just diagnosed

Hope & Wish,

Welcome to Healing Well. You've come to a great place for information and support. Don't hesitate to ask any and all questions...that's why we are here.

Gleason 6 PC is generally slow growing where active surveillance is appropriate in many cases. Gleason 9 PC is generally the more aggressive type. So, those are the extremes...Gleason 7 is serious enough and must be dealt with.

Just me, but how do we know that it is stage 3...did he already have imaging done (bone scan, CT)? What was his last psa?

Regardless, try not to stress out...easier said than done...get all the facts, get more than one opinion, check in with us here...and kick this thing back...

Jerry

hope & wish, welcome to HW, you found a great place and you're sure to get some wise opinions, real soon... I would not dwell one minute on the should of, could of, would of's; I did that for a while and realized it had zero value to my mental well being...

As you mentioned, age will be a factor in determining the right next step for your husband. Easy for me to say, difficult to do, but try to be calm and realize that there is time to weigh all of your options.

Radiation may be one option offered, and hormone therapy may also be suggested as a near term plan to stop the growth of the cancer, while you consider the next step. Your doctor will surely take into account your husbands health conditions in order to provide you with some good recommendations.

The NCCN guide in Gedmen's signature is a great place to start for information on PC.

best wishes,

Hope and wish, welcome. I understand you are, I will refer to your husband and you , as you, since you are the Poster, are clinically staged at stage 3 with a gleason score of 7. do you know whether it is 3+4 or 4+3. Are you sure he was clinically staged 3. You may be getting numbers confused. As Jerry L said, to be stage 3 means the cancer has been found thru some imaging device, like MRI., to be already outside the prostate , but not in lymph nodes or organs. My confusion comes because you expressed doubt as to whether it had escaped or not. Did your doctor tell you that they found that the cancer had escaped and was imaging done? Ok, lets get to it with the assumption it is stage 3. Stage 3 is curable. I will repeat stage 3 is curable. I agree surgery is not appropriate for you, not only be cause of age, but because if it is stage 3 its pointless. Not pointless in the aspect, Oh its too late you are doomed, but pointless because it won't get the escaped portion arguably. Depends on exactly what escape means , that is How far. A surgeon maybe able to cut a wide margin, i.e. a lot of extra tissue outside the prostate and get it all. Risky business, that! Tho they could still the escapee with radiation post op. Just skip the knife and nuke it. You called the treatment, seeds for the prostate, extra radiation for the nasty escapee. They may thro HT in also, not a bad choice , tho there are some manageable side effects. Just from the points you made I can tell your doctor is on it. I will tell you you have a real chance at a cure, at the worst ,life long treatment that will keep you alive for many, many years. No rose coloured glasses here, nice silverfish surfing shades tho, tee hee thanks for letting us be a part of your family in this " bump in the road"

hope & wish said...
This is my first post to the forum. My husband was just diagnosed with Prostate cancer, stage 3, Gleeson score 7; the urologist took 12 core samples with 6 cores being positive. We aren't sure yet if it has spead outside the prostrate, but is is likely. He is 71 so surgery isn't an option. We are going to see the oncologist within the next 10 days; we understand the treatment will be radiation - maybe the seed treatment plus radiation. We really don't know where we stand right now for the longer term; guess each individual is different.
Anyway, hindsight is wonderful but I can now see where one needs to pay more attention to the psa tests, etc.
My husband has been having the psa tests for approximately 15 years along with the digital rectal; his psa stayed between 4 to 5. However, he was having urinary problems for 2 years (which we now realize was the growing tumor pressing on the urethra (sp); the doctor was giving him some meds to reduce or relieve the pressure. It was only a month ago that he said, maybe you should have a biopsy. Of course, the result was cancer.
Any comments about this level of cancer would be appreciated.

Thanking you in advance.

Hi Hope and Wish,

For whatever it is worth for older patients, surgery depends on the overall health of the person. For example, my Dad was diagnosed with PC at Mayo Clinic in 1997. They gave him a choice between open surgery and radiation. He chose surgery -- and he was 73 years old.

He did just fine with the surgery and had no urination problems afterward.

Generally, if a man has a reasonable expectation of 10+ remaining years of productive life, surgery is a consideration, which is why they offered this option to him.

Now, it could be that radiation might just naturally be a good way for your husband to go, but do not rule out surgery as a possibility if he is in otherwise good health -- because 71 is not all that old.

It better NOT be all that old because I'll be there in just 7 years. LOL

Good luck!
Chuck

Resident of Highland, Indiana just outside of Chicago, IL.
July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA Sept. 2011 was 5.7.
Local urologist DRE revealed significant BPH, but no lumps.
PCa Dx Aug. 2011 at age of 61.
Biopsy revealed adenocarcinoma in 3 of 20 cores (one 5%, two 20%). T2C.
Gleason score 3+3=6.
CT of abdomen, bone scan both negative.
DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
My surgeon was Dr. Matthew Tollefson, who I highly recommend.
Final pathology shows tumor confined to prostate.
5 lymph nodes, seminal vesicles, extraprostatic soft tissue all negative.
1.0 x 0.6 x 0.6 cm mass involving right posterior inferior,
right posterior apex & left mid posterior prostate.
Right posterior apex margin involved by tumor over a 0.2 cm length, doctor says this is insignificant.
Pathology showed Gleason 3 + 3, pT2c, N0, MX, R1
adenocarcinoma of the prostate.
Prostate 98.3 grams, tumor 2 grams. Prostate size 5.0 x 4.7 x 4.5 cm.
Abdominal drain removed the morning after surgery.
Catheter out in 7 days. No incontinence, occasional minor dripping.
Post-op exams 2/13/12, 9/10/12, 9/9/13 PSA <0.1. PSA tests now annual.
Semi-firm erections now happening 14 months post-op & VERY slowly getting a bit stronger.

Welcome to HW. Sorry you need to be here.

Now is the time to learn all you can about this PC. You've gotten some good suggestions so far. I did radiation because my doctors didn't like the idea of doing surgery on me. I did beam radiation and almost 2 years later and I am doing fine. You might want to look into the brachy (seeds) as an option.

But mostly you need to talk to a bunch of doctors before deciding what to do. A second opinion from another surgeon might be in order as well talking to a radiation oncologist.

Keep us updated and ask all the questions you can think of,
Andrew

Welcome Hope & Wish, sorry you had to find us but believe me you will be glad you did. There is so much experience, knowledge, understanding and compassion here that will help you guys down the path.

If you could tell us more about your hubby's prostate cancer (PCa) statistics, it would help us, help you. Best way to do that is look at the biopsy report and then create a "Signature" in "My Profile" - see the bottom of our posts for examples.

It's a little early yet for me to weigh in too heavily, but in addition to the "Signature" I would also suggest that you have the biopsy slides sent out for a 2nd opinion, to one of the best labs such as Epstein or Bostwick.

Hang in there, no need to panic!

Best to you both.

hope & wish,

It is up to you to ask questions of your doctors and ask for copies of the reports. In Canada's national health system, the patient has all the same rights and responsibilities. I'm in the US, but I still have to ask for copies of everything. I go into all my meetings with doctors with my questions in writing, and write their answers down. It is your responsibility to make your questions and opinions known to your doctors.

One thing I would definitely ask is how the doctor arrived at a Stage 3 diagnosis without an MRI or CT scan. Did he say whether it was T3a (extracapsular extension) or T3b (seminal vesicle invasion)? Possibly he saw something on ultrasound, but that is rare. It is important because treatment options change based on the diagnosis.

The Canadian centers of excellence I am most familiar with, Princess Margaret Hospital and Sunnybrook, are in Toronto. Perhaps that is a possibility if the trip to Toronto would only be for about a week to 10 days? Surgery, SBRT and brachytherapy can all be done in that time frame. If it is indeed Stage 3, therapies will involve an extended course of radiation that, if combined with brachytherapy, will last 5 weeks (8 weeks without brachytherapy).

- Allen

One more vote for getting copies of all medical reports as well as CD's of any tests, and keeping them organized in a chronological binder.

As spouse and I visit my urologists and oncologists we find it helpful top record the sessions rather than scribbling notes we would have trouble reading afterwards, plus cannot replay hand written but can replay voice recorded.

My spouse found a USB device on PulseTV.com that doubles as a recorder. At the time $20 but she tells me this is another case where she saved me $$ and prices have gone up:}.

The USB/recorder device does not have to be plugged into a laptop to record, simple on/off switch with a light that indicates recording is taking place but then when you plug it in when you get home. sound quality is excellent in fact too good if we inadvertently shuffle papers.

I kind of snuck in the "we" but it helps if both the man with PCa and the partner attend these sessions to help organize questions and track replies, and compare notes afterwards.

Not sure what part of Canada he is from but there is a Canadian poster screen named Houseboy who has had amazing results nullifying his aggressive PCa. I am sure there are many others, as Healing Well gets posters world wide.

LupronJim



LupronJim

Just checking in with a question......

Does the Gleason Score indicate whether or not the cancer has escaped the prostrate capsule, for example,

Gleason Score 7 (3 + 4). And, for example, Gleason Score 6 would not have escaped....

Thanking you for now.

d

Thanks, Gedman for your prompt response; much appreciated.

d

KenTTK:

You are right - this diagnosis can be hard to sort through emotionally. Cancer is certainly NOT something newlyweds sign up for!
I encourage you to continue to educate yourself and help your wife and kids understand what this means. Nothing in life is guaranteed, but statistically you have every reason to be very very hopeful.
I have 6 adult children and a wife of 33 years. I needed to educate myself to keep THEIR worries within accurate limits.
As it turned out, four weeks after surgery, other than 6 small scars on my abdomen, I was hard-pressed to find any way my life had changed. I have no side effects. I went back to work 5 days after surgery. I didn't have to. I simply felt fine.
There are no guarantees, but whether it take 4 weeks or four months, you should expect a very positive outcome. Take the time to choose the right treatment for your physical AND emotional requirements. If RALP is best (it was for us) then keep learning as much as you can, set your family's expectations properly, but fully expect to exceed them!
Good luck in January!
Mikey