really is accomplished by waiting for more than a few months.  Robotic surgery is a EXCELLENT choice, because it; 1. removes the cancer (hopefully).  2.  If there is  still cancer left behind IMRT is doable.

I went out to the Cancer Treatment Centers of America for a second opinion (HDR).  All the Doctors there are into the radiation cure, but I did speak with one who said surgery was a good choice for me, and brought out the fact that after surgery ther is radiation if necessary.

All the best, don't wait too long!

Posted 6/19/2007 7:30 PM (GMT 0)
Hi ~ Dave,   Your posting….was in reference to the posting above which has been deleted for Forum Rule #4 Spam violation…     I would like to delete this posting completely but will not do so   until you see this message. Don't hesitate to contact me...  J Lee Post Edited By Moderator (bluebird) : 6/25/2007 7:05:59 PM (GMT-6)
Posted 6/20/2007 5:24 PM (GMT 0)
This site is a wealth of information. Thank you all. I've been following up links. I've had just two PSA readings in my life. The first, around January, was 10. The second, around March, was 6.4. I now have the biopsy report. There were 14 sticks., apparently in six separate areas (left apex, left mid, left lateral, right apex, right mid, right lateral). Three of these reas showed nothing. Here are the other three: B combined Gleason score of 6 (3 + 3). Tumor involves less than 5 % of tissue. Maximum dimension less than 0.1 cm. C same Gleason. tumor involves approximately 10 % of tissue. maximum aggregate dimension 0.4 cm. E. same data as B.
Posted 6/20/2007 6:04 PM (GMT 0)

KMC:

With your stats I don't think "watchful waiting" would be my choice, but think you have probably found it in an earlier stage, so any of the treatment modalities should provide you success.  YOU just have to decide the side effects you are willing to accept. 

Good luck in your journey for YOUR treatment choice.

Dutch

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