Hello, I’m new to this forum, a close friend who’s been through this saga turned me on (ugh!) to you folks. I have been reading many of the conversations you have here and I am very grateful for all the help and information you are all giving to me.
I’m pretty much in the beginning of my saga, not on the ‘other side’ yet. But, I’d like any comments about my journey so far, in case there might be any flaws in my thinking that you all might pick out. Thank you for any comments you might have.
Here we go. I had a PSA show up in the 4s in the fall of 2006; I was 52 at the time. My doctor decided to send me to an Urologist for further investigation. The DRE at the time was non-suspicious, but a biopsy was scheduled. The biopsy date was 11/29/2006, and the total PSA at that time was 6.1. Six cores were taken and no cancer was found, but I was told there was ‘Small focus of atypical glands’. I was told that they were going to just watch and wait, and would continue to watch what was going on with future PSA tests.
On 3/2008 another biopsy was taken, at that time the DRE was abnormal, it was stated there was ‘a ridge’ on the left base. The PSA was 7.5, and the 6 sample biopsy revealed one sample in the left base that had adenocarcinoma (Gleason score 3 + 3 = 6) involving 3% of the specimen. (Whoa! I’ve got a problem here!) I was told that they still wanted me to wait and watch. I was put on fenasteride, a female hormone derivative or something like that, which acts to shrink the prostate. Supposedly, the PC feeds off the same stuff that causes the prostate to enlarge in older men, and so this hormone therapy might cause the cancer to shrink. I didn’t know anything about prostate cancer at the time to be at all nervous about the DRE finding. I didn’t realize until seeing this forum that the ridge could be cancer in the margins.
I was still uninformed until this last biopsy. It was collected 4/29/2009. My PSA a that time was 1.7, but I was told the reading was affected by the hormone I am taking. It was 12 samples and I not only got a hit on the left lateral base in 20% of the tissue, but also in the Right Apex in 30% of the sample. Both were Gleason 3 + 3 = 6. (Oh No! This is getting serious!)
The interesting thing is the DRE was reported non-suspicious again! As far as I’m concerned this means better chance at nothing in the margins. (I’m sorry, the engineer in me understands statistics, and I would love to be looking at different areas in the statistical charts for organ confinement!) My first question is, they rated my clinical stage as T2c, but doesn’t that mean they can feel something in the DRE? My doctor commented that whatever was there has gone away. Shouldn’t I be rated T1c?
My head is swimming with all the choices available for treatment. I see them all on this forum, however, it appears that most of the people around here are talking about the RP journey, and most talk about radiation therapies are recovery oriented. The Urologist group that I’m seeing is primarily radiation guys. They do all types, but to their credit, my primary Urologist told me that I should consider RP. He stated that I should consider it because of my age (54 now). The Urologist expressed a little concern about the cancer found in the Apex. He stated that radiation in that area has resulted in a higher incidence in colon cancer 10 years out after those treatments. Have any of you heard this? Perhaps that was part of his decision to recommend RP. (Besides, I plan on living longer than 10 years!)
To make a long story short, I decided to go for the surgery. I feel it’s important that I can be certain the cancer is gone right away, if there is nothing in the margins, that I’ll know right away if I need recovery, and that I would rather live with the complications (continence and ED) if I can know for certain that I am cancer free. Do any of you have opinions on the soundness of my judgment? The surgery is currently scheduled for June 10. (Boy, they didn’t waste any time!)
To tell you all the truth, I am really concerned about the whole ED thing. All the talk about the things that have to be done to ‘get it back’ are initially distasteful and cause the prude in me to blush. But, when I really think about it, ‘you gotta do what you gotta do’. I really thank you all in this forum for your open and frank discussions on this subject. I’ve not heard anything about this part of the process from the urologists I’ve been talking to. They all just say ‘you’ve got a very good chance to get your potency back’. Well, there are certainly a lot of ‘degrees of success’ if you will. (I get that from this forum).
Above all, again, thank you all for making this forum the wealth of information it is, and thank you especially, moderators, for keeping it going. It’s really a comfort to share my own journey with all of you who are going through the same thing.
Biopsy1, 11/2006, PSA 6.1, DRE non-suspicious, Small focus of atypical glands
Biopsy2, 3/2008, PSA 7.5, DRE abnormal, 3% cancer on one sample, Gleason 3+3=6,
Oral hormone finasteride prescribed
Biopsy3, 4/29/2009, PSA 1.7, DRE non-suspicious, 2 hits, right apex 30%, left base lateral 20%,
Gleason 3+3=6 on both samples
Open RP scheduled for 6/10/2009