Playing the waiting game . . .

The results of my biopsy came back last week as follows:

Two of 12 cores positive, 40% cancer, PSA 5.2, T2b/T2c. I am 56 years of age and had a 5.1 PSA a year ago that was determined to be "a mistake" when the second PSA two weeks later came back at 2.3. This year's PSA and a repeat two weeks later were both 5.2. My Gleason scores are 3+3 and 3+4. My urologist has suggested the radioactive seed therapy, as according to him "the tumor is located at the front of the prostate and there is a greater possibility that cancerous cells will be left behind if the prostate is removed." I have made an appointment for a "second opinion" at UTMD Anderson Cancer Center in Houston, but will not be able to be seen until July 27 (three weeks at the time of this posting). Of course my mind is going a thousand miles per hour with thoughts like, "should I wait for three weeks?" and "should I go ahead with the treatment my urologist has suggested?"

Any input from you veterans out there will be appreciated!

No problem in waiting. I waited 7 months before treatment with much worse stats than yours. I think your doctor is giving you good advice. Most doctors and patients don't even consider tumor location when deciding a treatment, and it is one of the most important stats in determining a positive surgical margin and futher radiation treatments. Brachytherapy is a one hour procedure with much less side affects than surgery. There are many long term studies indicating that cure rates for all grades of PC are equal or better than surgery. If you are going to get seeded then find a doctor that has done at least 500 procedures.
JohnT

Jack,

While the ultimate concern here is metastases, and while the intuitive reaction is to act as quickly as possible to prevent metastases, the consensus across a broad band of MD's, not just us amateurs, is that you have time to think and to decide.

BTW, for discussion with docs etc., your PSA's are largely irrelevant, as is your Gleason 6 score. Your key number is your Gleason 7, which designates you as having a somewhat serious/aggressive form of the cancer. The Gleason 7, for example, largely takes Active Surveillance off the table

While as my signature informs I chose a different approach, and one that I am so far very happy with, seeds are clearly one of the premier remedies in terms both of efficacy and side effects in the current state of knowledge.

Don't take forever, and don't not do anything, but you do have the time to talk through issues with the specialists in Houston. Use the time to read up on options and impacts so you understand what you are being told, and so you can ask intelligent questions.

Good luck

While you're at MD Anderson, you might also want to check out the Cyberknife procedure which is administered there for prostate cancer. It's another option that might be appropriate for your pathology.

Good Luck.

Hi Jack, welcome and sorry you are here, both at the same time.

First, you've got cancer, and it's okay to panic.

Second, don't panic. You've got lots of time to be cured of this disease --- and isn't cure the "C" word us cancer folk like to hear!

The above isn't as contradictory as it may seem on first read. When you first get the news the first panic, at least for me, was, am I going to die? Will I make it to Christmas? My birthday? To see my grandchild graduate from high school? This panic was soon replaced by the panic of being faced with a treatment decision, one of the most important decisions I'd ever make in my life, and one I was ill equipped to make. It would be unreasonable not to feel high anxiety and some panic. It's normal. It's okay. But ....

Chill out. Take a deep breath. Don't panic. You've got lots of time to learn, and lots of time to be cured of PCa.

There are two issues with PCa treatments. One is, how effective is it likely to be for you at your age, and with your stats? The second is, how likely is damage, incontinence and ED being the two big ones, and do you feel about that? Then, you may have some trade offs.

I was 67 when I was diagnosed. My mother is nearing 97 and yesterday she went to her cottage. I hope to have her genes, and to roll through 100. It was easy for me to decide what I wanted was a 40 year cure ---- give my heart a fighting chance to take me. And, I was willing to cope with whatever trade offs there might be in the incontinence and ED departments.

There is no right treatment except the one you decide on. Only you can say if you're happy to go with the opinion of one doctor and roll, or if you want to dig in deeper and get more opinons, more options, and decide only after informed understanding and consideration of the alternatives.

What is pretty much for sure is that you really can take a deep breath and chill out some. You don't want to ignore a Gleason 7 (that's what I've got --- or had) but there's no need to put your executor on speed dial either. In a few months you'll have made a treatment decision, a few months after that you'll be treated, and your real health risks will be the things going on under your skin you don't know about ---- not the one that's being monitored.

Keep on posting, Jack. This is a great place to ask questions and learn.

Sheldon AKA Sleepless