Just diagnosed and frightened

I was just diagnosed with PC on 11-11-08 which proved to be the most frightening day of my life.  I am 64 years old with my father having had prostate cancer.  My PSA was 3.3 and was just done last month.  There were 14 cores taken on my biopsy resulting in 7 samples with a Gleason score of 7, two with a 6, and 5 benign.  There was also one mid core sample with a focal perineaural invasion noted.

 

I am visiting a surgeon on Monday 11/15/08 that does what I believe is called a Divinci laparoscopic procedure.  My doctor says that my low PSA, and the small size of the tumors is a positive, and he thinks it is contained within the prostate wall with the possible exception of the one core mentioned earlier.

 

What are your experiences out their as I am very new to this disease.

Thanks for the advice realziggy. As you can imagine I've been walking around in a daze for the past 5 days

Three months ago I was standing where you are today. There's a lot of information out there and you can find yourself in information overload. Learn as much as you can. Listen to your doctor. Ask, "why do you recommend that" as many times as you need. If you opt for surgery, find a surgon that has the most current technology available and experiance to use it. The more procedures the surgon has successfully completed the better. I had a very successful outcome with The da Vinci robot so I have a bias toward that procedure.

What makes a Dr do a biopsy when psa levels are somewhat normal for a 64 yr old man ?? Is it due to rapid rise or DRE ?

Ivory hope all works out well with you as it will im sure. It seems as though most worry like crazy and it all works out in the end.

Good luck we will pray for you again with the low everything it will probably all go fine

Hearing the news that you have prostate cancer is emotionally difficult.  I will never forget the day I got the unexpected news that I had prostate cancer.  I felt devastated.  But as time goes by, your emotions will settle some and you can do the work of researching the best treatment for you.

All three of the well-established treatments--radioactive seed implants, surgery  and external-beam radiation--have excellent cure rates and long-term survival.  The newer treatments look very promising but don't yet have an established track record.  It's your choice, so do the research (this web site is an excellent place for information and support) and make your decision.

 

After extensive research, my wife and I decided on surgery for reasons that were important to us:  (1) pathological staging where the extent of the tumor and margins can be accurately determined  (2) The PSA goes immediately to zero  (3) The availability of options like salvage radiation if the cancer recurs  (4) Incontinence and impotence tend to get better with time  (5) Less likely to get diarrhea and painful urination.

 

Best to you as you face this difficult diagnosis.  We're here to support you....Tim

 

 

Hi Ivory,

A bit of shock to the system to here those words. I think we all react with the same dread upon hearing the diagnosis. The best thing to calm the mind is to do the research on PCa and to talk with others who have been there. This is a good place for the later. There are many sites on the web that provide information about treatments and results. The good news is you appear to have caught it early and there is curative treatment available. Take your time, investigate options, talk with more than one provider (urologist and oncologist), talk with current and former patients, then make a decision on the basis of your case.

Good luck with your decision and best wishes for a successful treatment.
Don

Ivory-

That initial diagnosis of PC is indeed frightening. I was diagnosed on 12-9-2004 after 3 biopsies with a total of 50 samples.taken.  The urologist who diagnosed me was so eager to perform surgery that he told me that surgery was the only thing that would work for me.  His eagerness scared me more than anything!!  I got a second opinion at UAB in Birmingham, AL on December 23.  The Dr there told me that he would be comfortable with surgery, radiation, seed implant, or watchful waiting.  I was 59 at the time and my initial PSA was 6.3.   Gleason was 3+3 and one of the samples came back 5% involved.  A Radiation oncologist came in and spent some time talking to my wife and I about what was involved in brachytherapy, or radioactive seed implant. After we decided on brachytherapy, we went hime for the Christmas Holidays.

I returned to Birmingham on January 14, 2005 for a volume study.  What fun!!  My prostrate was measured to be approximately 60 cc, too large for the procedure.  I was promptly given an injection of Lupron depot and a prescription for 90 days worth of Casodex,  in order to shrink my prostate to less rhan 50 cc for the procedure.  The nurse administering the injection informed me that I would experience "hot flashes".  She forgot to mention that I would also enjoy being nauseated, depressed and not sleeping at night.  When I returned for snother volume study in April, the plan had worked!  My prostste was now an acceptable 42 cc and the implant procedure was scheduled for early June.

The implant procedure took about 3 hours and I didn't experience any problems of any signifigance with the procedure.  Went back to work the following Monday.  I am self-employed as a consulting forester, so I took it easy for a few days.  I went back for a check up a couple of weeks ago and my PSA was 0.2.  This is my first time to post, so I will close now.  If anyone has any questions I will answer them to the best of my ability.

Paul

Ivory,
As others have stated, we have all been down this road. Let me encourage you that it is not the end - you are in a good situation still as you caught it, and it is very likely you can be cured!

This is a blessed time to live for two reasons: The great options for cure and control, and the paths of communication. I would suggest you take advantage of the links to the many websites from this site and read, read, read. Secondly, I would read all you can from those who have gone through similar experiences. You have years of conversations to go back on here - there is a ton of information and who knows better than the very people who are experiencing the same things.

You will find a lot of peace knowing that thousands of others have faced the same things and they are doing well, and as you learn from them you will be equipped to make the best decision about your treatment. Blessings.
RB
Age 61 (now 62)
Original data - pre-operation
PSA: 5.1
T1C clinical diagnosis, Needle biopsy - 10 cores, Gleason 7 = 3+4 in 1 core (40%), 7 cores Gleason 6 = 3+3 ranging from 5% to 12%
All scans negative
Lupron administered 4/9/2008 for 4 months (with idea I would undergo external beam radiation followed by seed implants - then I changed my mind).
Robotic DiVinci surgery - Dr. Fagin (Austin) May 19th
Post operative - pathology
pT2c NX MX
Gleason 3+4
Margins - negative
Extraprostatic extension - negative
seminal vesicle invasion - uninvolved
1st Post PSA <.04
2nd Post PSA <.1 10/30/2008

I was standing where you are 11 months ago and I was also scared -- more shellshocked than anything else. After careful consideration and discussion with my wife, my doctor and a PC survivor I knew at work, I opted to have it removed and hopefully, be done with it. I had it removed 7 months ago, but not before taking a trip to Europe to unwind before the surgery. (I thought I would die on the operating table.)

Today, I am happy to say, was my first pad-free day, 7 months after surgery. I plan to still wear a light pad at work -- just in case -- because work can be very stressful. I did the pad-free thing while at home, by myself.

I can only tell you that everyone is different and people opt for different treatments and have different recoveries. The worst time for me was the first couple of months after the operation and then I started to see gradual improvement in bladder control. I still have ED but I prefer not to try Viagra or similar. My doctor tells me it could be up to a year before I know if my ED will go away. That's the downside, but considering the alternative, I think I'm very lucky.

You've come to a good place to talk about PC and the associated issues, including treatment.  If you have a good primary care physician and he/she is involved in the process of helping selecting/referring a Urologist/Specialist and in reviewing with you and the specialist the analysis of the testing results and possible options - I think you'll make the decision process easier.  Some people have time to wait, others don't.  Each of us is different.  I'm confident I made the right choice for me and really don't look back - it was a short term incident that I haven't let interfere much with my life.  I'm fortunate though, that my PC was caught early and apparently removed completely.  Best wishes as you consider your options.

Mavica said...
You've come to a good place to talk about PC and the associated issues, including treatment. If you have a good primary care physician and he/she is involved in the process of helping selecting/referring a Urologist/Specialist and in reviewing with you and the specialist the analysis of the testing results and possible options - I think you'll make the decision process easier. Some people have time to wait, others don't. Each of us is different. I'm confident I made the right choice for me and really don't look back - it was a short term incident that I haven't let interfere much with my life. I'm fortunate though, that my PC was caught early and apparently removed completely. Best wishes as you consider your options.

Mavica what is the deal with you and your primary care doctor? Your posts always start like that. WE all listen to our primary physician initially, and most I assume may get the first urologist referral that way. Mine is fine in fact one of the urologists I saw said his was a good initial find of a DRE on me. That said he's/she's a general practioner or an internal medicine doctor who doesn't keep up with Pca like a urologist nor does he/she need to. I respect him but it makes more sense to review tests with a urologist. I found my surgeon who is the director of research at the University of Colorado Urologic Oncology, through a local TV news report. My primary doctor had no idea of the advanced treatments that were offered there and nothing of the one I chose. Most of us diagnosed with PCa have time or should make time to learn and choose options. PCa is not a short term incident that should be quickly resolved so one can get on with his life. No it's frikken cancer after all and should be thoroughly learned about and what treatment you opt for should not be taken lightly or rushed to judgment. I think it's great you put so much trust in your primary doctor. Just don't advise everyone else to have such child like faith in theirs that you have in yours. You may take an initial recommendation to a urologist from him and go see that doctor, but don't let it end there. MD as another always said here does not stand for Medical Deity.

Ivory.  The good news is you have time.  And you have this wonderful place to exchange ideas.  But we are only a source of ideas, you have to find the right Doctor.  My situation was not much different than yours.  I had by biopsy 12/31/07 and then held off on the surgery until 4/14/08.  Prostate cancer does not move that fast, use the time to make sure you have the right medical team around you.

Just as you wait, start doing your kegel exercises.