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Recently Diagnosed

Biopsy 2/11/16
Gleason 8
13 out of 14 cores positive
PSA 6.7 (on Avodart)
CT Scan w/o contrast negative
Bone scan negative
Age 69
Pretty good health
Height 6'0"
Weight 258 pounds

Local Urologist who did biopsy wanted radiation with Lupron

2nd opinion at large hospital in South Florida - Urologist - radical prostatectomy

Radiation Oncologist also recommended surgery then radiation if needed (he owned a radiology company)

Surgery set for 5/20/16 - disappointed as I want it sooner and may entertain other surgeons and hospitals -

Re: Recently Diagnosed

Found this study - interests me as a Gleason 8 who is having a prostatectomy

Long-term outcome following radical prostatectomy for Gleason 8-10 prostatic adenocarcinoma- Analysis of 75,416 patients

Abstract: 717
Date & Time: May 5, 2013 03:30 PM
Session Title: Prostate Cancer: Advanced (I)
Sources of Funding: None

Introduction and Objectives
This study evaluates the long term survival following radical prostatectomy (RRP) for non-metastatic Gleason 8-10 prostate adenocarcinoma. (CaP)

Methods
All patients that were 75 years or less with Gleason 8-10 CaP that underwent RRP were identified form the SEER 18 database. Patients with metastatic disease, other modalities of treatment, with more than one primary cancer were excluded. Data was analyzed for demographics, stage at presentation, treatment modality and overall (OS) and cancer specific survival. (CSS).

Results
75, 416 patients were identified. The mean age was 61.4 years (range 26-75), 81.5%(n=61494) were white, 12.3% (9307) were Black and 6.1% (4615) belonged to other races. 46,286 (61.4%) patients also underwent Pelvic lymph node dissection (PLND) and 6167 (8.2%) patients underwent adjuvant radiation after surgery. The OS was 94%, 80%, 38% and 18% at 5-, 10-, 20 and 25-years respectively. The corresponding CSS was 94%, 88%, 68% and 64%.

The OS in patients that underwent PLND was 95% and 84%. There was no significant survival difference in the CSS in patients that underwent PLND or RRP alone. The CSS was 98% and 92% in PLND and 98% and 94% at 5 and 10-years respectively in the RRP alone group.

The OS in patients that received adjuvant RT was 90%, 70%, 38% and 18% respectively and the CSS was 94%, 78%, 58% and 48% at 5-, 10-, 20- and 25- years respectively. The CSS for patients that did not receive adjuvant RT was 98%, 91%, 70 and 65% at 5-, 10-, 20- and 25- years respectively.

Conclusions
Excellent long term survival can be achieved with RRP for G 8-10 Cap. PLND for these patients does not seem to increase survival significantly. Patients that required adjuvant radiotherapy had a significantly poorer survival when compared to patients that did not require adjuvant radiation.



Authors

Pokala, Naveen (Columbia, MO); Trulson, Jerry; Kiran, Ravi

Re: Recently Diagnosed

It would seem that your weight is the biggest threat to your life. It will make the cancer harder to kill with radiation, harder to operate on and seems to reduce the bodies ability to kill off cancer on its own. At least make sure you are getting a lot of exercise during cancer treatments even if you can't lose the weight (I know only too well how hard it is to lose it.)

Re: Recently Diagnosed

Hi Frank-

You are right, I wish I could lose 30 pounds and in a hurry -While I do have a gut, my weight is pretty evenly distributed and arms and legs are solid - the surgeon assured me he will not have a problem with my weight.

Although, I may post-surgery.

Re: Recently Diagnosed

The problem is not so much with the excess weight externally but with that unseen around the internal organs. I'm a bit older than you and an inch taller and at one time was 240 lbs. Despite all the treatment, I have been able to get that down to 220 lbs and maintain that level and that's with carrying excess fluid thanks to some lymphoedema following the lymph nodes being removed with my bladder and prostate three years ago. I never felt unfit, before whilst heavier, but I'm certainly a lot better now. The PCa may eventually kill me but I sure as hell don't want to lose out to heart trouble or a stroke meantime. You might feel the same.

I would advise getting that excess weight off through increased exercise and controlling your diet. A rate of a couple of pounds a week should be easily achievable and pose no risk.

Good Luck with that!

OC in England

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