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I am sure my story is no different than thousands of others but I am reaching out none the less. I am grabbing onto every straw of information I can find and seeking advice from those who have walked this path before me.
I am now beginning to work my way through the PCa maze. 65 year old with a couple of chronic conditions but mostly my health is very good.
My biopsy came back Monday with a Gleason 3+3=6 Prostatic Adenocarcinoma involving 2 of 9 cores and less than 5% of tissue on the Left Lobe. I was given the option of RP, Radiation or Watchful Waiting if I could wrap my head around walking around with cancer, as the Urologist put it.
The right lobe had only BPH. My prostate measured 71cm3 with outlet obstruction. My PSA has remained stable for 5 years hovering between 3 and 5 with normal DREs.
The process started when I went to consult about a HoLEP procedure to relieve the outlet obstruction. It is still the option with radiation and with the Active Surveillance.
If I am rambling, I apologize but any input is welcome and appreciated.
Well you have a very mild case of prostate cancer but a bad case of BPH. You can solve your BPH problem with an RP but your sex life will suffer and those Cialis commercials will become a lot more interesting. For some men the BPH causes so many problems that an RP would seem to make sense; you will have to decide on that one. Your PC is something you can ponder over the next few years. Watchful waiting (getting regular PSA tests) would seem to be the best idea for now. You might even get away with a biopsy only if the PSA (or PCA-3) starts going up.
Thanks Frank..
The Urologist thought I might be able to get the HoLEP to relieve the BPH, then just watch the PSA and do a biopsy once a year, if I thought I could live with it. He also told be that I could do the RP or radiation and I think the number of choices and lack of familiarity with the disease process just has me somewhat confused. I read the Johns Hopkins watchful waiting criteria and I seem to fit the category of low risk but still kind of weird thinking about just not treating it at all.
Aloha BS65,
Any treatment has side affects with a wide potential for each individual. All you half to do is decide whether those treatment side affects are worth treating what you are putting up with now. I know that we each have hope that this choice of treatment will make things better. In a way this type of thinking is not good. Accepting where you are now, living with what you have is in the long run a better way to go. All we can do is wish you the best of luck in your journey and may all your side affects be little one's.
Joe
I concur with the suggestion that you do not treat your prostate cancer as needing immediate attention. I've had surgery myself and it has worked well for me. However I do not think you should do the same at this point. If the DRE's are good and the PSA does not rise significantly then watchful waiting is appropriate. I don't have any knowledge to share regarding the other issues.
Thank you folks for all the great advice. I have settled somewhat since the initial shock of the diagnosis and have decided on a plan that I believe makes the best sense for me.
I am talking to a radiologist to discuss my options there on Friday. That will complete consultations with Oncology, Urology and plan to have my pathology re-read by another lab.
In April I am having the HoLEP performed to reduce the size of my prostate and relieve the outlet flow obstruction and the have the pathology read on that tissue which I hope will yield about 30 G. If this shows no worse cancer than the 3+3=6, I plan to pursue Active Surveillance with Vanderbilt or Johns Hopkins.
Hoping I am making the right call as I work my way through the maze and once again appreciate all of you.
Thanks Terry.
Your decision process and posts give me great encouragement that I am on the right track for me.
I am to meet with Dr Ballentine Carter at Johns Hopkins in Baltimore on the 28th of this month to discuss the Active Surveillance program and study they are conducting. My pathology is being re-read at Johns Hopkins as we speak and if they concur with Vanderbilt's reading, I believe it is the right road for me.
My current plan, unless it is derailed at that meeting, is to proceed with the HoLEP procedure at Vanderbilt on April 25 to reduce the BPH symptoms and then join the study.
I hope that my journey goes as well as yours seems to be going and each day brings new hope for better answers and treatments for Prostate Cancer.
God Bless and Thanks Again.,
Bill
Hey folks,
I realized I have been negligent in my follow up when I received an email from a new friend having similar issues.
First let me thank those who took the time to read about my problems and offer advice and compassion.
I decided to go with the HoLEP procedure for the urinary outflow issues and to monitor my PC by Active Surveillance. I had the surgery on June 25, 2012 after consults with Johns Hopkins Dr. Carter, Dr. Burris at Tn Oncology here in Nashville and Dr. Miller at Vanderbilt.
Dr. Nicole Miller performed the HoLEP surgery with Dr Sawyer on the last procedure of his fellowship. He is now in Virginia and I would highly recommend him to anyone. The surgery was completed on that morning and I stayed overnight in the hospital at Vanderbilt with no complications. The flush catheter was removed at about 5 a.m. and after about an hour I urinated with no problem. After my second urination I was discharged around noon and went home.
I had no pain, bladder spasms problems other than taking a daily nap for the first week, which is unusual for me. I was on lifting restrictions but able to get back on my treadmill, level and a slightly slower pace in about 5 days. Went out to eat and because I was passing blood (pink) at the beginning of the stream, Dr Miller had me take it easy for the first six weeks just to play it safe. At my checkup my flow was 792 ml at 39 ml/sec. I had some minor incontinence for about 2 weeks when I moved in such a way that pressure was applied to the area or I sneezed, etc.
No problems now.
Dr Miller decided that my biopsy was proven accurate when there was no cancer found in the 30 grams of tissue removed. I have a small amount of 3+3=6 gleason, 5% in 2 of 9 cores on the left side periphery.
I go for my first PSA on Oct 9 to get a new baseline and we will follow the Active Surveillance guidelines along with the VA and my AO buds.
Thanks again for the support and wanted to let you know how things were going. Too many times when it goes well we don't let other folks know and I wanted to make sure to do my part.
