Age 73, PSA 10, Gleason 8

mt father was just diagnosed with prostate cancer. We know very little of this disease. I read the pathology report but if course don't really understand. Total involvement is 22.5 percent. There is less than five percent involvement on the right side in one section. Each of the four sections on the left side has 30-50 percent involvement. His gleason score is 8 and Psa is 10. He starts radiation today. The doctors said removal of the prostate is being avoided due to his age. He is 73 years old. Does this seam like a proper course of action? Is radiation painful? What are the side effects?

This is the recommended course of action for a 73 year old with a G8. A G8 is considered aggressive cancer and you should at least inquire about adding a course of Hormone therapy to the radiation as this is common when dealing with high risk cancer.
It is imperative to have him exercise during radiation as this will reduce the fatigue he will experience. He may also experience some loose stools, Metamucil is good for that. He may also experience some frequency and urgency in urination. All these usually go away after radiation stops. There are some severe effects from radiation that approximately 2-3% of patients experience, so if anything is very abnormal you should tell your doctor. The radiation sessions are painless and he won't feel anything.
It may be a little late, but insure that your radiologist has done at least 250 procedures on PC as most of the radiological harm is caused by inexperienced ROs. If his RO is inexperienced i would stop the treatment and find an experienced RO.
Good luck and he should do just fine as long as he drinks at least 16 oz of water and voids his bowels before each treatment.

It's a serious and worrisome disease but it sounds like you are more worried than you need to be. The treatment plan you described is effective and well tolerated. Other guys can tell you the exact odds but it is quite likely that his lifespan will not be directly reduced by prostate cancer. (He needs to stay active and watch his diet to avoid the possible side-effects of the hormone therapy -- things like heart disease and diabetes -- which are more likely to kill him than the cancer.)

There are men who die of prostate cancer, and yes it is a painful process, but there is a good chance your dad won't be one of them, and even if he is, there are treatments that can delay that for many years and new treatments coming out every day.

Welcome to HW, sorry you need to be talking to us.

Sounds like you're getting great advice. RT with HT for your dad's case is what I'd expect to hear. The only question is, has the PC escaped the prostate or is it still confined? G8 is scary but if it's contained then there is actually hope for a cure. Even if it has escaped and there are mets outside the prostate, there are plenty of treatments that will keep you father doing fine for a very long time.

I know you'd like to look down the road and ask how long will he live. Well, know one really knows and anyone offering an opinion is likely guessing. From experience I'll say, that there will be discomfort and times pain. That can all be managed. Even though this is an aggressive cancer, don't start thinking the worst. The oncologists have a lot good meds and treatments. There is still every hope you father will be alive for many more years. We have guys here with advanced PC that are still living, 5, 7 years after DX.

True, the side effects of the treatments aren't fun and normal will change but life will go on.

I know it's hard to watch a parent go through this kind of thing - I was caretaker for both my mother and father. It's never easy.

Keep us updated on progress and ask any other questions you have.
Andrew

His 10 year survival rate from prostate cancer is close to 100 %. Take care of his heart, as that will be the most likely cause of death of all men. He will do just fine. I play golf with an 83 year old that had your husband' s stats years ago. He still has PC, but lives a full life in spite of the disease.

needadvice - first and foremost I'll also join in and commend you for taking an active role with your Father's health - good for you, and him!!!!!!

You've gotten some great advice already, and as you've seen, all of the weigh-ins are saying the same thing so that should give you an added level of confidence.

In particular, read and re-read our Brother Gunfighter's post - spot on and directly related to your Dad's situation.

Continued best to you both!

It sounds like you have a good plan and you seem to be a caring son. A loving family makes the journey a little easier. Try to keep his spirits up, it is a difficult thing to be told you have cancer. He has an excellent chance of successful treatment.

Good Luck,
Kris

With your father's numbers I'd be surprised to hear that the scans shows he has any mets. It's possible but his PSA is a bit low for that.

Remember that you're dealing with two numbers here. The Gleason score shows how far the cancer cells have progressed and generally the higher the number the more aggressive the cancer. That number alone doesn't indicate if the cancer has spread. The PSA is a measure of how active the prostate is and how many prostate cells there are in the body. Both normal and PC cells produce PSA. At a PSA of 10, there is a lot of prostate cells around but most guys with mets have much higher PSA numbers. At 10, there is still a good possibility that the PC is confined.

Don't panic until necessary and you're still getting test results. We'll let you know when you can panic. ;)

PC is a slow growing cancer, likely he's had it for many years. There are studies on how likely a G8 is to spread but I don't know those numbers. Left untreated, it will spread but catch it now and treat it, it's possible to keep it from spreading.

and even if there are mets, the HT and other treatments can reduce those and keep them at bay for many years.

Hang in there, things will start to look better when the docs can start treatments.

Andrew

I would respectfully disagree of "in the shops" description of what Gl score does. It describes the differentiation of the cells, which does in fact mean its aggressiveness. But it in no way determines the degree of spread. I suppose you could say it implies spread. Knowledge of spread would come from scans, pathology etc. In other words, I had 2 foci of 5 in post op pathology , the pathology determined there was 2 foci, gleason 5 did not indicate spread, as size of 2 foci, very small indeed. There is a difference. I just don't want the lady to think that because it is an 8 , he is riddled with cancer. Odds are very good that it is still contained. I also agree that his chance of having bone mets are minimal. So don't be too concerned with that . Take from these posts that by and large, your Dad is in not in a bad state and is treatable and very likely live his " natural" life span. Look, there are no guarantees in life, but the odds are in your Dads favor. There is a lot of disagreement on this site over dis and dat,but not on your issue, take comfort in that stay positive. Pass this on to your Dad and keep us in the loop, if you have the time…….

So got the call from doctors today that the bone scan will be on November 22. We are worried there are bone mets. I hear that's not a good thing. Does a high gleason indicate mets are likely. That and the high volume in his prostate of 22.5 percent affected tissue? I know that no one can answer definitely. Talking about this with my dad is hard. The guy just wants a good nights sleep. He wakes up to pee many times at night. Makes him tired through the day. I wish there was something I could do. He never even knew what prostate cancer was until he found out he had it last week. Never checked for it before.

I may be wrong , but I believe the 22.5% refers to the the the small cores that are pulled out with the biopsy needles. I had 70% in two cores and 5% or less in 4 0r 5 of the others. You do not add the percentages up to get a percent of all prostate tissue. just the ones in the tiny needle cores.. The only way to get percent of whole prostate, affected by cancer is with post op pathology. The need for this knowledge is not overwhelming and not a reason to choose surgery as a treatment. Many treatments are curative and it is never known what the total percentage is. For the record , mine was 9%. A psa of 10 is not that high, to be honest and if the biopsy was done locally by a pathologist not that experienced in reading pca cells , he may have erred on the aggressive side. I t happens. It may be a lower gleason. Of course it could be higher also. I am not giving you a pollyannish answer so as to calm you. I am giving it to you straight, based on the stats you provided and hope your mind goes there and not to the other. Obviously I have no control over that and your reaction to the news is very typical. Im just saying there is no reason in the stats of your case, to feel anything but a favorable out come here. I am 99.9% sure the bone scan will not show mets, The .01% is covered by faith.

Your dad,s total involvement in the cores is 22.5 %. pathology of Biopsy. The cores are a very small sample of the whole prostates tissue. The only way you can get the total percent of cancer in the whole prostate is by post surgery disection and to my knowledge your Dads prostate has not been removed. If I am wrong I hope someone chimes in for this ladies sake. If I am right I hope someone would chime in for this ladies sake. I had high volume of cancer in specific cores based on post biopsy pathology, but a small 9% involved in the complete prostate Lying on the pathologist examining table. It can be confusing, is usually is for newbies, which is why I try to re enforce newbies not giving advice, without a qualification, or as in my case, a reminder at the bottom of my post. Or a direct plea, usually unanswered, to those who presumedly know, my presumption I would add.

As an "old" guy I respectfully disagree with your fathers "old" guy friends.