Newly diagnosed at 42. Help!!

Welcome to our corner of the world. Sorry you need to be here but it's a good place to be.

First, take a deep breath. This whole thing is very scary and there are lots of unknowns but from you report, I'd say you're doing fine. At your PSA level I doubt that scan would find anything that may have escaped (any PC that may have would be microscopic in size and all but impossible to see on a scan). It's fairly normal to skip the scans before surgery. If your PSA and Gleason were higher they would.

When they get your prostate out they'll be able to do a better pathology report and will see what the margins look like. At G6 likely they won't find anything. PSA is a reasonably good indicator of how far things have spread (not great but not horrible) and at 5.1 I'd be surprised to hear you have anything outside the prostate - it's possible but the odds are in your favor at the moment.

The best thing is to see where the PSA is a couple of months after surgery. If you've gone to zero then the surgery got all the nasty PC cells and you'll be fine.

On this side of surgery and with your numbers CT, MRI, bone scans are likely not to show anything but if you really want I am sure the doctors who own the machines would love to get your money.

Keep us updated on your progress and let us know if you have other questions.
All the best,
Andrew

Thanks guys! Very helpful!!. I feel more comfortable now with not getting the MRI's and CT scans done.

No nodule felt and I have been staged at T1C.

I was 40 when i had my procedure. I'm 42 now and 100% fine. You'll also be fine.

Your numbers look good.

Just make sure your surgeon is experienced if you in fact decide to go with surgery.

I didn't have c-scans or MRI's. With your numbers there is no need for them typically.

This is a shock and a process, but you'll be fine.

With your numbers, you are in a low risk category. PCa is a slow growing cancer. IMPO, I would not rush out for surgery within weeks of being diagnosed. I would read relevant books first, one that comes to mind, "invasion of the prostate snatchers". and educate yourself with this and other forums first, taking your time to make a decision.

I'm coming up to 2 months after being diagnosed, with much worse numbers, and I am deciding on a treatment, I am intermediate risk so I no longer have the AS option.

My urologist recommended surgery as the first and best option. I don't agree, my situation poses too high a risk that surgery would still require salvage radiation. Surgery may not be you best option either, as the odds of side effects can be permanent.

Fauntleroy said...
With your numbers, you are in a low risk category. PCa is a slow growing cancer. IMPO, I would not rush out for surgery within weeks of being diagnosed. I would read relevant books first, one that comes to mind, "invasion of the prostate snatchers". and educate yourself with this and other forums first, taking your time to make a decision.

I'm coming up to 2 months after being diagnosed, with much worse numbers, and I am deciding on a treatment, I am intermediate risk so I no longer have the AS option.

My urologist recommended surgery as the first and best option. I don't agree, my situation poses too high a risk that surgery would still require salvage radiation. Surgery may not be you best option either, as the odds of side effects can be permanent.

Us young guys tend to do great with side effects when in the hands of an experienced expert. I have no side effects at all besides dry orgasms. Furthermore, there are potential side effects with any treatement.

The book you recommend is not a great book imo and in that of many other people.

I like John T's advice. It empowers you to dig deep and make sure you make the right choice regardless of that choice without planting seed of doubt which is the last thing any of us need at that stage of our journey.

Once you make your decision don't look back. The truth is that on paper, with your numbers, you're probably a viable candidate for 3-4 approaches.

Bottom line, with your numbers you're very likely to do great. This is what medical experts have told me and what I've seen countless times over on forums like this.

This is what I have been telling my friend in Italy (52) who was in your same shoes just a few weeks ago. He's decided on surgery with my surgeon as of now but since he will be in LA on a conference in late January I am trying to convince him to at least visit Scholtz (one of the authors of the book above). Not because I think it's the best choice, but because he owes it to himself to explore all options.

For low numbers like yours, they usually don't do bone scans, except as a reference for future scans should you take a turn for the worse later, they are inaccurate and give false positives and false negatives.

As for that book I recommended, I didn't mean it is "the book," but simply an example of literature you should look into to start your education,, prior to rushing out for any treatment

I was 42 when diagnosed too. My psa was only 3.8 and the Hopkins Uro felt a nodule. We probably started on pretty comparable footing, I guess. He did my biopsy and it came back G6, t2a. If memory serves, I had 6/12 positive cores. In the consultation a week after the biopsy, he told me that I should not wait a year to have some form of treatment. He's a surgeon, but he said seeds would likely do the trick equally as well. His one caveat, was that my age and the amount of radiation should be considered. I agreed and committed to open surgery. It was completed 11/4/2011. G6, encapsulated, no lymph node or seminal vesicle involvement, cancer was located on both sides of prostate.

A little over a year out now... what, 13 months, right?

Within 30 days I was completely dry and in no need of pads. The Dr. wanted me taking ED meds a month after my surgery and trying to have sex 3 times/ week. I tried and was able to have sex. It was difficult and I hated the side effects of the ED meds, so I stopped taking them except when wanting to have sex. But I did keep up with the physical therapy part of the ED regimen... manually (sorry if tmi... ). I started to see slow, but regular improvement. And the use of the ED meds when with the wife was largely successful by August... 9 mos. In the last 5 months I've continued the same pattern of therapy. I'm nearly ready to try intercourse without any meds, as I can do pretty well without them manually at this point. The only complication is that the erection is not completely reliable without the meds. With the meds, it's about a 90% certainty. Without, it's better than 60% but it ain't perfect.

I told my Dr. about my regimen and he said that it was fine and that I should continue to see even better improvements over the next year.

My 2 psa's since surgery have been zero's. The Dr. says there is no reason why I shouldn't plan on living another 50 years.

Other than feeling like I had been given a raw deal when I first found out, I feel I made the best decisions I could for myself and family. Ultimately, that's what you'll need to do as well. It sounds like you've made up your mind on surgery. If that's the case, go into it with the knowledge that you've found the right treatment for yourself and the right person to do it. Trust in your decision and learn to read your body in your recovery. Unlike many, I wasn't interested in walking miles toward recovery right away. I treated myself like a veal :) and when I felt I could start pushing a little, I did. I bounced back to feeling like myself within about 90 days, except for the ED and the occasional psychological, "Holy crap, I had/have cancer." feeling. Any questions I had went to my Dr. His experience and calm demeanor was a boon to my recovery.

I wish you calm, los1023. It must seem all uphill right now. It is, but it soon won't be. You'll be beyond your surgery and begging the uro to take out the cathether before you know it. :) And that first pee you take without that god-awful contraption will be one of the best of your life and you will continue your recovery from there.

There are about a dozen 40-somethings that were diagnosed around when I was. I only stop by a few times a month now, but hopefully you'll hear from some of them to encourage you. Take heart, all will be well. Good luck.

So glad you found this wonderful site. this place has given me so much solace and direction. My husband was diagnosed with PC on 10-3-12, the wonderful people on this site have guided me since then. You will find the same I am sure. My husband had DaVinci on 12-12-12. We have the path report back,which is not reflected below but i will get to that after the holidays. it was basically a good one and we are so thankful in the choice he made to just get it out. Good Luck to you, with your low numbers your odds are good for a great outcome. as far as the tests... My husband had a colonoscopy, bone scan, MRI, CT and then another more accurate 3T tesla MRI, all were clear and great. in retrospect a waste of money as they were all clear, but if you want those tests just ask for them. I must say and my husband would confirm as he has said it many times, he finds peace in knowing those tests were all clear. It provided and still provides him with solace. you are the one in the drivers seat here. not your doctors. ask all the questions. my husband has the most wonderful urologist. An MDA certified Urologist in New Orleans. he will sit there and answer my endless questions, which i assure you can last for awhile:) and i have called his nurse on numerous occasions and she talks to me and answers whatever i need answered. If you want the tests get them. if you have questions... ask them. but i do agree with others here that likely you are just fine! for us, the peace of mind was essential, if you need that as well... get it. good luck to you. my husband is almost three weeks from surgery and is having the usual issues but progressing well. You will do just fine. keep us all posted. this site is amazing. you are on the bad side of this right now. waiting on the surgery weighed on my husband tremendously. he spoke of it daily. once his surgery was done it was all downhill from there. Best to you and to yours. Contact me anytime if i can help in any way.
_______________________
age: 56
PSA 5.7
G7 -- 4+3
Robotic Prostatectomy with node dissection and nerve sparing - 12-12-12

Michael (my husband) was diagnosed at 39 years old with PSA starting at 18. he was put on antibiotic for a month and retested and it was at 12. So he decided to have DaVinci, on 2.2.10. We spoke to several different treatment Dr, and decided the surgery was the best option for him. Actually he decided and I supported. This decision is one that you need to be able to feel comfortable with, get as much info as possible. Michael did have all the pre-tests, MRI, chest X-ray.....everything was clear and we felt pretty good about what would be found during surgery. Again, this is something that you need to feel comfortable with, most would say it is a waste of money with the numbers that you have, but if it is going to give you peace of mind then you ask for it to be done!!

If you are embarrassed to ask your URO or the nurse, ask here someone will have had some common issue and will be able to direct you. Hopefully your surgery will be uneventful and your recovery quick. Dont push yourself after the surgery, it will all heal in its own time.

Susan

Los1023,

Good luck and best wishes for a speedy recover!

Hi Everyone,

Had my surgery yesterday and now comfortably resting in the hospital. My stomach is really sore since I have not been able to pass gas yet but I feel pretty good for the most part. I'm trying to walk as much as I can and looks like I will be able to go home tomorrow. Now just anxiously awaiting the pathology results from my prostate.

Thanks for the warm thoughts!!!