newly diagnosed

well, probably like most of you, we are reeling from this recent diagnosis. my husband is 78 years old and extremely fit and healthy, except for the prostate cancer. gleason 9 - lymph node positive. he had the prostate biopsy on may 26th, with all specimens positive. followed up with bone scan and ct scan of pelvis and then lymph node biopsy. appointment with sloan kettering oncologist 7/7/2015. i have been reading these posts for the past few weeks and it certainly does help to see what everyone else is doing, although not sure what we can do to stop from jumping out of our skin during the wait. is there anything else we should be doing?

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ok, i am going to try to enter my husband's numbers so you all will know what we are dealing with.

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psa 6/13/2014 29.63 11/12/2014 35.7 4/22/2015 46.54

prostate biopsy 5/26/2015 left lateral base gleason 8 (4+4) 30%
left base gleason 8 (4+4) 30%
left mid G8 (4+4) 10%
right case G8 (4+4) 50%
right mid G8 (4+4) 60%
right lateral base G9 (4+5) 85%
rights lateral mid G9 (4+5) 75%
right lateral apex G8 (4+4) 90%

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ct pelvis 6/2/2015
prostate gland is enlarged - evidence of adenopathy of the pelvic sidewall bilaterally left greaterthan right. largest lymph node of the right pelvic sidewall measures 2cm in diameter and largest lymph node of the left hemipalvis measures 2.5 cm.



ct guided left pelvic lymph node biopsy 6/29/2015
fragments of adenocarcinoma consistent with prostatic carcinoma.

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first appointment today at memorial sloan kettering oncologist. we are compiling a list of questions and would appreciate any suggestions. thanks everyone.

Post Edited (mrs. george) : 7/7/2015 9:23:09 AM (GMT-6)

It is definitely a shock to the system to learn you have cancer. It sounds like you see doing everything you can and are going to a top notch medical facility. Also, i your husband is in good hands with you. I know you will be able to be there with him every step of the way.

Mrs George,

I'm sorry to hear that disappointing diagnosis, and I could see why you'd be jumping out of your skin. All I can do is tell you that prostate cancer usually progresses slowly, especially when there are no detectable mets on a bone scan. With prostate cancer there are many options that are for the patient to understand and make.Sometimes the patient has to take the lead.

The standard of care with a positive LN is lifelong hormone therapy, and I'm sure your medical oncologist will recommend that. It can keep the cancer from growing for a long time, and the side effects (like hot flashes), while annoying, can be managed.

Often with men your husband's age, the recommendations stop there. The doctor looks at actuarial tables and assumes that some other cause will probably get him before the cancer does. More recently, doctors are taking account of a man's physiological age and not just his numerical age. With your husband's good health he may have many more years than are reflected in the actuarial tables.

If you decide that you'd prefer to pursue curative treatment, that may be an option as well. I suggest you read the following article I wrote, which precisely applies to your husband's situation, and share it with his oncologist, who may not have seen some of the most recent studies discussed there. Note especially that in the Lin study, the 5-yr overall survival was 86% among those who received both hormone therapy (ADT) and radiation therapy (RT):

ADT and radiation for first-line treatment of node-positive (N1) prostate cancer

I hope you've also taken the time to read the two stickies on the first page that explain the basics and show commonly used abbreviations. I apologize for all the abbreviations I toss around, which can be quite confusing to a newcomer. Please feel free to ask me to explain anything.

- Allen

Mrs. George,

Sorry you and your husband have reason to be here - and very glad that you are. This is a great place for support and "real world" feedback. I can't add much about your husband's condition, like halbert said the G9 guys will be of great help.

I would offer this for you - take care of yourself. Caregivers are of great value and importance to PC patients. Often they don't take care of themselves - please do. Your husband is a fortunate man to have such a loving and caring wife.

Take care. You and your husband are in our prayers,

Peace

Pat

Mrs. George,

Welcome to HealingWell. I'm sorry you have to be here, but you've landed in a great place for information and support. People like Tall Allen have a tremendous amount of good information to share. In fact, you've landed in two great places. Sloan Kettering is a world class center for prostate cancer treatment.

I can't offer a lot of specific information for a G9 cancer, but I do know that there are lots of guys here who are successfully managing those cancers. This is not the diagnosis you wanted to hear, but it's a manageable situation. We all wish you and your husband the best in your journey.

Jonathan

I wrote an article about ageism in prostate cancer treatment that may be of interest to you. The last section specifically addresses using radiation therapy with ADT and not just ADT alone.

Ageism in prostate cancer treatment

- Allen

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