Newly diagnosed PC

I am writing regarding my father. He is 70, in good health until now. His history is this. At his yearly check-up last April, they checked his PSA and it had raised from 2.3 to 4.3. His Dr. had him come back for a recheck in 6 months, and it had jumped to a 9.8. He was sent to a urologist who performed the biopsy. He took 12 core samples. 3 were positive. Two were 3+3=6 and one was a 3+4=7 on the Gleason scale. One of the samples says that focal perineural invasion is present. The Dr. is recommending radiation- either laser or seed for him. He went for a bone scan today to see if the cancer has spread outside the prostate. My question is, does this sound like an appropriate plan or are there other treatments not being offered to us that we are not aware of. He is supposed to see the radiation oncologist next week. Also, could anyone comment on what the initial prognosis sounds like. The Urologist says all should be well, but keeps qualifying it with IF the bone scan is good, or if the cells are not outside the capsule. I just want to make sure this is the right course of treatment for him. He is just a little difficult to deal with- He just does not like doctors or hospitals, etc... Its a challenge just to get him to the office for a physical and bloodwork every year. Any advice would be greatly appreciated. Thanks!

Thanks for the post. the Dr. seemed to think he was not a good candidate for surgery because of his age and his comorbidities (which is only elevated cholesterol). What treatment did you choose and was it successful so far? Thanks 

Lung cancer is another primary. Surgery took care of the prostate cancer so far. Zero PSAs for two years anyway.

Get lots of information from you doc and here and there are lots of books that are valuable. See the link at the top of the forum. You will have reading for a month.

Good luck...

Jim

Tojo -

Sounds like your doctor is giving you about the same info that we all got. There are multiple, very successful paths to healing with this disease. I have friends of various ages who have had open & robotic surgery, beam radiation, seed radiation (and sometimes both), hormone therapy, etc.

You will go through a series of decisions. If the bone scan is clear - you go down one path. If it is not clear - you go down another path. The patient's health & history are big issues, etc. These things will help lead you to a treatment decision. As mentioned above, educate yourself as much as possible. Do NOT hesitate to see other doctors. Ask for a consultation and hear what they have to say.

Be sure to check out proton radiation. That seems to be an up & coming treatment that is a good answer for some people - but it is only available in limited areas.

Good luck,
kcragman

Hello Tojo,

 

This site is an excellent resource for those diagnosed with PCa, their spouses and families, but please be aware that most postings are from men who have chosen surgery, radiation therapy or brachytherapy. This is probably due to urologists recommending surgery while oncologists suggest radiation/brachytherapy. It happened to me!! There are other choices, but you may need to be insistent with your health care provider.

 

For an alternative view on treatments please read the book "Surviving Prostate Cancer Without Surgery" by Bradley Hennenfent MD, and the publications at . . .

http://www.compassionateoncology.org/index.html

 

For alternative therapies, you might like to read the information and ebooks at . . .

http://cacare.com/

 

After educating yourself as much as possible about PCa then you will be in a better decision to make an informed choice together with your father, taking into account your father's age and clinical diagnosis.

 

Wishing you all the best, whichever road you travel. You might also be interested in the personal experiences at . . .

http://www.yananow.net/Experiences.html

 

taiping

 

 

 

 

 

 

 

 

 

Hello Tojo,

 

I chose Intermittent Triple Androgen Blockade Therapy which, in 1-year, brought my PSA down from 19.6 to 0.02. Then I stopped taking the medications except the AVODART (later PROSCAR) as "maintenance". After another 3-months my PSA is currently 0.01.

TAB is NOT considered a cure for PCa and my PSA is likely to rise in the future. The aim is to manage PCa like it's possible to manage, not cure, diabetes or high blood pressure. I hope to be one of the 92.5% of men with prostate cancer who die of something else. Unfortunately, death and taxes are unavoidable !!

If and when my PSA starts going up again to a significant level, or PSA doubling time seems high, I may decide either to try another course of Intermittent TAB although I'm more inclined to try a more holostic approach with a herbal treatment.

I am not convinced the conventional treatments of surgery or radiation offer any long term survival benefits, as suggested by several studies. For example, see . . .

http://www.annals.org/cgi/content/full/0000605-200803180-00209v1

 

All treatments have negative side effects and quality of life issues. For TAB some of these are (a) lack of libido and ED, (b) enlarged breasts, (c) hot flashes, (d) tiredness and emotional issues, (e) loss of bone density (and others). TAB is not a cake walk and takes some determination to complete the course of treatment. It is said that all negative effects are reversible, using medication if required. I still have libido and ED issues, but personally at age 62 I'm not very bothered about that. I'm more interested in survival.

In addition, TAB (as descibed on the Compasionate Oncology web site) is definitely NOT a mainstream treatment. My primary physician is Dr Steven Tucker in Singapore, who did a study about TAB with Dr Bob Leibowitz, see . . .

http://www.asco.org/ASCO/Abstracts+%26+Virtual+Meeting/Abstracts?&vmview=abst_detail_view&confid=37&abstractid=20271

 

Again, TAB may not be for everyone, but the reason for this post is to let people know their are other treatment possibilities which may not be suggested by their doctors. That's why it's necessary to read up everything you can find about PCa and come to an informed decision.

Hope this helps . . .

taiping 

 

 

 

Yes it is scary when a loved one is diagnosed with cancer. However it is by no means a death sentence. With a very low PSA of 1 (in July?) and now a Gleason of 6 (the lowest that gives a positive for cancer), your doc is right. It is low risk, and it's much more likely that your hubby will die of something other than PCa.

The tests are standard, and there will be many possible treatments, including a "do nothing" option. In the meantime you can study the other options, most likely some form of radiation with perhaps hormone therapy (which is what I think the Casodex is). Surgery is perhaps less of an option at age 71. but if your hubby is otherwise fit and healthy, it would be still possible.

So yes, it is a shock but at the same time, there is plenty to be optimistic about.

Thank you both so much! I didn't realize that a Gleason 6 was the lowest that gives a positive for cancer. I have read everything I can get my hands on and I thought that Gleason 2 was the lowest! I guess we will find out more tomorrow. My prayer is that it has not spread to any other site. When the urologist sent a copy of the prostate ultrasound photo he highlited a couple of small dark spots which I am assuming is the malignancies. Thank you, thank you!
Nan

Hi Nan,
This is a great site for advice and opinions of treatment options. It is the only one a lot of us go to. Research...research...research. Do not jump to a treatment without learning all you can about the different treatments. There are several different ones and you and your husbands choice is strictly yours. Get a second opinion if you'd like. Any Dr. worth his salt won't mind at all.
Find a local support group, besides this one. There is one in my area that I didn't know about untiln yesterday.They won't offer you medical advice, but they will show you the paths to take when seeking that advice. I'm 57 and my doctor says I'm one of the young guys. At 70, things don't progress quite as quickly as in younger folks, so you have time to really stop and think about it. I was diagnosed Oct.27th (day after my birthday...Happy birthday,Bob) and have opted to have DaVinci surgery in January. My Gleason is 7, (4+3), Psa 14.5. Biopsy: 4 positive, on the left side, pre-cancerous on the right. Bone scan and CT scan negative. No invasion of the lymph nodes or seminal vesicles.

Keep in touch and read all you can about this bad hand you've been dealt. But...Get some sleep.

Good luck.
Bob

We got excellent news today! It is our 40th wedding anniversary and what a great day it has been! Bone scan, blood work and chest x-ray were all fine! WHEW! We spent 90 minutes discussing the various options with my husband's doctor and have opted for surgery in January! My husband's cancer is on only one side of his prostate and is in 3% of the gland. His Gleason 6 (3+3) and he has been on hormone therapy since diagnosis. His doctor told him surgery was considered a "cure" and radiation was considered a "control". I feel a great sense of relief that he has decided on surgery. His doc said he is a "young" 71 and should have no problems. Thank you everyone for your information and your support..it means a great deal to me!
Thanks again..off to a good night's sleep!
Nan

Dear Nan:

Not to interfere with your sound sleep and I know everyone is different in their decision making processes but...from the way I understand your posts and your timeline, your husband is only a week post-diagnosis and has talked with only one doctor and you have made a decision?

For me, I found it appropriate to take the time to do a lot of research - hard copy and web - and consult with multiple doctors in different disciplines before making a decision.  With early stage PCa you usually have time and options.  I'm not suggesting that your decision is incorrect and, if this works for you guys, God bless.  But I needed to ask multiple questions of multiple people before I could sleep well about such a huge decision.

Hello All..I appreciate so much everyone's input! We have been researching everything we can find on all procedures at reputable sites, Mayo's, John Hopkins, etc. My husband also has several friends who have undergone various treatments and so he has their input. He simply isn't comfortable with leaving the cancerous prostate in place. He wants it out and wants to get on with life. He is very active and wants to keep up on his daily routine without interruptions for EBRT, etc. Our urologist told us that once you have radiation that if you would choose to have your prostate removed at a later date, recurrance, etc that it is very, very difficult to have done. Also there is some bowel problems associated with brachytherapy or so we were told. So, those were considerations for him as well. I think that I would choose surgery, if I were in his shoes. I would want it out and gone! But, I think that is up to everyone's judgement along with their doctor's. I think my hubby is very confortable with his decision as he seems anxious to get the surgery behind him (14 Jan 2009) and continue onward! So here are my best wishes for a wonderful Turkey Day! Don't eat too much and will talk again soon!
Thanks again!
Nan

Hello Nan:

I will just share one more thought and then shut up.  I am not trying to talk you out of surgery or trying to get you to second guess yourself.  I was encouraged to talk with more than one doctor and that gave me more peace of mind as different disciplines have far different perspectives on this disease.  If you're satisfied with your choice of doctor and treatment that's great and I wish you both the best.  And, given surgery is your choice, I hope you discussed open vs. robotic and asked the very important question re the number of procedures your doc has performed...check out another thread called "Experiece Counts" to see the latest studies on that point.