New G9, some support needed

Hello all,

I have been reading your posts and find them very interesting and supportive. I thought that sharing my diagnosis, treatment and follow-up might be useful for me and for new people. I had a biopsy resulting in G 3+3 (6/10). I also had an abdominal scan (eco) to see if there were any other abnormal growth, and the results were negative.

So, we decided to go for a Radical prostatectomy in late november (29/11/2013). After the surgery, we had the results of the prostate analysis showing a worse gleason score of 4+5 (9/10), with left seminal vesicle invasion, capsular invasion and bilateral extracapsular growth.

As you can imagine, this is a shock new for me, taking into account the initial result of the biopsy (G6). So, I guess that I have now a T3bNxMx cancer until I get the remaing bones scaning, etc

I do not know if the fact that the initial abdominal scan was negative would mean good news with this new situation (G9 after surgery), or it does not mean anything.

I will keep you update with the new results, and, in the mean time, any advices are much appreciated.

Thanks!!!!

A few more questions, if you know. What was your pre-op PSA? How old are you? Do you have a copy of your post-op pathology report? (We have some guys here who can help you read it.) Does it mention positive surgical margins? (or "resection" margins?) What is the airspeed velocity of an unladen English sparrow? What is your favorite color? How are you doing with recovering continence after your surgery? Have you talked to a medical oncologist yet? (This would be a good time to find one.) What is the nearest big city to where you live? Perhaps we can mention some outstanding doctors in your area you might consult.

Pepis,

Welcome to Healing Well.

I am sure that this news was a smack in the guy...but hang in there.  As scary as it seems...there is life after a cancer diagnosis...even as a gleason 9, t3b.. or whatever the stage is.

I took the scariness to even another level and have bone mets...but you just have to decide early on that you're going to pull out all the stops.  Kick this stupid cancer in the butt...and there are lots of tools to do so.

You're allowed to be shocked for a period of time...then fight back...

If you have any questions...or just need to talk...do not hesitate to post here...or even email me.

Jerry L.

Hi again,

Thanks for your quick responses. My abdominal scan was not an eco, sorry for the confusion but I had various test over the last year and it gets confusing. I had a Computed tomography (CT) scanning so as to assess if there was extension in the pelvis, and it resulted negative, with no abnormal growths. The CT result, the biopsy (G6), along with my previous PSA of 6.2 (03-2013), 5.3 (09-2012) leaded us to take on Radical prostatectomy. As said, unfortunatelly the analysis of the prostate resulted in G9 with left seminal vesicle invasion, capsular invasion and bilateral extracapsular growth.

I am 56 years old.

I would like to know how accurate the CT could have been previous to surgery? Does it mean that lymph nodes are not infected?

Thanks,

Pepis,

I think that a CT scan can only detect abnormalities down to like 5-7 mm and can't be used as a definitive tool in determining lymph node involvement.  I'm sure it can pick up some, but not in all cases.  It is helpful in providing useful information, just can't pick up everything.  I usually see confirmation of lymph node involvement only by way of surgery.

I guess I don't know my stages very well...after your surgery, did they say you had lymph node invasion?

And, how has your recovery gone so far?  and when is your post op PSA?

Again...hang in there..

Jerry

 

From 9'ner to 9'ner - sorry to hear of your diagnosis. I just wish you well, mate!

Pepis,
Welcome aboard Healing Well!

Sorry to hear of your pathology outcome. Just goes to show you how little info you get from a biopsy. This is one of the benefits of surgery. At least now you know what you are dealing with and can prepare a treatment plan for the future.

We have many GL9 members on board that will help you and of course, now you are a member of our brotherhood and sisterhood.

We are all in this together!

Bill from Florida

Hello All,

Thank you very much for your messages!!! It does really help and its much appreciated.
Yesterday I received my bone scan and my first PSA (6 weeks after) after surgery. Bone scan is negative and PSA 0.08, which I dont if falls into undetectable PSA.

The two options offered by my Urologist are:

1.- radiotherapy (Three-dimensional conformal radiation therapy )
2.- wait for 3 months to assess PSA change. If changed, apply

These are the two theoretical options, but his personal opinion is 1. Any recommendation? What type of radiotherapy is better given my case?

Thanks!!

---------------------------------------------------------

AGE: 57
PSA 6,4, growth from 5,4 in the last 6 months. (01/03/2013)
Biopsy: 13 cilinders extracted, 4 infected. G3+3(6/10) (29/10/2013)
Radical prostatectomy with laparoscopic (29/11/2013).
Pathologic analysis of extracted prostate: G4+5(9/10), left SVI, PNI, VI and ECE POSSITIVE, and negative margins.
Bone scan, Pelvic CT negative (16/01/2014).
PSA 10/01/2014 (6 weeks after): 0.08
PT3bN0M0 thinking about radiotherapy.

Post Edited (pepis) : 1/17/2014 5:45:08 AM (GMT-7)

PeterDA beat me to it, but would definitely recommend expanding your team to at least a radiation oncologist and a medical oncologist to be the quarterback with you reserving your right to call the plays.

Even though surgery is not a very likely option for me due to bone mets, I also have a second opinion urologist/surgeon on my team, more for his advice than his cutting skills.

LupronJim

Hi all,

A quick update on my treatment:

I posted "negative margins", but It was incorrect, in fact I had possitive margins. With my state and G9, I have decided to go for adjunct radiotherapy. When I went to the oncologist, I was also recommended to have Hormone treatment for two years. RT and HT are recommended for high risk cases right after RP, but I havent made my mind yet on the HT. Any similar case, opinion to help out with it?

Thanks!