Husband newly diagnosed

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crankycrink
New Member


Date Joined Nov 2008
Total Posts : 6
   Posted 7/15/2009 2:53 PM (GMT -6)   
Hello.  Am writing as my husband is not computer-oriented, and I just need to get these biopsy results out there, to see what you all think.    I've been reading this forum for over a year... watching my husband's PSA readings, and well, here I am for real.  I've learned so much already from reading, now its unfortunately my turn.
 
1.5 years ago, hubby who was 59 then, had PSA of 7.1.   Due to many congenital problems in the intestines, and a myriad of other health problems (heart disease,(EF of only 22%, he has an ICD pacemaker) diabetes, stroke in 05,  colostomy due to birth defect issues, it was agreed that he would W & Wait to see if PSA was going to rise.   Well, it did to 10.2, and biopsy was in order.  Again, due to nerve-endings highly sensitive, this biopsy had to be done under MAC anesthesia in the hospital. 
 
We just learned on Monday of the results.  
 
12 cores taken, 6 on left, 6 on right.
RT Base Lateral:  3 & 3  10%   Perineural invasian noted
Rt Base:              3 & 4   50%
Rt. Mid Lat:          3 & 4   90%
Rt. Mid  :              4 & 3   30%
Rt. Apex Lat:        3 & 4    60%
Rt. Apex:              4 & 3    90%
 
Only 1 core on left side (Left Base) was a 3 & 4  - 10%.  Other 5 were benign.
 
Dr. said:  Gleason 4 & 3 = 7  (aggressive 7)
 
We are off for CT scan and bone scan on Friday, but hope it will be negative since PSA is 10.2.   Hubby has severe hip pain on his left side.  Been getting worse for a few months now.   His appetite has not been good in the last 2 months.   
 
Due to his terrible health, surgery is out.   Dr. mentioned seed radiation.  I don't know if he will be a candidate for this - any opinions on this subject will be appreciated.    I'm afraid all his congenital problems (he only has one kidney-like that at birth) may prove a problem for the radiation.   Should we even go to the radiation oncologist, or maybe we should ask our dr. for a name of a prostate oncologist.  Any suggestions for good oncologist in prostate field in the Atlanta area would be appreciated.
 
Thanks for listening.  Will keep you posted, and thanks for any opinions or info you could share with us.  
 
CrankyCrink's Wife
 
 

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4188
   Posted 7/15/2009 3:33 PM (GMT -6)   
Sorry to hear about your husband's diagnosis. He has a lot of other health problems that may affect his treatment options.

Seeds alone may not be the way to go with a gleason 7 and so many cores involved. Seeds plus IMRT could be a good option. It delivers higher dose than IMRT alone with less side affects. The Danatolli Center is in Fla and would be worth contacting.

I would definately see a prostate oncologist because of his other health problems. Charles Meyers is in VA and he's the closest I know of.
JohnT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DX BPH and continue to get biopsies yearly. Positive Biopsy in 10-08, 2 cores of 25, G6 less than 5%. Scheduled Surgery as recommended.

2nd Opinion from Dr Sholtz, an Oncologist said DX wrong, path shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G 4+3 approx 2.5cm diameter.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and burining urination. Daily activities resumed day after implants.

Scheduled for 5 weeks IMRT in July

JohnT


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 7/15/2009 4:09 PM (GMT -6)   
Hi Cranky's wife,
Welcome to HealingWell. Your husbands number are not far from mine. I did have a higher PSA but everything else looks close. Duke University is not too far to go, and they have a great facility for prostate cancer. Also some great doctors in Florida and one that might be just what your husband needs. In Jacksonville is a facility for proton therapy. Proton therapy is a different way of delivering radiation that does minimal damage to surrounding tissue. I am usually a surgery guy when recommending treatment, but this looks like the right time to recommend proton therapy. If you would like to look at that option, we can point you in the right direction...

Again welcome to the best place on the web for support and help. I believe that your husband will do well with his prostate cancer. His other health issues, hopefully, won't be a bigger problem...

May peace and blessings always be with you,

Tony
 Age 47 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 11, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 7/15/2009 4:28 PM (GMT -6)   
I am so sorry that you (and your husband) have to be here. Given your husband’s many medical issues I think a top-notch oncologist should be your aim. There are so many rare variables here that you need someone with the broadest possible knowledge of options.

I would not judge hip pain and appetite except to say that being diagnosed with PC is enormously stressful.

Certainly seeds would be the least stressful of the available active treatments and that might tip the scales even if the probabilities were not the best.

Keep in touch – we do not have the answers, but we are here to offer support wherever this may lead.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan, Bone scan 1/09 both negative.

Robotic surgery 03/03/09 Catheter Out 03/08/09
Pathology: Lymph nodes & Seminal vesicles negative
Margins positive, Capsular penetration extensive Gleason 4+3=7
6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
10 weeks: no pad at night -- slight leakage day/1 pad.
3 mo. PSA 0.0


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 7/15/2009 6:51 PM (GMT -6)   
Hello Cranky's Wife,

Glad you found us, hope we can be a help and comfort to you.

With the percent of cancer in his positive cores and being a strong Gleason 7, I was surprised to hear that seeding would be a sensible option. He has a lot of PC going on there, and that is only what a biopsy is seeing.

I am in SC, but don't know anyone in particular to reccomend in Atlanta.

I wish both you and your husband well, and please keep us posted of your travel with PC

David in SC
Age 57, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsule, one post. margin, clear lymph nodes 
First PSA Post Surgery   2/9 .05, 5/9 .10, 6/9 .11, 8/11 ?
Lastest 7/13 met with Rad. Oncl, they want to start radiation, 70 gray, I am still considering all options and opinions
 
 


crankycrink
New Member


Date Joined Nov 2008
Total Posts : 6
   Posted 7/16/2009 7:44 AM (GMT -6)   
Purgatory said...
Hello Cranky's Wife,

Glad you found us, hope we can be a help and comfort to you.

With the percent of cancer in his positive cores and being a strong Gleason 7, I was surprised to hear that seeding would be a sensible option. He has a lot of PC going on there, and that is only what a biopsy is seeing.

I am in SC, but don't know anyone in particular to reccomend in Atlanta.

I wish both you and your husband well, and please keep us posted of your travel with PC

David in SC
 
------
Purgatory,
I read your earlier posts about your visit with the radiation oncologist, where you state that he feels that one has to be "squeaky clean" to undergo successful radiation.  Is that why you think it may not be a sensible option for him?  He is for sure not squeaky clean, due to many things going on with him in that area of the body.   I read where in Proton therapy before each treatment they have to inject the rectum to ensure good mapping control; if this is so, husband cannot undergo due to nerve damage/pain .   I know we have time to explore options, but don't know how many options there are in reality.  Perhaps ADT may be the least invasive way to go.
 
Thanks for posting a reply.
 
DD


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 7/16/2009 7:54 AM (GMT -6)   
DD,

The reference was restricted only to the "seeding" method of radiation treatment. I was seeing him for the possibility of conventional radiation, not seeding. I had asked him his general opinion of seeding, and thus he answered. BTW, he has done over 400 seeding patients and said his partner had done over 1,000. Certainly they weren't anti-seeding as a treatment.

His point, was they feel it is only effective with men with small to average size prostate, low PSA with little velocity, and no higher than a Gleason 6. This is how they determine at the radiation center where I live.

I know from others here, other clinics have other criteria.

David in SC
Age 57, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsule, one post. margin, clear lymph nodes 
First PSA Post Surgery   2/9 .05, 5/9 .10, 6/9 .11, 8/11 ?
Lastest 7/13 met with Rad. Oncl, they want to start radiation, 70 gray, I am still considering all options and opinions
 
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 7/16/2009 8:00 AM (GMT -6)   
P.S. DD

With your husbands medical hisitory that you have share, there are a lot of risk factors for any PC treatment option. The stress of surgery could be a problem with his heart and previous stroke, radiation could be a problem in general with some of his other maladies.

You two are definitely going to need to get some very good opinions, since you must be close to Atlanta, there are some outstanding doctors and facilities there.

If he didn't have all the other medical issues, which he does of course, based on his psa and biopsy results with such high cancer cort % (similar to mine), I would reccomend, and many others, that he should have surgery, and sooner rather than later.

But you definitely needs some good sound experienced medical advice here. Feel bad for the both of you, but there will be an answer and a suitable and safe approach for treatment out there.

David in SC
Age 57, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsule, one post. margin, clear lymph nodes 
First PSA Post Surgery   2/9 .05, 5/9 .10, 6/9 .11, 8/11 ?
Lastest 7/13 met with Rad. Oncl, they want to start radiation, 70 gray, I am still considering all options and opinions
 
 


oldflyingfarmer
Regular Member


Date Joined Jun 2009
Total Posts : 32
   Posted 7/16/2009 8:25 AM (GMT -6)   
If you are interested in radiation and seeding, I would check with RCOG in Georgia. I know of men that have been treated there and they were extremely pleased. I opted for surgery myself and am not sure if salvage treatment will be needed yet.
Hope this helps and good luck.
Age 55
Diabetic on insulin pump
PSA started rising in 2007
2 negative biopsiesthru 2008
2009 PSA 31, TURP found Gleason 9 cancer
Started holistic approach while waiting for surgery
RRP on May 27, 2009
Cath out 2 weeks after surgery
Very little drip, some pain
Waiting for post-op doc visit July 16, 09 with fingers crossed


crankycrink
New Member


Date Joined Nov 2008
Total Posts : 6
   Posted 7/16/2009 8:33 AM (GMT -6)   
Gentlemen, thanks for your replies and info.   Good luck today, oldflyingfarmer, at your post-surgery visit. 
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