Help!

I'm 57y.o. just diagnosed with pc.  My cancer is extremely small, my prostate is extremely small based on rectal exam, cancer in one quadrant and has not spread, my Gleason is 3+3, and I had biopsy because PSA went from .6 to 1.3 in one month.  I obviously have been seen by my urorologist who insists I do something and reccod brachy.  I saw a medical oncologist who reccod active surveillance as did the chairman of the  urology department at Univ. of Miami.  I have read about proton therapy and hifu.  With radiation I was told that it could give me other types of cancers.  With hifu, i was informed that a downside is that the cancer may simply go into remission.  I have no idea regarding side effects of this treatment which is a question in itself.  Plus, i'm learning that the cost is astronomical and not necessarily convered by insurance.  I have additionally talked to other pc patients and they had surgery.  My niece who is brilliant and in med. school feels strongly that the only answer is surgery (by the way, she is not going to become a surgeon). 

So, there it is.  My head is spinning.  I want to feel comfortable with active surv. however I dont know if I will become anxious by virtue of doing nothing and knowing that I have cancer in my body.  Also, I read articles that are not in favor of this approach.   I am emotionally drained and having a hard time focusing on my work-i am a clinical psychologist.  My wife says she understands what i'm going through however she tends to minimize illness and bury her head in the sand.  If I hint at being down/depressed, she questions why seeing as the cancer was detected early and the doctors don't appear to be that concerned if they are suggesting active surv., etc.   I realize I have to make my own decision about what to do.  It's that there are so many options which is both good and bad cause lit eads to a lot of "mental masturbation" that in turn gives rise to anxiety, depression, and confusion.

 I welcome feedback.

"I saw a medical oncologist who reccod active surveillance as did the chairman of the urology deparment at Univ of Miami"

Therein is your answer.

" My niece who is brilliant and in med school feels strongly that the only answer is surgery (by the way she is not going to become a surgeon)."

She could well be brilliant. (by the way, she is not a medical oncologist or chairman of the urology department at Univ of Miami either)

Your wife might not tend to minimize illness as you suggest: maybe she thinks  that the medical oncologist and chirman of urology deparment  know what they are talking about

Ventana:

I hope this will help to reduce the head spinning. YOU ARE NOT GOING TO DIE FROM THIS. 

Your numbers and your PROFESSIONAL recommendations are that this is eminently curable, even without treatment at this time. You have a small, non-aggressive cancer, identified early, and you are advised, and supported by top area specialists. You have time to think about this, read, study and reflect. For now the best course for you is to decide NOTHING. Reflection and time will supply the necessary consideration to make the best, most informed decision. Once you are an informed and balanced student of this disease you will be ready to move forward confidently and without regret. You are a lucky man, in the context of this disease. I hope that in your professional life you suggest to others to listen to those close to you who know the most and love you the most. I think that your message above suggests your course of action.

Ventana,  Take a deep breath.  My husband was diagnosed in Oct 07, PSA 3.4, Gleason 3 + 3.  He had a radical robotic surgery in late Dec.  He is doing remarkably well.  After seeing two urologists and a radiologist, we decided on the surgery.  In addition to lots of internet research, talking w/ other PCa survivors (friends of friends, cousin's husband, etc) we also attended a PCa support group meeting.  The support group meeting gave us an opportunity to openly discuss the "full spectrum of treatments" w/ actual patients, rather than just hearing statistics.  Good luck in your decision.

On 2/27/2008 ventana110 wrote:

I'm 57y.o. just diagnosed with pc.  My cancer is extremely small, my prostate is extremely small based on rectal exam, cancer in one quadrant and has not spread, my Gleason is 3+3, and I had biopsy because PSA went from .6 to 1.3 in one month.  I obviously have been seen by my urorologist who insists I do something and reccod brachy.  I saw a medical oncologist who reccod active surveillance as did the chairman of the  urology department at Univ. of Miami.  I have read about proton therapy and hifu.  With radiation I was told that it could give me other types of cancers.  With hifu, i was informed that a downside is that the cancer may simply go into remission.  I have no idea regarding side effects of this treatment which is a question in itself.  Plus, i'm learning that the cost is astronomical and not necessarily convered by insurance.  I have additionally talked to other pc patients and they had surgery.  My niece who is brilliant and in med. school feels strongly that the only answer is surgery (by the way, she is not going to become a surgeon). 

So, there it is.  My head is spinning.  I want to feel comfortable with active surv. however I dont know if I will become anxious by virtue of doing nothing and knowing that I have cancer in my body.  Also, I read articles that are not in favor of this approach.   I am emotionally drained and having a hard time focusing on my work-i am a clinical psychologist.  My wife says she understands what i'm going through however she tends to minimize illness and bury her head in the sand.  If I hint at being down/depressed, she questions why seeing as the cancer was detected early and the doctors don't appear to be that concerned if they are suggesting active surv., etc.   I realize I have to make my own decision about what to do.  It's that there are so many options which is both good and bad cause lit eads to a lot of "mental masturbation" that in turn gives rise to anxiety, depression, and confusion.

 I welcome feedback.

I have PC, PSA 76.41 and Gleason 9.  I had radiation.  I have not heard of other cancers caused by radiation, can you explain?  Thank you

ventana,

While you are evaluating your options make sure you frequently monitor your PSA velocity.  57 yrs old is young.  Do not base your choice of treatment on hear-say.  You should do the research on the success rates and side effects of all alternatives, including cryo, hifu, surgery and radiation.  Best of luck.

bayman16 

On 2/28/2008 Johnw100 wrote:

"I saw a medical oncologist who reccod active surveillance as did the chairman of the urology deparment at Univ of Miami"

Therein is your answer.

" My niece who is brilliant and in med school feels strongly that the only answer is surgery (by the way she is not going to become a surgeon)."

She could well be brilliant. (by the way, she is not a medical oncologist or chairman of the urology department at Univ of Miami either)

Your wife might not tend to minimize illness as you suggest: maybe she thinks  that the medical oncologist and chirman of urology deparment  know what they are talking about

 

 

 

Thanks for responding.  I appreciate your comments!

On 2/28/2008 Thoosier wrote:

Ventana:

I hope this will help to reduce the head spinning. YOU ARE NOT GOING TO DIE FROM THIS. 

Your numbers and your PROFESSIONAL recommendations are that this is eminently curable, even without treatment at this time. You have a small, non-aggressive cancer, identified early, and you are advised, and supported by top area specialists. You have time to think about this, read, study and reflect. For now the best course for you is to decide NOTHING. Reflection and time will supply the necessary consideration to make the best, most informed decision. Once you are an informed and balanced student of this disease you will be ready to move forward confidently and without regret. You are a lucky man, in the context of this disease. I hope that in your professional life you suggest to others to listen to those close to you who know the most and love you the most. I think that your message above suggests your course of action.

Thanks for your response.  I appreciated  you taking the time to answer my message. 

On 2/28/2008 Censusgirl65 wrote:

Ventana,  Take a deep breath.  My husband was diagnosed in Oct 07, PSA 3.4, Gleason 3 + 3.  He had a radical robotic surgery in late Dec.  He is doing remarkably well.  After seeing two urologists and a radiologist, we decided on the surgery.  In addition to lots of internet research, talking w/ other PCa survivors (friends of friends, cousin's husband, etc) we also attended a PCa support group meeting.  The support group meeting gave us an opportunity to openly discuss the "full spectrum of treatments" w/ actual patients, rather than just hearing statistics.  Good luck in your decision.

Thanks for your thoughtful comments.