This forum is for the discussion of anything to do with Prostate Cancer. There are only four rules:
No fundraisers, no commercials (although it is OK to recommend choices of treatment or medical people based on your personal research; invitations to participate in third-party surveys are also acceptable, provided there is no compensation to YANA);
No harvesting e-mail addresses for Spam;
No insults or flaming - be polite and respectful at all times and understand that there may be a variety of points of view, all of which may have some validity;
Opinions are OK, but please provide as much factual evidence as possible for any assertions that you are making
Failure to abide by these simple rules will result in the immediate and permanent suspension of your posting privileges.
Since this is an International Forum, please specify your location in your post.
Rodlift, I do not in anyway want to add anxiety to your situation, just communicating information--which you may or may not already be aware of..if I missed it in the discussion, I apologize in advance. The reason I am posting is, your current PC status is very similar to what mine was 9 years ago. I had surgery, and the pathology changed some of the caner from 6 (which it was at biopsy) to 3+4, 7..I would not have know this unless I had the surgery. I am no expert, but seem to recall that often an "upgrade" can/does occur when the entire gland can be analyzed. Again, just information based on very close similarity to your case.
I had surgery when I was 59. My Gleason was also upgraded from 6 to 7 after surgery. Had to undergo salvage radiation and hormone therapy. Wish I would have had surgery a year or two earlier. Good luck with decision.
I, too, had 5 of 12 cores positive. That was back in 2012. My Gleason, however, was 7(3+4); and my percentages were %100, a couple %80, and the other 2 over %50. I chose to go with surgery, mostly because I wanted to know exactly what I had.
That said, while 5 cores is bad; its still less than half. And your low percentages are a plus; not to mention the Gleason 6. I know the temptation is to just get it out as quickly as possible. But you have to remember that PCa is very slow-growing. Even with my biopsy numbers; which I received in January of 2012; I still didn't have my surgery until April of 2012. You have some breathing room. Wait until the emotions settle down before you make any decision.
A Gleason 6 is a good candidate for AS. Five cores is probably borderline; but still doable. You do have to weigh it against the side effects of surgery. Two years after surgery, I still wear a light pad every day. Most days I don't have any problem; but every now and again I will squirt when I stand up too fast, or if I cough too hard.
I already had ED pretty badly from Type II diabetes; but the surgery completely took away what function I did have. That is still the case. Now, my final pathology numbers were bad. My Gleason was upgraded to an 8, and the cancer had escaped from the capsule; so my surgeon had to be aggressive in his cutting, and was unable to do any nerve-sparing, so that attributed to the ED. Your case may be completely different; but you still have to weigh the possibilities.
Remember that AS doesn't mean you do nothing. The doctor keeps an eye on things. If your PSA continues to rise, then you can always opt for another treatment. But don't feel like you have to decide right now. You have plenty of time, with your numbers. And while quality of life does not trump life; it does make a difference. I know that I made the right decision; especially with my final pathology numbers; but living with the side effects is no picnic.
More than happy to share with you my experience with PC. My story is very similar to yours. I am 56, in Jan 2014 I was diagnosed with PC. Previous PSAs were in the low 2's spiked to 5.4 in Oct 2013. Biopsy came back with 5 of the 12 cores as positive at a 3+3=6 Gleason. I suffered with BPH for the past 5 years and going to the bathroom frequently was getting old fast. Due to my age and large prostate I elected robotic surgery to remove the prostate.. Surgery pathology showed that the cancer was confined to the prostate. Gleason score remained the same. Today, marks 6 weeks since I had the surgery. No complications, no issues with incontense, ED gradually getting better. If you go with robotic surgery make sure the surgeon has performed many. Best of luck to you!
Randy, thank you for the post. Very encouraging to me. I am looking at the robotic surgery, Dr. Brian link in Oklahoma City, has done 700 of them. I wish I could find out more information, but it appears he has done quite a few. In your opinion, does this qualify as a experience surgeon? It is very difficult to find out information on these doctors. I did go and consult with him, and he seemed very confident. Best of luck to you, and thank you for taking the time to reply. I very much appreciate it.
After looking at all angles, I have decided on removing my prostate. That was a big hurdle to cross, but feel most comfortable with this decision. Now I am faced with the decision to use DaVinci method or have my urologist do an open procedure. Here is my delima: The surgeon I am seeing says he prefers open, and he did a friend of mine 10 years ago with outstanding results. But he is getting older and does not do as many as he used to. ( has done about 400 total) The Dr that does the Davinci (Dr. Brian Link in Oklahoma City) Has done over 700 of these (the most in Oklahoma) What is your advice? Can you reasearch Dr Brian Link and Dr Richard Herlihy? I can't find much other than generic. I want to be sure I get the best treatment. Both seem very confident. Any help is apprciated.
From my reading it would seem like open may be slightly better IF the surgeon is a top one - tricky definition. Otherwise a highly recommended and experienced robotic surgeon may be preferable. I had an open surgery after switching from an older experienced surgeon to a younger more modern (and reputed to be gifted) one and am very glad that I made that choice. He did the operation in 48 minutes vs likely a 4 hour operation with the older fellow. No real pain afterwards other than one episode of gas afterwards. Spent 48 hours in the hospital. I agree with your decision to get rid of the cancer one way or another given your particulars. One needs to walk a lot after the surgery to reduce gas - and to speed recovery. Take laxatives afterwards and have a bunch of books ready to read.