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new diagnosis

Just turned 50 and got my first PSA test 9.1 went to different Doc he checked again PSA 8.3 free PSA 10%
Sent to Urologist he took biopsies and just got results two 3+3=6 and 3+3=6 and a 3+4=7
Now they want to do CT scan and Bone scan next week. I do not no what to think. Feel like sticking my head in the sand and doing nothing as the side effects scare me more than the fear of cancer.
Any thoughts please.

Re: new diagnosis

Ducman,

Can you give us more info: mm length of cancer and mm of gleason 4 in the 3+ 4 sample. I would like to suggest a mpMRI (multi parametric MRI) with a Tesla 3 or 1.5. This imaging will not pick up low volume gleason 6 tumors but will identify the higher gleason tumors that might be missed by the TRUS biopsy. You could also request that your biopsy slides be sent for a second opinion to John Hopkins. Do you have enough prior PSA tests to calculate you PSA doubling time.

Fred

Re: new diagnosis

Ducman, I think that it best if you are "proactive" given your circumstances. "If" you are a candidate for the seeds I hear there are fewer potential side effects. I'm not a doctor. Whatever route you decide to take in conjunction with your urologist, I feel it's time to get cracking and get cured ( or as close as possible to it ) given your #'s.

Re: new diagnosis

Thanks everyone for the replays not sure of size I will have to find that out next week.

Re: new diagnosis

Let me assure you:(1) most of us who participate on this site know exactly how you feel, and (2)a diagnosis of prostate cancer is not a death sentence, the latter is especially true for a Gleason score of 3+3 or 3+4.
Now is the time for research; a process you have begun through your participation on YANA. A good next step would be to get a hold of Bob Marckini's book "You Can Beat Prostate Cancer..." This book is readily accessible, an easy read and well worth its modest price. I suspect you will find his detailed discussion of most of the common methods for treating prostate cancer helpful.
Best wishes.

Re: new diagnosis

Hi Ducman,
It take's a while to get your head around around the fact that you have been diagnosed with prostate cancer (PCa). But with your figures stated, you won't be moving upstairs any time soon. Use your time now to do some research on the various treatments, which may be offered to you by your treating physician. I suggest this path as ultimately it will be you that will be making a treatment decision, even if that decision is not to have treatment. Being knowledgable about treatment options, will facilitate a well informed decision by your good self.

Do feel free to bounce any questions off us, just bear in mind that their may be different viewpoints in the answers you receive. We are all on the same journey, some of us just choose to utilise a different mode of transport that's all. My best wishes go with you, now your journey too has commenced.

best wishes
john

Re: new diagnosis

Don`t stick your head in the sand, as you have plenty of time to do a lot of research in to treatments.It may be a bit nerve racking, but you have started on the track buy getting a second opinion at an early stage. Best of luck Bob

Re: new diagnosis

Thanks everyone you are making me feel better. I go for my CT scan and bone Scan Thursday

Re: new diagnosis

Greetings

How well we remember hearing the verdict, prostate cancer. My father passed away after it had spread throughout his body, in 1972, so I had time to do some research. Still the fear of cancer I could feel in my body, and it wasn't until I did some research that I could calm myself.

Mentioned earlier twice I believe, the Bob Marckini book is excellent, and discusses what I thought looked like a better solution for me than surgery, that is Proton Radiation. I was carrying considerable fear because of the possible side effects of surgery or radiation, as I had also read Dr. Patrick Walsh's book, 'Guide to Surviving Prostate Cancer', and viewed the fine line drawings of surgery procedures which showed the proximity of the nerves in the area. Yes, they are very close. So basically the fear of side effects made me decide upon the Proton Radiation Therapy at Jacksonville, Fla.

My Psa was in the 8 to 10.0 range when I arrived at the UFProton Center in Dec 2008 for 39 treatments. That's me in the yellow gantry in the pictures on my page. What surprise I had walked into, it was a country club setting. I rented a room for my dog and I and set out sightseeing Jacksonville. Once a day I would drop by the Center for a cup of water and a treatment, about 45 minutes, then free for the day. Truly a country club atmosphere as they provided lectures and lunches, golf and beaches...... to tell you the truth, today I feel as if I never had had any prostate cancer, and my only side effect is a slight bloody stool discharge about every 6 months. My Psa had shown the classic rise, an upward exponential growth curve spiking at the 9 to 11 area, then following treatment it plummeted straight down and leveled off at the 0.9 area.

Best wishes, and don't let those fears get you....

charley

Re: new diagnosis

Got my CT scan and bone scan today, now have to wait to Mar. 23 to see Doc. Has anyone heard much about HDR Bracheal Radiation treatment it sounds like a pretty good way to go.

Re: new diagnosis

My reaction to this thread is a bit different than some of the others. First, I'd say whoa, do research yourself and talk to your doc and then start narrowing down treatment alternatives. For now, open mind, you're learning.

I'd also suggest you have a spouse or close friend get involved with you in detail to give you a live sounding board and another set of ears when you talk to your doctors. And to help you with finding the right treatment.

I don't know why your doc says it'll be March 23 before you get to see him. That kind of delay is uncalled for in my opinion. Can you do something about that?

Finally, a very satisfactory outcome is highly likely for you. Put your mind and energy into good and timely decision making in the meantime. I know this is a big shock, we in this group have been there. We are reassuring with good reason, not just being nice.

Re: new diagnosis

Ducman,
The reason you have to wait so long is they know that nothing will be seen on the scans (and they shouldn't have bothered doing them).

You are low to intermeadiate risk and have lots of time to decide on what you want to do. If I was in your position I would opt for active surveillance. Once you get Gleason Score of 4 & 3 it is time to act. As I've commented numerous times "the longer you wait the better the treatment outome and side effects will be"

Re: new diagnosis

Thanks Billy for the info

Re: new diagnosis

Hi Ducman,

You should know that the National Comprehensive Cancer Network (or NCCN, for short), which is a non-profit alliance of 25 of the world’s leading cancer centers, has an active surveillance (AS) protocol, REGARDLESS OF AGE, for patients with either very low risk or low risk cancers. Among other criteria, a patient must have a Gleason 6 (or less) cancer in order to fit into either of those two categories. A Gleason 7 patient, whether they be a 3+4 or 4+3, is considered to be an intermediate risk, and they do not support AS as an option at that risk level if you have 10 or more years of life expectancy left. To learn more, you can Google "NCCN guidelines for prostate cancer".

Personally, I agree with their guidelines, and the only time that I have read about the acceptance of Gleason 3+4 patients into an AS program is when they were over 70 years old (that was in Dr. Klotz’s Stonybrook active surveillance study).

From reading your posts, I could be wrong, but I got the impression that you weren’t considering AS anyway. Just in case you are, though, I have to respectfully disagree with Frank and say that, IMO, it is not a safe strategy at your risk level.

Good luck with whatever you decide. Be well,
Alan M in the USA (practicing AS since 2007)

Re: new diagnosis

Sounds like good advice to me Ducman.
best wishes
john

Re: new diagnosis

Thanks NCCN is a good read and very informative

Re: new diagnosis

From a physician survivor, who did a lot of research before making a decision:

It sounds like you have an intermediate risk tumor; for such tumors, some radiation protocols provide significantly higher cure rates than surgery. This is not a just matter of opinion; there is solid data to support this.

The information is summarised in an article which compares cure rates for many different treatment options. If you seek complete cure, it tells you what you need to know to decide on treatment which maximises your odds for cure. It does not address side effects or social considerations; it is not the whole story, but a very big part of it. The data is presented graphically, relatively easy to understand. Many well educated layman will be able to understand the results; any doctor can (if he/she can't, find another doctor).

The article is "Comparative analysis of PSA free survival outcomes....", by Grimm et. al., British Journal of Urology International, Supplement 1, 2012.

I can email a copy to you or your doctor. The important data is in color diagrams; color reproduction is a must.

I advise you to consult a radiation oncologist at a university center. There you can be sure that the doctors will be familiar with the medical literature on the subject, and can advise you accordingly.

Some non-university centers can offer equally good information and treatment, but how is a layman to know which ones? This is why I recommend a university center. If there is a good center closer to you, they can tell you about it. Do not be swayed by advertising or recommendations from friends. Go to a pro; your life is at stake.

There is more detailed information in my Survivor Story, and I am a registered mentor.

Brooke Jennings, MD

Re: new diagnosis

Thanks for the advice and I would greatly appreciate a copy to read. Can you see my email from post or do I need to send it to you.

Will this get through?

Fred

I previously tried to reply using Firefox, but the Reply button didn't work. I am trying again with Chrome.

Will it go through?

Brooke

Re: Will this get through?

Hey "Ducman", I gotta tell you that I love that name Ducman. Well done.

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