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Posted 4/19/2017 1:40 AM (GMT 0)
My partner has been doctoring with elevated PSA for a few years. He is 69 with PSA in 2015 of 4.5, 2016 - 4.85 , goes this weekend for next PSA. He had a biopsy end of March and was told last Wednesday that one of the 12 cores was cancerous... he was told 6 on the scale of 1-10. Otherwise healthy.. He was given a book (100 Questions and Answers), told to come back in 2 weeks (26th) to discuss treatment...surgery or radiation. I have spent the past week reading, googling, crying and reading more and crying even more. While all the reading is good I know the best are hearing others stories... looking for suggestions and experiences.

Forgot...was told prostate was enlarged..60cc

Post Edited (joyf00) : 4/18/2017 8:58:55 PM (GMT-6)

Posted 4/19/2017 2:04 AM (GMT 0)
When you say "6 on the scale" are you talking about a Gleason score of 6? If so, this looks to be a very low-risk cancer, and based on the information you've given us (your partner's age, PSA level, PSA history, and Gleason score 6 cancer in only 1/12 cores) this doesn't look like anything that needs to be treated at all, certainly not right away.
Posted 4/19/2017 2:08 AM (GMT 0)
First, welcome to the forum. Nobody wants to be in this club, but often the news isn't as bad as it first sounds.

I'm sorry to hear the bad biopsy news. However, you should know that the PSA numbers you mentioned aren't outrageously high and the Gleason 6 score is as good as it gets. And having only one of 12 cores positive is also very encouraging. Many urologists would advise against treatment under those circumstances, and I know guys with similar numbers who are holding off.

Read up on "watchful waiting" or "active surveillance," as it's sometimes called. A Gleason 6 cancer may not ever turn into something that's life threatening, so getting tested on a regular basis just to keep an eye on it can be the most prudent course of action. He may need to treat this one day, or not. If treatment becomes necessary his cancer will still be very treatable. If his doctor wants to treat this right off, I suggest that he get a second opinion.

Chances are excellent that your partner is going to be fine. The more you learn, the more you'll realize that this isn't as bad as it sounds. Take a deep breath and try to relax. This is going to be ok.
Posted 4/19/2017 2:12 AM (GMT 0)
Welcome to HW.

First, that's not much PC and on the lower risk side. Next, do read the sticky threads at the top of this forum - tons of great info there.

PC isn't like most cancers, it's slow growing and very treatable. Your partner has every chance of a positive outcome and for this to just be a bump in the road of life.

What should you do? Don't panic (you will, but try not to). Get a second opinion biopsy. Ask about active surveillance, AS, as an option. You can delay treat by years in some cases with this. If he decides to treat you might find the radiation options slightly better for his age (surgery can be tough on a body).

and what's going to drive you both nuts is that most mainline treatments are going to work fine and deciding between them difficult.

Finally, know that you've got plenty of time to research your options. PC is a slow grower so you have months to figure out what to do - don't let anyone rush you into a decision.

Hang in there and ask all the questions you have - we're here most days,
Andrew
Posted 4/19/2017 2:59 AM (GMT 0)
The Gleason Score is only 1-10 in theory. In 2005, the medical community declared that a combined Gleason score below 6 was not treatable cancer. So, as far as having any concern, a Gleason score of 6 (3+3) is a minimal risk level of prostate cancer. Unfortunately, by 2005, many, many men with indolent G 5 cancers had been treated and suffered life-changing side effects.

In recent years, there has been a raging controversy among the top prostate cancer experts as to whether G 3+3 should even be considered a cancer.

So, when I read that yet another man with Gleason 6 is being rushed into treatment by some doctors, it just rings out "greed" in my opinion. You need to research "active surveillance" and "overtreatment of prostate cancer".

I had the same diagnosis as he has. Eight years later, I have had no significant PCa progression, and certainly no side effects lessening my quality of life.

Tell the doctors to cool it. Rushing into treatment should never be taken lightly, as his cancer, like mine, may never be a threat to his life.

Good luck.
Posted 4/19/2017 3:04 AM (GMT 0)
It is very common for men in their sixties to have traces of low grade cancer in their prostates. If he has a Gleason 6 cancer (3 + 3), many experts believe this type of tumor does not behave like a cancer. Gleason 6 cancers do not leave the prostate and metastasize, therefore offers no threat. He is a fantastic candidate for active surveillance. This means he would be closely watched, periodically re-biopsied and not treated with either radiation or surgery. There is a tendency to over treat these tumors when they generally do not need to be treated at all. Get other opinions and do not worry.

Paul
Posted 4/19/2017 4:21 AM (GMT 0)
Be very careful here...your partner is about to over treated...there is absolutely no need to be crying...I get why you are...{You have little knowledge of PCA} the psa's you mentioned are normal for a man of his age...he should never have had a biopsy Trust me you will have a reason to cry from his side effects if he stays on the road he is on...Pay attention to the posts you have read and the others hopefully coming
Posted 4/19/2017 7:21 AM (GMT 0)
Please read the sticky for the newly diagnosed - that will explain all the terms.

His kind of prostate cancer is called "low risk," He can be watched with active surveillance, or he can be treated with surgery, brachytherapy or SBRT (external beam radiation). For low risk men, all treatments have cure rates of more than 97%. More than half the men on active surveillance have been able to stay on it for more than 20 years - Often, low risk prostate cancer never progresses, and when it does, it is slow-growing so he'll have plenty of time to treat later.

Please, take lots of time to decide.
Posted 4/19/2017 11:06 AM (GMT 0)
Hello joy and welcome. You have already been given great advice. I'll just emphasize the need to get the biopsy slides reread by an expert lab such as Epatein or Bostwick (see the sticky thread for new patients at the top of our forum). Also, TAKE YOUR TIME. There is a very good chance that active surveillance is a good choice. If you decide against that there are MANY treatments that are likely to cure him.

I know it's easy to say relax...but by that I mean slow down, focus and get educated before pulling any triggers. Stick with us; we will help you thru this.

Jim
Posted 4/19/2017 12:21 PM (GMT 0)
Another Hello and welcome, joy. You have gotten some extremely good advice above, and I strongly advise you to take it to heart. I know the "simple" diagnosis, just the words "he has cancer" can shake the foundation of your world.

Take heart. As the others have said, this pathology report sounds like the very tiniest beginning of something that may never become serious enough to warrant any active treatment. Active surveillance may be just the ticket.

I don't know you, your partner, or his doctor, but any doctor that wants to move right to treatment with this biopsy report is putting the cart before the horse. First you must determine if any radical treatment is needed at this time. It really may not be needed right now, if ever. If the doc tries to rush you with scare tactics ("It IS cancer. . . "), just tell him you need time to think and to seek a second opinion. Do that. Get the second opinion. With G6 PCa, things move verrrry slowly. You have time.

If you do decide to move to some form of radical treatment, as Tall Allen said, you have several choices, any of which can be curative for favorable risk cases. Spend time here, read about the various treatments (you can start learning by reading the stickies for the Newly Diagnosed), ask questions and learn. Odds are that if you ask about any of the mainstream treatments, there will be someone here who has completed it and will be happy to share their experiences.

Take a deep breath. Your tears are from shock, they should not be for fear of the future.
Posted 4/19/2017 2:37 PM (GMT 0)
Welcome-

You're getting great advice here. Let me echo that: don't panic! His diagnosis sounds like a low risk case, so there's no rush. He may not need any surgery or radiation at this point.

Get another opinion, read up on this forum, research on the internet.

Keep us posted.
Posted 4/19/2017 10:47 PM (GMT 0)
Here is a classic case for potential over-treatment. Low risk: Gleason 6, low PSA and considering patient's age.

And as many as 1/3 of all prostate cancers are over-treated.

And it's really easy to see how you go down this road. Man checks PSA, PSA goes up, man panics, gets biopsy, biopsy indicates cancer, man worries about having cancer but not doing anything about it, urologist agrees with concerns about risk even though it's low, urologist does his job, man lives with side effects.
Posted 4/19/2017 11:10 PM (GMT 0)
You've received great advice. Treating such low risk cancer could result in worse results than not treating it. Active surveillance is all that's necessary.
Bob
Posted 4/20/2017 12:53 AM (GMT 0)
Hi Joy, sorry you have to be here. As you have read above, if it is a Gleason 6, there is time to research and understand this diagnosis. I wish you and your partner well on this journey.

This is another reason why the John Hopkins grading of 1 through 5 makes sense. Joy would have been a little less nervous about a "1" out of 5, instead of the "6" out of 10.

-JR
Posted 4/20/2017 1:06 AM (GMT 0)
Hello Joy and WELCOME !!....listen to these guys ......David
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