Need Some Advice on PC

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m14expert
New Member


Date Joined Aug 2009
Total Posts : 1
   Posted 9/1/2009 10:47 PM (GMT -6)   
Greetings to all.  My name is Bill Palmer and I have been diagnosed with Prostate Cancer in Jan 09.  I had my first Biopsy in Sep 08 after a slight bump in my PSA. (2.2 to 2.65). My father was diagnosed with PC 12 years ago and had RP.  He is still going at age 73.  I however am 47 and while the prognosis is good I have had great relief from some of the stories on this board and downright fright from some others.
 
Anyway not happy to be joining this club but grateful as hell there is a club to turn too.
 
Thanks
 
Bill Palmer
 
Diagnosed 12 Jan 09.  1 core positive of 12 taken (no gleason as sample was too small)
 
1st Biopsy in Sep 08 had 1 core with ASAP of 12 taken.
 
Went to Virginia Mason in Seattle for a 2nd Op and had a mapping / saturation Biopsy in Aug 09.  2 cores of 24 positive with a gleason of 3 + 3 on both.  PSA is back down to 2.4 with free PSA of 21%.
 
 

MrGimpy
Veteran Member


Date Joined Jul 2009
Total Posts : 504
   Posted 9/2/2009 1:19 AM (GMT -6)   
Hi Bill,
There is a lot of info that will help you in your decision and getting through your recovery stages

Most important thing is your mental approach to PC, you cannot will it away, its there, and there are options that will enable you to move forward with a long and healthy life

No-one wants to hear things like surgery, radiation, catheters, pads, incontinence, impotence, ED, etc. Familiarity with those things and more that you will hear from Dr's will help you

But honestly its been 5 months since I had my prostate removed and the road to now was not really all that bad. The unknown was scarier than the reality.
Stats:
Age: 52
PSA (2008)=1.9
Biopsy on Jan 09, 2009
One (1) out of twelve (12) cores was positive, plus external nodule found
Gleason Score = 3+3
Surgery (Da Vinci, robotic prostatectomy): 4/7/09
Removed Catheter: 04/19/09
100% bladder control - Pad free 7/09
PSA 7/09 undetectable, under .0


CPA
Veteran Member


Date Joined Feb 2008
Total Posts : 655
   Posted 9/2/2009 6:15 AM (GMT -6)   

Greetings, Bill.  Welcome to this site and to the club that no one wants to belong to.  You have many options and most importantly, you have lots of time to make a good decision.  You will hear from many here that have elected many different options and I am convinced that the option that is right for one guy is not right for another.  There is not such thing as the only "right" answer.  You have to find the one that is right for you.  I am convinced that your doctor - guided by you asking good questions that you will ask because of the detailed research you have done - is the right person to help you make the final decision.  By doctor, I tend to think of your primary urologist - not a surgeon or a radiation doc or a doc who does mainly seed implants or one of the other options. 

In my case, my urologist (who doesn't do surgery or radiation - he specializes in impotence) after doing my biopsy, sat down with my wife and I and went over options.  Based on his recommendation I chose surgery - mainly because of my age.  You are younger than I was.  However, there are younger guys who end up doing radiation or seeds and do well.  You have to find the option that is right for you. 

Bottom line for me - surgery has a big plus and a big minus.  The minus is you will most likely have more side effects (impotence, incontinence, no ejaculation).  The big plus for me is knowing where I stand and the fact the prostate with the cancer in it is gone.  Absolutely no guarantee that I won't have to have some followup treatment sometime, but all indications are that my cancer is gone.  I am one of the very, very fortunate ones that didn't really have to deal with incontinence (dry at day 3) nor deal with impotence (yes, I take a pill 2 times a week but no big deal). 

Find the right choice for you, make your decision and go with it.  Never look back - only forward.  As our friend Dale said on another thread just this morning, we all plan to be here debating the issues and supporting each other 10 years from now.  You have found a group of guys (and gals) who have been there, done that and are interested in helping you in any way we can.  Please keep us posted on how things are going.  David


Diagnosed Dec 2007 during annual routine physical at age 55
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 pos; 2 marginal
Gleason 3+3; upgraded to 4+3 post surgery
RRP 4 Feb 08; both nerves spared
Good pathology - no margins - all encapsulated
Catheter out Feb 13 - pad free Feb 16
PSA every 90 days - ZERO's everytime!
Great wife and family who take very good care of me


webstergl
Regular Member


Date Joined Mar 2009
Total Posts : 25
   Posted 9/2/2009 9:03 AM (GMT -6)   
Bill

Hello, sorry to hear that you have been DX with PC. From your post it appears that you have caught it very early which is a good thing, as MrGimpy says there are many options for treatment and each treatment option comes with it's own set of post procedure side affects, but as you will read on this forum it does not mean that you will or will not have them it is different for each man. do your research you already have your father to go to and with those on this forum you will be able to become more informed and chose the right treatment for you. I personally think that you should not look to far down the road concentrate on what you need to for now which is the best treatment option, don't worry to much about the side affects that may happen there will be time for that afterward if that would arise . Sometimes you just have to roll with the punches. Keep a good attitude try to remain positive, ask questions and I truely believe that it will all come out good for you.

Gary
Age 54 (Dx age 52)
11/06 severe prostate infection PSA was at 52
2/07 PSA still at 6.2
3/07 Biopsy
4/07 5 of 12 core samples positive with Gleason at 6 -7
6/07 Robotic Radical Prostatectomy
Pathology showed Cancer was organ contained
Last 4 PSA’s 0
11/08 Dx with BNC (Bladder Neck Contracture) due to scare tissue
3/08 balloon dilation
8/09 AUS implant now waiting 6 weeks for activation


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4268
   Posted 9/2/2009 10:36 AM (GMT -6)   
Bill,
Welcome, you will get a lot of opinions on this site, that's why it's so good. With your stats you are the poster boy for all treatment options. The mapping biopsy gives you more confidence in your stats and reduces the uncertainty that you have agressive PC, your low PSA also confirm this.
There are a lot of studies on Active Survelience that show that 75% of PC in your range never show signs of progression in 7 years, and those that do are treated with no sign of matatsis in the future. Because of your young age the PC has a lot of time to grow, but with a good diet there is a high probability that you could go the rest of your life without being treated and if treated the cure rates are similar as if you were treated today. The key is to get a doctor that is experienced in AS.
Every other option is also available, similar cure rates and varing side affects ranging from severe to minor. Tudpuck and I are seeders and have had good results with minimal side affects; most of the others are surgery patients.
The Prostate Cancer Research Institute recommends "no immediate treatment" for your stats. Their web site has a lot of information on all treatment options.
Good luck on any treatment you choose as it is highly individual and you have to determine what is important to you. As long as your PSA doubling time remains greater than 3 years you have an excellent prognosis from any option. I estimate I went about 12 years from the time my PC was detectable to treatment and my doctor said I could have probably gone 10 more before it affected me; so you have plenty of time to research and get several opinions. Diet is extremely important in slowing or stopping progression so pay attention to it.
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 DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology 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. G7, 4+3, approx 16mmX18mm.

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. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 9/2/2009 10:44 AM (GMT -6)   
Bill, welcome and hello, glad to have you with us at HW.

You are one of the fortunate few at this point, I agree, you have the full range of options before you. If ever there was a case for AS, I fully agree with JohnT, you are the guy. With the low core number, low Gleason, etc, would not be in a hurry to rush to any particular treatment. You would be a good candidate on the surface for join our "seeded" brethren, both doing great so far.

At 47, you should have a lot of good years ahead of you, and I wouldn't want to be straddled with harsh side effects unless I was convinced it was the right path.

So study hard, choose wisely, and don't be pushed by anyone, doctors included.

You only mitigating factor from your post is that your dad has PC, but again with your present numbers, you look on the safe side.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20%, Contained in capsule, 1 pos margin
2009 PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/09 met 2 rad. oncl, 7/09 cath #6 - blockage, 8/09 2nd corr surgery, 8/9 cath #7 - out after 38 days
 


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 9/2/2009 2:07 PM (GMT -6)   
Hi Bill! Welcome to Healingwell! Sorry you have to be here, but glad you found us.  My father had his RP done at VM in Seattle by Dr. Chris Porter and had a good experience.  The entire team was fantastic and while the outcome was not what we hoped, it by no means reflected the team at VM.  They operated like a well oiled machine and we were very happy with the expertise and the kindness they showed.  Good luck and I am happy to answer any additional questions!  Keep us posted!
Father's Age DX 62 (now 64)
Original Gleason 3+4=7, Post-Op Gleason- 4+3=7,
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin, One positive node. T3a N1 M0.
Bone Scan/CT Negative (Sept. 10, 2007)
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07, Lupron beg. Dec 03, 2007 2 yrs
Radiation March 03-April 22, 2008- 8 weeks 5x a week
July 2, 08 PSA <.02
Oct. 10, 08 PSA <.02
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum


Franchot
Regular Member


Date Joined Jun 2009
Total Posts : 131
   Posted 9/2/2009 2:54 PM (GMT -6)   
Reading all your stats, I'd also agree with seeking out a doctor who would entertain the option of Active Surveillance. I'm close to your age (I'm 53) and my numbers are slightly higher than yours and I've elected to pursue Active Surveillance. I don't regret my decision and all I've had to do is tweak my diet so that I'm living a healthier life.

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4274
   Posted 9/2/2009 3:47 PM (GMT -6)   

Dear Bill:

Sorry you have to be here and I'm sure you will find advice/help for anything you want to ask.

I just want to tell you that I agree with JohnT and David completely.  At the very least find a doc with experience managing AS patients and, if your psyche can handle it, that could be a great option for you.

Tudpock


Age 62, Gleason 4 +3 = 7, T1C, PSA 4.2, 2 of 16 cores cancerous, 27cc
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 7/1/09.  6 month PSA now at 1.4 and my docs are "delighted"!
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