Newly diagnosed G8, prelim metastatic diagnosis

Welcome to HW. Hopefully the biopsy will show something else other than a met. With a Gleason of 8 a met is possible, but he will have a lot of treatment options. Keep us posted and I wish both of you the very best outcome.

Michael

Thanks to you both for the encouragement.

The doctors have mentioned a "Hail Mary" combo of prostatectomy and radiation to treat the lesion, if metastasis is confirmed. Just holding out hope that they don't confirm it. I didn't know that the hormones were needed in advance of the radiation, so that's very helpful info. I think the doctor used the words "low PSA", but maybe I misunderstood. We took in a lot of information in a short time.

Thanks again!

57Partnership said...
.. I didn't know that the hormones were needed in advance of the radiation, so that's very helpful info...

I started with RALP and when a positive node was found, that triggered two more follow-up treatments since that positive node put me in another risk category. My surgery was in March, 2015, I started Lupron July 31, 2015 and by November 2015 my pelvic bed was healed enough for radiation.

Hi 57Partnership,
Sorry to hear that you and your husband find yourself on this site but you did find a great bunch of supportive guys and their significant others that can help you navigate these uncharted waters you are in. I too had lesions in two spots on my spine that at the insistence of my urologist were biopsied and found to have no cancer. Each biopsy was performed separately. My urologist recommended surgery and without the biopsy, I would have never been offered surgery and would have been treated systemically. I must say that before the biopsy I was placed on hormone therapy and some suggest that hormone therapy works extremely fast to shrink tumors. Others suggest that although the doctor performed the biopsy he likely missed the cancer. I think my point is that if you are considering surgery, have the lesion biopsied to determine if cancer exists there. Otherwise it will be more difficult getting surgery approved.

However, surgery has many side effects and both you and your husband must be fully aware of what the side effects are and whether they are worth having surgery.

Almost a 10 said...
Hi 57Partnership,
Sorry to hear that you and your husband find yourself on this site but you did find a great bunch of supportive guys and their significant others that can help you navigate these uncharted waters you are in. I too had lesions in two spots on my spine that at the insistence of my urologist were biopsied and found to have no cancer. Each biopsy was performed separately. My urologist recommended surgery and without the biopsy, I would have never been offered surgery and would have been treated systemically. I must say that before the biopsy I was placed on hormone therapy and some suggest that hormone therapy works extremely fast to shrink tumors. Others suggest that although the doctor performed the biopsy he likely missed the cancer. I think my point is that if you are considering surgery, have the lesion biopsied to determine if cancer exists there. Otherwise it will be more difficult getting surgery approved.

However, surgery has many side effects and both you and your husband must be fully aware of what the side effects are and whether they are worth having surgery.

Thank you, 10. Biopsy on the lesion is scheduled to ensure we know what's there.

Want to hear something crazy? Insurance has denied RALP because, and I'm quoting, "documentation does not support the medical necessity for a prostatectomy as there is no evidence of lymph node or distant metastatic involvement". Has anyone ever experienced this?

Thanks, Michael. I thought so too! I talked to the HR Director at my husband's employer this afternoon. She's going to personally call the group insurance broker on Monday and have him call Blue Cross/Blue Shield. The HR director is a cancer survivor herself, so she seemed happy to go to bat for us. In the meantime, I'll be putting together a letter and getting what we need from the doc in case it isn't resolved through HR.

57 partnership,
Welcome to HW from one wife to another. I also like to be informed. And as you are finding out, this is the place to get a lot of good information. It is also a good place to get support, vent and know that others truly know what you are going through.
I've been here long enough to see that what holds true today may change overnight, based upon new research and trials.
The surgery to "debulk" the tumor is a fairly new consideration, once mets have been discovered. If I read your post correctly, you were denied by insurance for RALP because there was no identified mets? Well now, that just doesn't make any sense. Most time surgery is an option only if there is no mets. Jeeze.
At any rate, keep posting and asking questions. You seem to have gotten well informed already.
Btw, check out the thread "Letters to the newly diagnosed".
Beth

As I am sure you have noticed, some of us have strong personal feelings regarding one treatment or another, some push their choice as the best due to personal emotional investment.

Your task, however, is to listen to the docs, weigh all of the information you acquire, then go ahead with what you believe to be the best course of action for your individual case.

All prostate cancer treatments come with a bunch of side effects, some shorter term, some permanent. Some are immediate, like surgical side effects, and some take years to show up, like radiation side effects or the 'chemo afterglow' of ADT/HT/first round chemo. The point of all of them is to kill, stop, injure, weaken or slow the cancer. If they are effective in that regard, then the side effects are worth tolerating in my opinion.

Good luck!