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Re: Advice please!

Good luck Will. I have been there and I know how scary it is. My advice is learn as much as you can about the disease and it will help you better deal with it. Be advised there are many differing opinions by health care professionals and men that have prostate cancer. Learn what you can and pick a treatment that you are comfortable with. This web sight is a great place to start. I would also recommend the book "Invasion of the Prostrate Snatchers" by Blum and Scholz.

Re: Advice please!

Sorry to read of your diagnosis Will. Your anxiety, depression (and possibly anger?) are all part of the emotional mix we have all had to deal with. It probably doesn't help to hear me say "It will get better.", but it will.

One of the most heartwarming experiences I have had in running this site for fifteen years now (I started a year after I was diagnosed back in 1996)is the fact that most men say, once they have recovered from the intial shock; once they have made their decision as to what therapy suits them and once they have been through the therapy, "There is a life after a prostate cancer diagnosis - and now I know how important that is."

From what you have said it seems you have done the basic work and made a decision that you feel comfortable with. Just one point that wasn't clear from your post. How many of the 12 cores were positive? And did you get a second opinion on the Gleason Scores from one of theRECOGNISED EXPERT PATHOLOGISTS . That is something I believe everyone should consider seriously.

Good luck, whatever ath you choose. Read through the stories of men who have gone before you and see how long they have survived and how they live their lives.

Terry in Australia

Re: Advice please!

All twelve cores showed prostate cancer of at least 6 on right and 7a on left :(
I could get a second opinion on it but if it was just a couple of cores I might have question....

Re: Advice please!

Will,

Since you say you have twelve positvie cores, that would indicate a high possibility of a large tumour. There are some studies that imply a higher probability of the disease having spread beyond the gland or the casule where the tumour is large.

For that reason, having confirmed that all biopsy results are positice and are graded correctly, I suggest that you try to establish more accurately the size of the tumour. Whilst MRI and CT scans are unreliable for very small tumours, they can usually detect large ones. If you can, perhaps a Color-Doppler would give an even more clear picture.

The point of this post is that, if there is a large tumour and a higher probability of escpe from the gland, surgery may not be the most appropriate choice.

All the best
Terry in Australia

Re: Advice please!

Thanks,
I am scheduled for an Endorectal MRI in 3 days.
The doc said the same thing, but wanted to make sure I had a date, so that i may have surgery if he suggests it proper after looking at the MRI.

Lets just say that surgery may not me the best option, what do you think would be?
Thanks for any info.
Will

Re: Advice please!

Will,

I don't know if you have read any of the E-Letters I try to send out from month to month. If not perhaps you'd like to just have a quick read of the short piece headed Metatasized Disease in E-Letter 9 .

The reason I am suggesting this is because if the tumour is as big as the current pathology report implies, there MAY be a greater chance that the disease is possibly out of the gland or even "systemic" or "micrometastatic". The difference between "systemic" and "micrometastatic" being that in the former, inactive cancer cells might be lodged in remote parts of the body: in the latter cancer cells might be active even if they were unidentifiable. Size is a factor in trying to estimate the probability of escape from the gland, but this is less likely with low Gleason Scores - hence my repeated suggestion to have a review of your pathology.

IF there is this greater probability, then it may be better to consider a wider therapy - radiation: proton or photon/ brachytherapy or EBRT (External Beam Radiation)which would deal with the gland and the capsule and/or ADT (Androgen Deprivation Therapy).

I think it unlikely that there willbe any clear evidence guiding you to one specific therapy, but I do think that having surgery on November 29 may be rushing into a life changing treatment (all prostate cancer treatments are life changing) before you have fully explored the diagnosis or your options. I say that, not critically, because I fully understand the kind of reactions we all have to the word 'cancer' being applied to us, but I also know that many men wish they had spent more time gaining a better understanding of their options and the likely outcomes.

I don't know if you have been through the site page by page, starting at the page labelled DON'T PANIC but it may be worthwile spending some time doing just that. If that is more than you want to do, then can I suggest you follow the pointers in the page labelled SURVIVING PROSTATE CANCER and especially the section on that page headed ASSESS STATUS BEFORE DETERMINING STRATEGY.

Good luck to you whatever your decision - keep asking questions. Oh and please let us know how you go by sharing your story with us .

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