Recent Diagnosis

I am 65 years old and I had a prostate biopsy on 8 November 2018 after my PSA began to rise. My story begins in October 2016 when my testosterone lab was 114. It stayed in the low 100’s and in June 2017 I was referred to Urology. It continued with a downward trend and in July 2017 it went to 106. Prior to being referred to Urology I had been started on testosterone patches without much success in raising my testosterone. After being referred to Urology I was started on testosterone injections with regular labs to monitor my PSA. My testosterone went within normal range levels, but my PSA went up so the testosterone injections were stopped. In October 2017 my PSA was 4.9, December 2017 was 5.6. I did a round of antibiotics and in March 2018 it was 4.5. In June 2018 it was 5.9 and in September 2018 it was 7.5. The September 2018 labs were a PSA Free and Total and the Free % was 9, which fell into the 56% chance of cancer range. After another 3 week course of antibiotics in October 2018 my PSA went to 5.1. It was at that time, rather than wait and do more blood work that I decided to have the biopsy.
The biopsy came back with 4 out of 12 cores positive, a Gleason score of 7 (3+4), Grade Group 2, both lobes involved, PNI in one sample, cancer localized within the prostate.
After getting the biopsy results back, I opted for the genomic testing. The Oncotype DX GPS was completed. The GPS score was 42, High Risk, Adverse Pathology was 62%, High Grade Disease was 39% and Non Organ Confined Disease was 43%.
I was not a candidate for Active Surveillance after the genomic testing scores. My last PSA Free and Total was on 24 December 2018 and PSA Total was 6.8 and the PSA, % Free remained at 9.
I have opted for the surgery route after discussion with my Urologist. After researching all the possibilities for my situation, I was able to make a more informed decision regarding my treatment decision. There would be possible complications with all the treatment options. I have opted for the surgery as I wanted to get rid of the cancer while it is contained. If there is some cancer left over after the surgery I can always have radiation therapy at that time, not the other way around.

Cookin, welcome to our club that none of joined by choice!

Best of luck to you from another "surgery guy". I'm coming up on 4 years since my RALP, and I'm doing fine. Cancer free and no issues from side effects. Like gary said, make sure your surgeon has done a lot of procedures--and you can ask him about his personal record for cancer control and side effects.

Welcome Cookin - I am a few months ahead of you, similar age and issues, two months past RALP, and you have come to the right place to get information, search away and ask questions. I only wish that I had found this forum right after my doctor sent me to the urologist. I would have had more time to absorb everything and ask better questions.

Just some quick comments:

1) MRI of prostate can be very informative on actual location of cancer.
2) Second opinion of biopsy results at J. Hopkins might help confirm the classification to be sure.
2) A visit with the RO (radiation oncologist) was really worth it, did not change my decision but made me think hard about it.
3) The surgery is not quite as easy as advertised and the catheter reminds you of this quite often.
4) Experienced surgeon and their track record with continence and ED issues is important.

Good luck and I am hoping that surgery cures your PCa if you go that way.

Craig

Welcome to HW.

You have all the options open to you and every reason to expect a great outcome.

Andrew