need answers

my husband was diagnosed with pc about a month ago. the left side was unnoticeable and the right side was a gleason 7. the perenial was listed not identified. the dr did a DRE and said he could feel cancer in the nerves so they would have to be removed. can a doctor actually feel that. we are gonna see if the left side can be spared. his psa was 37. he is scheduled for robotic surgery but still thinking about radiation. he is taking this very hard. has been depressed all month saying they will be taking away his being a man. any advise i can share with him

hearbeat,

I am also the wife of a PCa husband so know what he and you are feeling. It is overwhelming at times, but know we are all here for your support.
Ask any questions you have and others will chime in I'm certain.
If you haven't got second opinions do so before you make any decisions.
Try and stay positive and let your husband know there are many options coming down the pipeline. We have all been there where he is and know he will face many feelings but will eventually get to acceptance, with the love & support of you and his family and all of us.
Can't really answer if a Dr. can feel cancer, as it sounds doubtful, perhaps others will answer that!
Stay positive but let your husband vent.
Keep posting as we will be listening.

BOOGEE

Heartbeat -- Welcome to Healing Well. I’m glad you found our forum. I’ve gotten a lot of information and encouragement from the people here on a patient to patient basis. They are very knowledgeable and caring. I think you’ll definitely find inspiration here reading the stories of others who have gone before you battling PCa. The people on this site are amazing, wise, caring, and compassionate. If you have questions – ask them.

Please don’t rush into a decision. You will both get through this. PCa is a slow growing cancer, so you have time to educate yourself and make informed decisions. An excellent book to start with is “Dr. Patrick Walsh’s Guide to Surviving Prostate Cancer.”

Getting that diagnosis is really tough, we’ve all experienced it so we know what you’re going through. When you hear, “you have Cancer”, it knocks you out. Initially you are in shock and feel despair. But you pull yourself up, and seek information and educate yourself about PCa and start making decisions.

We all shoot for the trifecta: cure the cancer, cure the incontinence, and cure the ED. Usually in that order of priority. Curing the cancer of course is paramount, resolving incontinence comes next, because that’s something you live with every day of your life, and third is fixing the ED.

I’m not sure if a doctor can feel the cancer on the nerves while doing a DRE. Perhaps someone here has heard of this and will chime in. Just so you know, he does not need both nerve bundles to function, but ED is a side effect he will most likely deal with.

I would encourage you to get a second and maybe a third opinion. Consider talking with a radiation oncologist and a medical oncologist. Consider going to a major cancer center; many offer multi-discipline programs where you can schedule appointments with more than one specialist in one day. Travel if you need to.

In doing my research on PCa, what stood out to me as the most important factor in your outcome is the amount of experience and skill of the doctor doing your procedure (whatever procedure you choose). As for surgery, a radical prostatectomy (open or robotic) is a very complex operation, one of the most difficult surgeries in medicine. There are definitive studies that demonstrate better outcomes if your surgeon has done 250+ procedures. In my opinion, you want someone who’s done over 700 of that particular procedure (open or robotic) and you want someone who does at least 3 per week. There are no do-overs. Ask what your surgeon’s numbers are. If he’s won’t say or is evasive – find someone else.

Best of luck to you both and keep us posted.
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I am the wife of a husband with advanced Pca. Prostate cancer is often described as a roller coaster ride, some ups and some downs. After the initial shock wears off, you will learn to deal with his situation and move forward.

"Being a man" isn't just about sex. Having Pca doesn't make anyone less of a man. I can assure you that since my husband was diagnosed with Pca he has become the most "incredible man" I have ever known. You will see that the men here on HW are caring, supportive and loving. That is my definition of "being a man". Sleepless couldn't have said it better.

You will find lots of support and information on HW. If you need to rant, rave and scream, this is the place to be. We are all hear for you. If you need a women's perspective, you can contact me through email.

Good luck to both of you on your new journey.

Zimac

You have come to the right place for sure. I wish I had had such a place 10 years ago when my husband was diagnosed. It was so scarey to hear the cancer word! My husband and I felt our lives were over.
10 years later, we live our new normal and can even forget about PCa at times.
It will get better for you and the key is information of which there is tons here. 10 years ago, things were so different from now. Now there is the promise of so many treatments. You can see from my signature all the treatments my husband has had. The newest one MDV3100 he just started.
Hang onto hope and come here for information, for support, for friendships.
You will hear this chant more than once - we will beat this crap.

Please don't just jump into surgery as you should also investigate radiation therapy. A combination of brachytherapy (either permanent seeds or temporary High Dose Rate) and external beam (IMRT/IGRT) has been shown to be as effective and sometimes more effective than surgery with less damage and side effects.

Check these websites to learn more.  For HDR brachytherapy, www.cetmc.com, the website of the HDR pioneer Dr Jeffrey Demanes the head of Brachytherapy at UCLA; and for permanent seeds, www.prostrcision.com, the website of Dr Frank Critz, the doctor that pioneered the use of concurrent IMRT and brachytherapy.   Also look for very good radiation oncologist that specializes in prostate cancer treatment.   Your urologist will give you referrals to rad-oncs he works with.

My urologist would not take me on as a patient until I sought opinions form another urologist, two radiation oncologists, and a medical oncologist. Also he would not operate on me because he expected the cancer to be out of the prostate and would then require additional radiation treatment. He did not want to subject me to the risks and side effects of both surgery and radiation.

heartbeat,

When I was first diagnosed I went through a period of being in a funk. I eventually pulled out of it just fine. Time may help your husband regain his equilibrium and optimism. As far as ED goes (and I do have it), I do just fine. I have to make certain accommodations and adjustments but I will put the quality and frequency of my sex life up against that of any man without prostate cancer. It just takes some effort and creativity. Best wishes.

Dear Heartbeat,

I can understand completely where you and your husband are right now and my heart goes out to you both as this is an awful time. We can all remember too well that head-spinning period in our lives, but it will get easier.

Take time to breathe and be there for each other but most importantly, educate yourselves. Do not be rushed into making a treatment choice without considering all of your options as there are no do-overs. Get advice on all the treatment options available to you, question that advice fully and only then make your decision.

As mentioned above, please do look into a combo of brachytherapy and external beam (IMRT/IGRT).

Also, from a wife, some advice for you too if I may. Do not forget to look after yourself. I know I hit the wall around 3 months after Jeff’s treatment – I think I had been running on adrenalin rush and full battle mode up to that point. Make sure you have someone close to you other than your husband who you can talk/cry with.

Sending you a hug from the UK and wishing you both all the best.

Susan
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Heartbeat,

With a psa of 37 and a G7 neither surgery or radiation has a high probability of a cure. The high psa is indicative of the cancer being elsewhere outside the prostate. Sorry to be the bearer of bad news, but it would be worse to undergo a treatment that would not be successful.

My best advice is to find a prostate oncologist (There is a list by location in the appendix of "Invasion of the Prostate Snatchers" by Dr Mark Scholz. I would also get a PAP blood test as this is the best indicator that cancer has progressed beyond the prostate and you may also choose to get a Chlorine 11 PET scan which would be much more accurrate than a CT scan which your doctor will recommend. In any event he needs additional testing and staging by an expert before any treatment decision.

A G7 tumor would never alone generate a psa of 37 unless it was a transition zone tumor, which should have been indicated on his biopsy report. The source of the excess psa must be identified before any treatment is recommended or you are just rolling the dice.

Good luck and there is still a lot of hope if you take the right steps now in identifying the true biology of his cancer.

JohnT