Diagnosed with prostate cancer and worried!!!

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Diagnosed with prostate cancer and worried!!!

by John-Can on Sat May 19, 2018 06:04 PM

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Dear all,

I was diagnosed with prostate cancer a few days ago and my urologist says, after introducing the results of the biopsy, that I need treatment. My last PSA was 5.76 and out of 12 cores, I have 6 cancerous cores. All are grade T2 and their Gleason scale score is 3+3=6. My urologist says all these cores are located on the right lobe of my prostate gland and they are confined to prostate gland. I requested a CT scan, MRI scan and bone scan to make sure that there is no spread, but the doctor says there is no need for MRI and bone scan and only CT scan is needed. I am extremely worried and confused because I don’t know what to choose for treatment, radical prostatectomy, radiotherapy (external beam, brachytherapy) or cryotherapy. Please help me, I want to hear your opinions. Any comment or advice will be highly appreciated.

RE: Diagnosed with prostate cancer and worried!!!

by Jaimeizquierdo on Sat May 19, 2018 07:13 PM

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On May 19, 2018 6:04 PM John-Can wrote:

Dear all,

I was diagnosed with prostate cancer a few days ago and my urologist says, after introducing the results of the biopsy, that I need treatment. My last PSA was 5.76 and out of 12 cores, I have 6 cancerous cores. All are grade T2 and their Gleason scale score is 3+3=6. My urologist says all these cores are located on the right lobe of my prostate gland and they are confined to prostate gland. I requested a CT scan, MRI scan and bone scan to make sure that there is no spread, but the doctor says there is no need for MRI and bone scan and only CT scan is needed. I am extremely worried and confused because I don’t know what to choose for treatment, radical prostatectomy, radiotherapy (external beam, brachytherapy) or cryotherapy. Please help me, I want to hear your opinions. Any comment or advice will be highly appreciated.

Sorry to hear this John, I am about to see my urologist because my PSA came back 5.8. May I ask you if there was any bacteria involved in the disgnosis? I work with diet and natural healing and would be interested in this information. I know of one individual that recuperated through conventional treatments but also heard from alternative cures such as Apex hydrogen water. I write about cancer treatmen information you might want to explore. My website is www.bodytalkmiamibeach.com . Please let me know if any of the information is of any help to you. I wish you promp recovery

RE: Diagnosed with prostate cancer and worried!!!

by StackPointer on Sun May 20, 2018 03:39 AM

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I’ve been through this process over the last year. You should take control of this problem now and go to a modern facility that has the capability to perform genomic testing and 3t multiparametric MRI. I went to a medical school with a genitouronary oncology department. My oncologist, before I saw him, ordered my slides from the pathologist and had them re-evaluated by a pair of pathogists who specialize in prostate cancer. I went from 3+3 to 3+4. Then, they sent the slides for genomic testing to establish the aggressiveness of the cancer. If the cancer is not aggressive, you could have the option for active surveillance instead of surgery, depending on age. While waiting on that, I had the MRI and that report came back showing a 1.2cm tumor and a 4mm tumor, but no indications of surrounding structures. Because my cancer was aggressive (moderately, I think) I am having robotic surgery this week. Our nearby facility is small, with a long line waiting on the robot. And I had to reschedule the first date. My point: a urologic cancer specialist at a large facility is worthwhile. I live in a small town and you cannot get advanced services in a small hospital. Also, they may want to order the ct and bone scan. That seems typical for 3+3. A second opinion on the pathology is ESSENTIAL. Two excellent pathologists can have different opinions on the grading. Take control today. FWIW.

RE: Diagnosed with prostate cancer and worried!!!

by Jaimeizquierdo on Sun May 20, 2018 03:10 PM

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Thank you for the advice John; I am seeing a harvard educated urologist at Mount Sinai in Miami Beach but depending in the diagnosis will get a second opinion.

RE: Diagnosed with prostate cancer and worried!!!

by Himads on Sun May 20, 2018 06:32 PM

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Hi John,

I just went through this process. I was diagnosed with prostate cancer in February with a Gleason of 6. 6 of 12 cores positive (highest PSA was 5.9). I looked at several of the options - robotic assisted radical prostatectomy, radiation, or active surveillance. I selected the radical prostatectomy and had this done two weeks ago. Post surgery, the pathologist report on the excised prostate gland was a Gleason of 7. I did take some time to research the options and surgery, to me, was the best one. I ruled out radiation because it is difficult to do surgery on the prostate following radiation treatment. I figured I would save the radiation if the cancer had spread to other areas. Fortunately for me my margins were clear so it appears no spread of cancer to other areas. 

Yeah, it's a tough decision but you have some time to make yours. Don't feel as though you have to rush into anything. Saying that, however, I made my decision in about 2 weeks after consulting with the surgeon and radiologist. I went to a major medical center in Florida to have my procedure done and the surgeon was excellent.

For me, I did not consider non-medical, alternative therapies. This appeared too risky. I had a healthy lifestyle and took many of the supplements that alternative treatments suggest. Active surveillance also appeared too much of a risk. While I may have waited another year and monitored with PSAs and an additional biopsy, I decided that I did not like the "ticking time bomb" aspect of the prostate cancer. Also, other than the cancer, I am healthy and did not know how my health would be in a year if I waited to do surgery.So , I decided to take it out. For me, this was the wisest course.

I am now two weeks post surgery and doing reasonably well. I am having some urinary problems but it's not too bad. The surgeon spared as many of the nerves as possible. The urinary catheter was a novel experience for me, but I got used to it after a couple of days. The catheter was removed 8 days post surgery.

If you don't have a copy, "100 Questions & Answers About Prostate Cancer: Fourth Edition" is really good. I initially got it through library loan and was so impressed with it that I ordered a copy from Amazon.

OK, John, that's it. If you have any questions about the procedure and recovery, I will be happy to answer.

Himads

RE: Diagnosed with prostate cancer and worried!!!

by John-Can on Mon May 21, 2018 05:26 AM

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Hi Himads,

Thank you for your valuable imput. I would like to know how long your surgery took and are you still suffering from its pain and how long this pain is expected to last?

Also please tell me why you chose Robotic surgery rather than Laparoscopic surgery?

I wish you fast recovery.

RE: Diagnosed with prostate cancer and worried!!!

by Himads on Mon May 21, 2018 08:39 PM

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The surgery took approximately 5 hours. The pain was never too bad, even following the day of surgery. I stayed two nights in the hospital. I was on pain meds during the hospital stay (some morphine and oxycodone) but I didn't take too much of it. They sent me home with pain meds and I only took one dose at night. I stopped the pain meds after about 8 days. Two weeks post surgery, the pain is minimal (some around the incision points and some a little deeper). I'm not sure how long the pain is expected to last, but it is getting better every day. This is a major operation so I expect it will take some time to fully resolve. But it's not bad at present.

I went with the robot assisted because the robot arms have a greater range of motion than with standard laparoscopy, there is less blood loss, and its overall surgical ease of use. Now, you need to find a surgeon with experience with this procedure. The surgeon who operated on me had done over a thousand of these procedures.

Best of luck with your decision. By the way, my pathology report was negative for the margins, so I'm hoping they got all the cancer. 

Feel free to ask me any questions.

Himads

RE: Diagnosed with prostate cancer and worried!!!

by Himads on Tue May 22, 2018 10:51 AM

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Hey John,

One clarification. The actual surgery probably took about 4 hours. The additional hour was some post-surgery recovery prior to regaining consciousness. The weirdest thing about the procedure is that I went into the surgery quite healthy (that is, feeling no symptoms) and then after surgery having IV tubes sticking out of my arms and a urinary catheter. Well, hopefully it will be a case of short-term discomfort for long-term gain.

By the way, prior to the biopsy I had a 4K score test (a genomic test to assess risk for aggressive prostate cancer of Gleason score 7 or higher if a biopsy were to be performed). My results fell just into the high risk range, which is 20% or greater. My score was 23%. You might want to consder this test but be careful because insurance companies may not pay for it. My insurance carrier said I needed pre-authorization for the procedure.

OK, that's it for now. Best of luck to you.

Himads

RE: Diagnosed with prostate cancer and worried!!!

by John-Can on Wed May 23, 2018 07:30 AM

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Hi Himads,

Thank you for your answer. I wonder what are IV tubes? Could you please tell me more about them?

As for the genomic test, does every prostate cancer patient have to do it to know the aggressiveness of his cancer?

Best wishes to you for fast recovery.

RE: Diagnosed with prostate cancer and worried!!!

by John-Can on Wed May 23, 2018 07:32 AM

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Thanks a lot to everyone who answered.

I met my radiotherapy oncologist today and we discussed the risks, advantages and disadvantages of radiotherapy. I wanted to make sure that the cancer has not spread outside my prostate. He performed DRE on me and said it is impossible for a G6, PSA 5.7 cancer to have extra capsular extension. I asked for an MRI to confirm his opinion, but he said there is no need for that. He said my cancer is T2a. As for my N and M stages, he said the biopsy report doesn’t show that, but we don’t need it at this time. I also asked him about the effect of radiotherapy on cells and tissues (prostate, bladder, urethra, semen vesicle) and he said radiation stops cell division and I wonder when a cancer cell stops dividing and eventually dies, it is ok, but what about normal cells and what may happen if they all die?

 

I’m also not sure if an oncologist can decide that my prostate cancer is T2a by just performing DRE?

Is an MRI really NOT unnecessary for me at this time?

Best wishes to all.

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