Newbie, now what?

I was diagnosed on 3/30 and will have my surgery on 5/10.
I am totally scared out of my wits.
Below is my biopsy results, How do I fare? What have others experienced with these type of numbers.
52 years young, praying hourly!

Thanks in advance!

1. Prostate, Right Apex: Biopsy:
- Prostatic adenocarcinoma, Gleason grade 3 + 3 = 6/10
- 2/2 cores involved by carcinoma
- Carcinoma maximally involves 40% of single core
- Total sample involvement is 20%
- Perineural invasion not identified

2. Prostate, Right Mid: Biopsy:
- Prostatic adenocarcinoma, Gleason grade 3 + 3 = 6/10
- 2/2 cores involved by carcinoma
- Carcinoma maximally involves 20% of single core
- Total sample involvement is 20%
- Perineural invasion is identified

3. Prostate, Right Base: Biopsy:
- Benign prostate tissue with chronic prostatitis

4. Prostate, Left Apex: Biopsy:
- Prostatic adenocarcinoma, Gleason grade 3 + 3 = 6/10
- Carcinoma involves 10% of 1 of 2 cores
- Total sample involvement is approximately 5%
- Perineural invasion not identified

5. Prostate, Left Mid: Biopsy:
- Prostatic adenocarcinoma, Gleason grade 3 + 3 = 6/10
- 2/2 cores involved by carcinoma
- Carcinoma maximally involves 25% of single core
- Total sample involvement is 15%
- Perineural invasion not identified

6. Prostate, Left Base: Biopsy:
- Prostatic adenocarcinoma, Gleason grade 3 + 4 = 7/10
- 2/2 cores involved by carcinoma
- Carcinoma maximally involves 80% of single core
- Total sample involvement is 80%
- Perineural invasion is identified

Barfy,
Not a Dr. but your numbers look great. I would have loved to have your numbers. If you were a little older, I would think you to be a good candidate for active surveillance ( watchful waiting )! The G-7 core is a bit concerning but the core samples are mostly G-6 and a very small percentage of the cores are cancerous. Surgery will most likely be curative but with your stats I am not sure I would have had surgery. It will change your life but I believe you will never have to eorry about Prostate cancer again. See you on the other side.

Welcome to HW.

Two ways to beat fear: Name the fear and gain knowledge.

You're going to be fine. Surgery isn't fun, but lots of guys get through it just fine. You'll have side effects to manage and will need time to heal. Normal will change.

In a year from now you'll wonder what was the fuss all about.

Still, we've all been there - the fear of the unknown. The what ifs? It's easy for a guy like me to say, "don't worry," but I know how hard it is for a guy in your place to not worry. For now the best you can do is prepare for the event. Focus on the short term stuff - getting through surgery and healing.

The rest will take care of itself.

and in the long term, the surgery has every chance of being the only treatment you'll need and the PC will be gone.

Hang in there and ask all the questions you have, we're here most days,
Andrew

Take a deep breath - you are rushing too much for your own physical and mental well being. You have what is called "intermediate risk" prostate cancer. That gives you plenty of time - months - to decide what you want to do about it.

It is a very good idea to get your biopsy slides looked at by Epstein's lab at Johns Hopkins for a second opinion. This is a very routine thing to do - just call your Uro's office and tell them. It may cost you $250, but is well worth confirming because your treatment choices depend on it.

Assuming it is confirmed, make appointments with doctors who are specialists in brachytherapy (low dose rate and high dose rate) and in SBRT. Use the questions at the end of the "sticky for the newly diagnosed" when you meet with those specialists. And never depend on one specialist to give you accurate information about another specialty - they just don't know and often may misinform you.

You have time. Prostate cancer is slow growing at this stage. And try to rid yourself of what you think you know about prostate cancer based on what you've heard about other cancers. The men who regret their decisions are the ones who panic and rush into treatment.

Barfy,

I am 8 weeks out- glad I had the surgery. Recovery is slow so be patient. ED and incontinence is part of that so be prepared. I would agree with the advice of start doing your kegels now. With your number surgery is very likely to be curative. Please keep that in mind. Good luck to you and check back often.

Thank you everyone for the positive support! I really needed that now. What about the "perineural invasion is identified". Does that mean it is most likely outside the prostate? In the nerve bundle?

Hello Barfy and welcome. Your numbers indicate that a number of options may cure you. If you have already taken all of the steps that Tall Allen suggested then congratulations and good luck on your upcoming surgery. If you have not, I suggest you slow down re-read his post and proceed to take a logical and educated approach toward your treatment.

Jim

Do not worry about the perineural invasion. It's pretty meaningless. The thought is that the nerves are an eassier pathway forn the cancer to escape, but this has not been proven. Extra Prostatic Extension is a more important indicator, were there any lumps indicated during the DRE? Did you have an MRI?

Barry, I've nothing to add to the PNI, you've been given good information.
Just a comment on RT...VERY DOUBTFUL THAT A Dr would schedule you for RT without discussing it with you. Also, nobody would schedule you for RT with 4 g6's and 1 g7 , before even getting surgical pathology back.

Read this 10 times, because it's true: you will not die of PC

Barfy, that is a line that most of us in here hate with a passion. "prostate cancer is the good cancer". Really?

The important thing to think about is that you owe it to yourself to understand what your options really are. Fact is, that Urologists...who are the ones who do most PC diagnosis....are surgeons. They recommend what they know. Asking them about radiation is like asking your dentist who should take care of your foot injury. You still have the opportunity to slow down and check all the options.

Now, if you are committed to doing the surgery, then--as a 'surgery brother'--I wish you the best, and make sure you check in from the other side.

Sorry for the bad choice of words. I did not mean to offend anyone or down play prostate cancer. I have decided to go with the surgery on May 10. I will be here through out, probably with more questions than answers. I have only shared my news with family. I realize people will find out in time but I am just not comfortable telling people. How did others handle this? The hardest thing I had to do was tell my wife & kids. I lost it big time.

Barfly,

It was also hard for me to come out to others especially my kids. What I focused on was that indeed I had cancer but it was very treatable and likely curable. I actually felt relief to have the surgery scheduled and the information out to all my family. It felt like I was in charge and taking charge after 14 months of AS. Good luck to you.

2-3 weeks is about normal for a desk job. You'll be told not to lift anything over 5 pounds for 4-6 weeks post surgery so long as you don't need to lift anything, you'll be fine.

Likely the first week back will be difficult as you'll still have incontinence issues and need to be wearing pads to manage that. Fatigue may be a problem the first week or two as your body heals (your body will divert energy to healing).

It's major surgery and they'll be doing a lot inside your body. It takes a long time to heal. My brother took 4 weeks and felt that was about right. Some here have reported going back after a week or two and being just fine. Everybody reacts differently, but if you can get 3 weeks, I'd take it to heal and adjust to life without a prostate.

Hang in there,
Andrew