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Since you stated a Gleason score, I assume he had a biopsy. Normally, the next step is a CAT scan and a bone scan. Both of these are used to see if the cancer has spread beyond the prostate. If there is significant spread, surgery is not a good option. Get those two tests before committing to any treatment.
My husband Michael, age 46, just had Da Vinci surgery on April 23rd of this year. His doctor did not order any additional test such as CAT scan, etc. prior to his surgery as he did not feel it was necessary due to early detection. We, however, did ask about these tests after learning that so many others on this website have had them. Due to our questioning, his doctor then offered to order them if we would like. We opted not to based on his professional opinion ane experience.
If you would like to ask any further questions please feel free to write me at leslie12212002@yahoo.com. I will try to help in any way.
The Prostate Book by Dr. Scardino of Memorial Sloan-Kettering Cancer Center recommends bone scans be reserved for men with T1 or T2 who have a PSA greater than 10 or a Gleason grade 8 or higher. They also say CT scans are of little use unless cancer is aggressive. --- my urlogist does them if Gleason score is 7 or above, not for a Gleason 6.
All the research shows that there is near 0% chance of getting a positive Bone Scan or CAT scan for PSA < 10 and there is the chance of a false positive. I agree that for you husbands numbers there is no benefit of doing additional testing before getting treatment.
Ruth: Tell the urologist both you and your husband would feel more comfortable having more tests done like an MRI, CTscan and bone scan. The urologist is using his past experience and statistics as he has been through this many times but remind him this is your first run and you want all bases covered. One thing I learned is that every case is different and sometimes statistics don't apply to your case. Remember once the surgery has started and they biopsy the lymph modes and if it has spread beyond the capsul, they may stop the operation and so back to the drawing table. There are other options available to you at this point and I fully understand you would like things to get started as quickly as possible but don't act too quickly without talking to the urologist about other options available.
First things first. If you want to contact other wives about how best to deal with the inevitable issues that arise from a diagnosis and treatment, can I suggest you go along to Judy Thurman’s PROSTATE CANCER FORUM FOR LADIES ONLY a group dedicated to educating women about Prostate Cancer; its treatments and side effects. Give he my best wishes and tell her I sent you along!
Although it is normal protocol to send men with a diagnosis like your husband’s for bone and CAT scans, most experts regard these as a waste of time and money because the chances of any spread being identified is very small. If you feel more comfortable getting these scans done, do so by all means.
I don’t know if you have been through the site yet. If not it may be an idea to do so because there is a good deal of information for you there and many suggestions as to what information you should have before making any final decision.
Perhaps the most important issu is, as Dr Jonathan Oppenheimer, one of the leading pathologists in the US says on his BLOGFor the vast majority of men with a recent diagnosis of prostate cancer the most important question is not what treatment is needed, but whether any treatment at all is required. Active surveillance is the logical choice for most men (and the families that love them) to make.
I think this may be an important point for you because it seems from what you have said that your husband may have what is termed an insignificant tumour, defined as being:
1. Nonpalpable
2. Stage T1c
3. Percent free PSA 15 or greater
4. Gleason less than 7
5. Less than three needle cores with none greater than 50% tumour.
If his diagnosis fits this, then you might like to consider ACTIVE SURVEILLANCE
At the very least, you should seek answers to all these QUESTIONS
Don’t rush into anything. You most likely have months – perhaps years to make a decision.
All of it ... the treatment, the need for additional testing, side effects, everything.
The word "cancer" scared the heck out of most of us and it's natural to want to get it taken care of as soon as possible, but don't take one person's word for it.
Most (well, some) doctors would encourage second opinions. My Urologist actually recommended it. He knew I was confused and scared. It helped to hear it from other sources.
As others have stated on here, it's our opinion that you have time on your side, for now.
Good luck in whatever y'all decide to do ... we'll be here for you.
Ruth,
I am also 47 and had a gleason score of 6.9. Your surgery is tomorrow so best of luck and if you need to talk just reach out my store is also on the web site. I had the robotic on July 10th.
