Husband just Dx with prostate cancer today

Welcome, Finnman to our forum.  I am sure you will receive good answers to your questions.  My husband's stats are similar to yours.  We went with the DaVinci Robotic Surgery and for us it was the best move.  Good luck in your researching - I wish you both the best!

Much blessings,

Aimzee

Finnman, sounds like you have a lot going on right now, and may be on information overload.

I'll try to answer some of your questions but please remember that I am not medically trained so my opinions should be viewed as just that.

Gleason 6 is generally considered low-risk so, yes, you have some time to further research treatment options. Not sure what your doctor meant by "moderate" unless he was referring to the how much cancer was found in each sample taken. For example: if the biopsy took 10 or 12 samples, and 5 or 6 of them came back with a "heavy" burden of cancer (say, 40% or more), then this may define moderate. Usually you hear "low risk", "intermediate risk" and "high risk" when prostate cancer is diagnosed. A Gleason 6 is considered low risk; Gleason 7 is intermediate, and Gleason 8 - 10 is high risk.

As to treatment options, when the doctor meets with you and your husband, they will review the options. For the majority of Gleason 6 cases, surgery and radiation are both treatment options. Of course, there's always active surveillance (no treatment, just constant monitoring and possible additional biopsies). I am not familiar with any of the radiation treatments as my husband had the robotic surgery 4.5 years ago...he was a Gleason 7 with a PSA of 6.4 and 2 out of 10 samples positive.

As to insurance, it all depends on who your insurance provider is and what type of policy you have. I would suggest that you contact the insurance company and find out exactly what they would cover. Decent medical insurance should cover both surgery and radiation but call and ask so that you have some peace of mind.

Hope this has been of some help to you. We have some very knowledgeable members who and hopefully one or two of them will stop by to address some of your questions. You're on the right track in that you are researching what you can. But, be careful researching on the Internet: I did alot of that and drove myself crazy in the early days of my husband's diagnosis. Once you meet with the doctor, you should have more information...ask for a copy of the biopsy report and have the doctor explain the findings. This will help to not only ease your worries but will also help in the treatment decision-making process.

I'm sorry to hear about your husband's cancer diagnosis.  It's a terrible feeling when someone tells you that you have cancer.  For me, it was like a physical blow. 

However, I'm glad you've found this site.  I didn't stumble upon it until after my surgery, and I've often wished I had found it sooner.

Gleason 6 has a significantly better prognosis than higher Gleason scores, and it's likely that every treatment option will be available to you, possibly including Active Surveillance and deferred treatment.

In regard to insurance, I hope you have more  luck than I had when I called Blue Cross/Blue Shield.  The first person I talked to seemed completely unfamiliar with prostate cancer surgery.  He actually asked me if it would be outpatient surgery!  And then he went on to explain what the costs would be for us, calculating it as if it would, in fact, be oupatient surgery.

We had to call back and find a more knowledgeable person to get the true picture.  In case you're wondering, the total amount "billed" was on the order of 90K when all was said and done, but that was negotiated down to an amount about half that, and we ourselves paid a bit over three thousand dollars out of pocket.

Good luck to you.  Keep your spirits up.  Stay in touch here on the forum.  Find the very best doctors available to you, and decide carefully.  All treatments are effective, but you'll eventally find the one that is best suited to your particular situation.

Finnman,

Welcome to our part of the world - the one no one "wants" to be a part of. Most who arrive here are as you, too much information, not enough information, too many sessions with Google on the internet ...

Until you review a copy of the biopsy report, it is too early to be considering specific treatments. Ask for a copy at the next appointment, and ask for copies of all lab & doctors reports from here forward. If you have or can get one, take a small recorder with you. Ask if the doctor minds before turning it on (most don't seem to). You will find that what was said, what you heard, and what you remember later are very different. Having that recording to go back to is often very important as you try to remember exactly what treatments were discussed.

We have had many threads on Proton vs. Photon radiation. Because of the changes and time both have been around in their current versions, you won't find any long-term statistics. Here, we seem to find that the outcomes are very similar. The discussions generally surround side effects, which the Proton camp will have you believe are less. I was trying to get it approved for myself early on. In the final evaluation, it seems to come to cost. My insurance considered the two to be medically equivalent, so would not pay the significant additional cost.

Take your time, read a lot, get a 2nd,3rd,4th and 5th opinion. You will need to pay your deductible and out of pocket if you have insurance. At 64 years old and a gleason 6 wait for medicare if no insurance. Watch out for your insurance fiscal year or you may end up paying two deductibles and out of pockets. Really consider watchful waiting if low percentage of cancer. Sorry about being so brief because I'm working off my droid and I hate texting.

Hi, and welcome Finnman.

As others have pointed out already, everything you have indicated so far points to a low-risk case...which also happens to be the most commonly diagnosed type of case.  One of the things you should be aware of is that prostate cancer (PC) is really two, or maybe three, very different diseases.  There is a smaller percentage of cases, on the opposite extreme from you, which are indeed lethal.  Some PC experts have suggeted that it might be beneficial to stop calling low risk PC a "cancer" because simply the use of that word often triggers patients into an unwarranted desire for aggressive action.  [There have been other similar name-changes of diseases for exactly the same reasons...but the discussion on potentially changing the name of low-risk PC is still on-going.] 

Perhaps you've heard or read about some of the recent controversy about PSA testing and PC overtreatment...?  It's been hard to miss in the news media.  A number of medical studies have recently addressed the "harms and benefits" of treating (or "overtreating") low-risk PC cases.  I would suggest that now is a time for you to educate yourself about PC...low risk cases certainly do not need to rush into any treatment, so I encourage you to take time.

Here's a good starting point:  LINK.  This is an article & video from Dr Gerald Chodak (posted online just a few days ago) who is an internationally recognized PC expert.  In the article, he talks about some of the study results, and he stresses, "It is absolutely critical that we make sure that every man diagnosed with prostate cancer is aware of these results."  He's talking about you (your husband), and newly diagnosed men like you, and the need for you to educate yourself about PC before seeking any treatment.

best wishes...

Ah, thank you, James C, for pointing that out.  I had previously gone through the step to register because there is so much good information—Dr Chodak's featured articles/videos, in specific—on the Medscape site, and so I had forgotten that this initial step was required. 

Registration is free, and I can confirm that they don't send registrants emails...

You need to visit www.yananow.net    (you are not alone now=yananow) great info, a forum, and 1000+ patient journalized histories to read by categories of treatment types....just the kind of perspectives you need to see PCa from plenty of angles.  It has been around for over 10 years, run by PCa fighters and not biased or taking money from drug companies and such.  Terry H. is our main man for 'building that'....it is excellent.

Welcome, but sorry you have to be here. Take your time and find the best doctors you can. Start a journal and keep all you notes, lab tests and results in it. It gets confusing with all the information you will receive. Be sure to get copies of all tests, scans, etc. Look into all your available options including AS.

You can read what I went through by clicking on the link in my signature.

I'm going to come down on the other side of the Walsh book as I always do. Of course your uro gave it to you. He is a surgeon...Walsh is a surgeon. Walsh's book has a lot of info, but the final word from him (and I've communicated with him one on one) is that while there are many ways to treat PC, only one is the correct way.
Do yourself a favor..if you read Walsh's book, read one by Bradley Hennenfent called Surviving Prostate Cancer Without Surgery.
From all you've posted, you have some very good options...and many of them do NOT include surgery.