newly diagnosed surgery next week

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TryingToStayCalm
Regular Member


Date Joined Aug 2010
Total Posts : 53
   Posted 8/22/2010 7:23 AM (GMT -6)   
I am a wife of a 56 yr old man in good health, other than being newly diagnosed with PC. His PSA was creeping up for a few years and finally went from 3.2 to 5.8 in 4 months. We just recently had bloodwork done again and in 4 weeks it rose to 7.9.
 
Biopsy of 12 cores showed 2 cores at upper left leaning on the nerve at 3+4, with between 70% and 90% and the two under it 3+4 at 85% and 50% . 2 other cores had 3+3 and 10% . There is perineural invasion of the upper left nerve. Total of 6 cores affected. Bone scan and MRIs showed no metastases. Boy I hope that made sense.

We did lots of research (I am the online junky) and spoke with several people who also had PC, several docs, and decided that with how aggressive the cancer is, how young he is, and in generally good health, we would proceed with the robotic surgery. It is scheduled for 8/26. We have been told there will probably be a sural nerve graft as they will probably have to take the nerve on the left side.

We are starting to get very nervous. Both about the surgery and of course the side effects. Mostly we just want him to live a long life. At 56 he has many years ahead.

How do you deal with the fear? the information flying at you from all sides? We have read Walsh's book. I have read articles, and websites and found my way here (Thanks Fairwind). How do you handle this black hole of the unknown? And how the h*** did this happen so fast? I thought if you get tests yearly and it showed cancer it would be a watch and wait kind of thing? Sorry. I'm not naiive. just angry and scared.

Thanks in advance for any support.
Judy

Post Edited (TryingToStayCalm) : 8/22/2010 6:26:16 AM (GMT-6)


tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2845
   Posted 8/22/2010 7:47 AM (GMT -6)   
Judy - you have every right to be angry and scared - you're human - and so is your husband - and the problem with that it nothing makes sense at times - the same disease affects everyone differently - my dad and grandfather had slow developing PCa ( they died of other things) and mine was very aggressive - and was treated as such.

-I applaud you on your research and apparent openness with each other - one of the side effects of research is information overload !
- the week before my surgery I stopped reading anything that dealt with PCa, so my conscious and subconscious mind could filter through what I had learned the previous weeks - and to prepare for "the now"...
-there are excellent links here for spouses , as you have already learned, as well as helpful hints for post-op care ...

-and one key thing to remember - take care of yourself !!
- the care-giver is of no use to themselves or spouse if all bent out of shape ... make sure you have me-days and non-cancer days ( or half days) :-)

-glad you discovered this website - and sorry you have to be here - but it is a good place for support and information
-aside: does the husband have a name? ( can be a nickname for anonymous status)

-keep us updated
hugs
BRONSON
Age: 54 -gay with spouse, Steve - live in Peteborough, Ontario, Canada
PSA: 10/06/2009 - 3.86
Biopsy: 10/16/2009- 6 of 12 cancerous samples, Gleason 7 (4+3)
Radical Prostatectomy: 11/18/2009
Pathology: pT3a- gleason 7 -extraprostatic extension -perineural invasion -prostate weight -34.1 gm
Post Surgery-PSA: April 8, 2010 - 0.05 -I am in the ZERO CLUB - hooorah!
Next PSA: October 8, 2010 -TBA

Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 8/22/2010 7:51 AM (GMT -6)   
Judy, as one wife to another, I hear you loud and clear. How did this happen so fast? The answer is that it probably didn't since cancer usually takes years to grow to the point that it can be found through tests and scans.

Your husband is the same age mine was at diagnosis (see my signature). Your husband's situation warrants action and I'm glad that both of you have made a decision as to treatment. The biopsy results you posted made total sense - sounds like you know what you are talking about. If I read it correctly, 6 out of 12 cores were positive and your husband's Gleason is a solid 7. There is a fair amount of misleading information about AS. As you have learned (the hard way), there is no one size fits all formula. Your husband's case (and mine for that matter) proves that annual check-ups and regular PSA monitoring does not necessarily equate to being diagnosed with a low risk disease.

As far as the nerve graft and quality of life, do not assume that this will automatically equate to ED issues. My husband had both nerve bundles spared and still suffers from ED two years after surgery. You will be hearing from many soon and will find that the advice most will give you is sound. My personal opinion is that surgery seems to be the best treatment option for your husband. Did the surgeon mention whether or not it will be done using the robot or via the traditional "open" procedure?

Angry and scared is normal for both the patient and those who love them.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (solitary focus of extraprostatic extension). Perineural tumor infiltration present. Apex margin, bladder neck and SVs negative. Final Gleason 3+4. PSA: 0.0 til July 2009. August 2009 - 0.1, September 0.3, October back to 0.0, December 0.0, March 2010 0.0. Next PSA in 6 months. Thank you God!

daveshan
Regular Member


Date Joined Jan 2010
Total Posts : 363
   Posted 8/22/2010 8:13 AM (GMT -6)   
Being angry and scared is par for the course. There are 2 things to remember,

1. Prostate cancer has a very high cure rate if found early

2. The members of forums, while excellent sources of information, are not an accurate cross section of PC survivors in general, many many men have successful surgery and move on with their lives.

I was diagnosed at 55, along with the news that my doctor forgot to inform me of a PSA that more than doubled a couple of years earlier. I lived with fear an anger for several months with much lost sleep. Finally acceptance took over and my life is as good now as it every was. The odds are with us, and your husband has a very good chance of a normal life. Spousal support is key for us married guys and it sounds like your husband has a good partner on his side.

Best of luck to you and your mate.
Dave in Durango CO
Diagnosed 12-09 age 55
07-06 PSA 2.5
01-08 PSA 5.5 (PCP did not tell me of increase or schedule follow-up!!!!)
09-09 PSA 6.5 Sent for consult with Urologist
11-09 Consult, scheduled for biopsy, found out about PSA from '08 (yes I was pissed)
12-09 Biopsy, initial Gleason 9 (4+5) later reduced to 8 with tertiary 5, ain't much but I'll take it.
01-10 Bone Scan, "appears negative"
03-01-10 RRP in Durango CO by Dr Sejal Quale and Dr Shandra Wilson, no naked eye evidence of spread, Vesicles and lymph nodes taken for microscopic exam.

03-16-10 Removal of cath' and pathology results of samples.
Multifocal carcinoma with areas of Gleason pattern 3, 4 and 5, Overall Gleason grade 4+4 with tertiary 5, Bilateral involving 21% of left lobe, 3% of right lobe, Invasion of left Seminal vesicle, Tumor focally present at left resection margin, 9 lymph nodes removed all negative, Tumor staging pT3b NO MX

04-23-10 PSA <0.04....... 06-07-10 PSA <0.04..... 08-03-10 <0.04
05-03-10 1 week without pads
06-28-10 ;-)

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3887
   Posted 8/22/2010 9:48 AM (GMT -6)   
What part of the country do you live, Stay Calm?
Age today: 68. Married, 6', 215 pounds, active, no health issues.
PSA at age 55: 3.5, DRE negative. Advice, "Keep an eye on it".
PSA at age 58: 4.5
PSA at age 61: 5.2
PSA at age 64: 7.5, DRE "Abnormal"
PSA at age 65: 8.5, DRE " normal", biopsy, 12 core, negative...
PSA at age 66 9.0 DRE "normal", BPH, Finesteride. (Proscar)
PSA at age 67 4.5 DRE "normal" second biopsy, negative.
PSA at age 67.5 5.6, DRE "normal" U-doc worried..
PSA at age 68, 7.0, third 12 core biopsy positive for cancer in 4 cores, 3 cores Gleason 6, one core Gleason 9. Finesteride discontinued, still no urinary symptoms, never had any..From age 55 to 65 I had no health insurance.

I have a date with the robo surgeon on Sept 3 but I'm keeping my options open. I'm also looking at seeds combined with IGRT which seems to be having good results with high-risk patients..

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 8/22/2010 10:02 AM (GMT -6)   
With your husbands solid Gleason 7 cores, with fairly high cancer %, he already would not be a candidate for any kind of AS or watching. With his numbers, and his age, and his general health being good, as you state, then many would reccomend surgery to him as a primary treatment. The open or robotic argument is less important, the quality of the surgeon is the most important factory if you decide in favor of surgery.

Your husbands PSA velocity really concerns me too, as that is an issue that has been determining my own path and fate since I was diagnosed with PC. Hopefully, the size and scope of his cancer is as the biopsy indicates, though there have been plenty of men whose's staging and gleasin get upgraded after surgrey, when pathology is done on the entire removed prostate.

You came to the right place, glad you are here. There are no guarantees about the ED side or incontinence side when dealing with surgery for PC. We have men that had extensive nerve sparing ops and still have total ED 2 years later, despite going to top 10 hospitals and having brand name surgeons. It ends up being very localized to each particular patient as much as any thing else.

Good luck ahead, and keep posting


David in SC
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 ?
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, on Catheter #21, will be having Ileal Conduit Surgery in Sept.

Timm
Regular Member


Date Joined Feb 2010
Total Posts : 83
   Posted 8/22/2010 10:02 AM (GMT -6)   
For what it's worth, I threw myself into a seris of mystery novels [ James Lee Burke] It gave my mind a little rest.
The week before surgery is bad, filled with fear and what ifs, try to focus on the end of next week, by friday all the fear and anger will be gone, replaced with that was'nt that bad at all. Hang in there, your all most there.
 
                                                                       Good luck  Tim 
58 yrs.
PSA 6.94 12/10
Bio. 8 of 12 cores pos. 2/1
Gleason 3+4=7
Da Vinci 4/14
Tumor volume 9%
Extraprostatic extension- within margins
Margins clear
T2c NO Mx
PSA. 6wks. surgery .01
PSA. 4 1/2 months .01

rhb47
Regular Member


Date Joined Mar 2010
Total Posts : 208
   Posted 8/22/2010 10:05 AM (GMT -6)   
Hi Judy,

Sorry you had to join us, but welcome to the forum and also the August Club-check out the thread called August surgeries. My husband just had surgery 8/9 and I want to wish you and your husband all the best. Sounds like you've done your homework and you'll find this forum a great resource. Lots of great people here-they really helped me thru our adventure and became good friends.

Renee
Husband diagnosed 3/10
Age 56, PSA 4.7, free 7.6%

Biopsy 5 of 10 cores positve-all right side-25% to 57%

Gleason 6

DaVinci surgery with Dr. Vip Patel scheduled 8/9/10

Post Op: Gleason 3+4=7
Negative surgical margins
Negative lymph nodes
No seminal vesicle invasion
No angiolymphaic invasion
perineural invasion present
Both nerve bundles spared

TryingToStayCalm
Regular Member


Date Joined Aug 2010
Total Posts : 53
   Posted 8/22/2010 10:14 AM (GMT -6)   
@ Fairwind - I am in NJ and the surgery is with Dr. Samadi at Mt. Sinai on 8/26. GL with your visit with the robo surgeon. My husband never had a day of symptoms either. PSA climbed from 2.0 to 2.5 to 3.2 in a year and a half with NO abnormal DRE and then shot to 5.8, 4 months later with prostate enlarged.

@Tatt2man - thanks for the research kudos and you may be right about stopping all reading at this point. It seems I have upped the reading and the level of anxiety! Hubby's nickname is "M" for this forum's purpose. We have been together for almsot 40 yrs (dating, & married) and feel like our world is coming apart. I know we are strong enough to get through anything but never thought the "anything" would be something like this. Congrats on being in the zero club!

@ Sephie - the only thing I know for sure Sephie is that if he didnt go get it checked when he did - three months later - it would have metastesized for sure. So thank god for checkups even though it didnt provide the best results. I envy people who have deep faith .. mine is not exactly shallow but it's not as deep as I would like. I am meditating for peace for him, an eas(ier) process, and quality of life. The surgery is Robotic and potentially "light" radiation after depending on what Dr. Samadi finds when he goes in. .

@Dave - thanks for the comments. I can certainly understand your anger at not having been told sooner. Sounds like you are on your way to gaining good control and things are looking up for you! M has been out of work for over 6 months and now this. I want him to feel like the man I know he is - and this does not help.

Thanks again to all. I never realized how much sharing and hearing others stories could help. With deep appreciation,
Judy

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 8/22/2010 10:41 AM (GMT -6)   
Probably read what English Alf posted at top of our topics thread page, home page. It tells one very precisely the details of handling, preparing and dealing with literally all aspects of having surgery and preparing a patient for things from about any angle you can think of. I think it is brilliant as a document, covers more than you might want to really actually know, that's a clue how incompassing it is. We should have things like this for every treatment scenario as total disclosure and heads up on, need to understand things thoroughly.  (as to the black hole you mentioned....sounds like you understand PCa more than you might think)

Best to you in this.
Dx-2002 total urinary blockage, bPsa 46.6 12/12 biopsies all loaded 75-95% vol.; Gleasons scores 7,8,9's (2-sets), gland size 35 normal, ct and bone scans appearing clear- ADT3 5 months prior to radiations neutron/photon 2-machines, cont'd. ADT3, quit after 2 yrs. switched to DES 1-mg, off for 1 yr., controlled so well, resumed, using intermittently, pleased with results

Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1267
   Posted 8/22/2010 11:07 AM (GMT -6)   
Hi Judy, welcome and I'm sorry that this PCa is giving you such stress as I well remember my stress 14 months ago.

My sister, who had had cancer surgery a number of years ago said to me a few days before I was eviscerated, "in a couple of years this will all just be a blip in your past." I couldn't imagine it being a blip. I was in major panic overload. But, here I am, and the surgery as well as the pain, anguish and agony which followed the diagnosis and filled panic time to surgery is really just a blip on my backward radar. Oh sure, every 90 days I get a bit fussed for a few hours while waiting for my latest PSA, but with each test that becomes less.

I do, however, have one major side effect which is rarely discussed here but which, in all openness and honesty should be fessed up to and acknowledged: I'm alive! And, the cancer that's likely to kill me isn't PCa ---- it's the one I don't know about. The PCa one is being monitored and if it pops back up ( I had dinner two nights ago with a friend whose PSA suddenly went up 8 years after surgery) there are many treatments I can do to keep the beast at bay.

Now, as for getting on top of your stress, pain, anguish and agony here's some advice from the old fart department:

* Before treatment, which you'll be finished with come Thursday, the critical thing is pathology and the reason it is critical is that it is the key to making the treatment decision. The good news is you've got your pathology, the decision for surgery has been made (and it's an excellent decision, I'm sure) you've got the surgeon, the OR is booked, and, as my surgeon said to me, "the most dangerous part of surgery day for you is the trip to the hospital. Once I've got you in my OR you're safe." At 56 your husband will be even safer in the OR than I was. So, you can reasonably and realistically cross pathology, treatment decision, and surgery off your worry list. "Easy for you to say!" you're saying --- and you're right, it is easy for me to say. I've been there, done that, and frankly it was a piece of cake. I've had more stress having my teeth worked on than the surgery was. They've got drugs in the OR he's going to love. You've not been there, done that, yet. However, if you take a deep breath, and let reason take over from emotion (granted, not easy when you think there are monsters under the bed going to jump out and bite you) then you really can cross pathology, treatment decision, and surgery off the list.

* The next thing to worry about is recovery. I was able to minimze my recovery concerns by telling myself that every day across North America there were thousands of surgeries more miserable than mine --- new hips, new valves, bowel cancers, etc. --- and all those people were coping with recovery; I would too. And your husband will. Once he's rolled out of the OR and says 'hello' to you you'll both feel 1,000% better and each day will get better and better. So, I think you can in all good conscience cross recovery concerns off your list.

*So, we're pretty much left with incontinence and ED. Pretty much worst case is he dribbles when he sneezes and injects whoopie juice to get a woodie. Can you and he live with that? Is having him alive, laughing, and sneezing worth worst case? Yes, right? So, in all good conscience you can cross this off your list. Whatever changes there are in life style are ones you'll learn to live with --- and the operative word is 'live.'

What it boils down to, Judy, is you've got yourself worked up into a state (and I've been there so I have total sympathy for you) and that state is far, far more based on emotions grinding on emotions than it is on realistic, statistical, worries.  Whatever issues M and you may have, need for radiation, or whatever, you'll deal with. 

You ask how do you deal with the fear? You'll deal with it when you put it into perspective. And, when you do, you'll start to worry about the real risks --- the dangers of that drive to the hospital, for example. I don't ask you to minimize the risks. Just put them into perspective. 

I'll be watching for a post from you at the end of the week.

Sheldon AKA Sleepless
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
From "knock out" to wake up in recovery less than two hours.  Actual surgery 70 minutes
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"
 
Oct 1st 09 -- dry at night, during day some stress issues.
Oct 31st padless 24/7 
 
First post op PSA Sept 09  less than 0.02
PSA on Oct 23, 2009 less than 0.02
PSA on Jan 8, 2010  less than 0.02
PSA on April 9, 2010 less than 0.02 
PSA on July 9, 2010 (one year) less than 0.02
  

Post Edited (Sleepless09) : 8/22/2010 10:14:37 AM (GMT-6)


F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3984
   Posted 8/22/2010 12:10 PM (GMT -6)   
Judy -- my urologist steered me away from surgery because there's a 60% chance that my cancer is out of the capsule and i had no growths or blockages.  because i'm younger and in good health my doctor, an open prostate surgeon who's partnered with a da vinci surgeon, thought i was a better candidate for an aggressive combination treatment.  the side effects vary from the different treatments but incontinence hasn't been an issue.  i can't tell you about ED because i have been essentially chemically castrated by lupron beginning five months ago.  i have a beautiful wife 14 years younger than me and ED is right at the bottom of our list of worries ... at least for now cool .
 
here's an essay written by andy grove of intel in 1996 that pretty much sums up how we feel about my treatment plan.
 
 
coping with fear.....at first i was very fearful to the point of having anxiety.  i was terrified of the biopsy and my mind kept telling me that i'd be dead in 2-3 years.  at that point i had to erase my bookmarks to sites like this and let my wife, a biologist and angel, do the research.
 
i am also a 12-stepper with more than 20 years "clean".  i now attend more weekly meetings (usually four); one meeting deals with illness in recovery. i also talk regularly with good friends and hang out -- e.g, we go to dairy queen every friday for ice cream.  i also pray for strength and give thanks for my wonderful life, family, friends and pets. 
 
oh, i also began a sub-clinical dose of celexa before starting lupron to help with hot flashes.  my hot flashes are muted and the celexa helps control my emotions.
 
today i am in acceptance about my condition and my job is to deal with the fear and side effects of treatment.  the rest is out of my control.  remember that gaining acceptance is a process, not an event.
 
good luck to you!
 
F8


age: 55
PSA on 10/09: 6.8
no symptoms, no prostate enlargement
12/12 cores positive....gleason 3+4 = 7
ADT, brachy and IMRT

Post Edited (F8) : 8/22/2010 5:29:19 PM (GMT-6)


Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3887
   Posted 8/22/2010 3:52 PM (GMT -6)   
"I am in NJ and the surgery is with Dr. Samadi at Mt. Sinai on 8/26"

That's great. You are in good hands. There is no right or wrong choice. You made a GOOD choice, that part is done, now move on.. Concentrate on the pre-surgery prep work, getting some post-surgery supplies ready and then just wrap it up and put it away. You have done all you can do.. Take a couple of days off and have some fun...
Age today: 68. Married, 6', 215 pounds, active, no health issues.
PSA at age 55: 3.5, DRE negative. Advice, "Keep an eye on it".
PSA at age 58: 4.5
PSA at age 61: 5.2
PSA at age 64: 7.5, DRE "Abnormal"
PSA at age 65: 8.5, DRE " normal", biopsy, 12 core, negative...
PSA at age 66 9.0 DRE "normal", BPH, Finesteride. (Proscar)
PSA at age 67 4.5 DRE "normal" second biopsy, negative.
PSA at age 67.5 5.6, DRE "normal" U-doc worried..
PSA at age 68, 7.0, third 12 core biopsy positive for cancer in 4 cores, 3 cores Gleason 6, one core Gleason 9. Finesteride discontinued, still no urinary symptoms, never had any..From age 55 to 65 I had no health insurance.

I have a date with the robo surgeon on Sept 3 but I'm keeping my options open. I'm also looking at seeds combined with IGRT which seems to be having good results with high-risk patients..

medved
Veteran Member


Date Joined Nov 2009
Total Posts : 1100
   Posted 8/22/2010 6:15 PM (GMT -6)   
Judy - M has two really big advantages that many men don't have: A terrific surgeon and a wife who really cares about him.
Age 46.  Father died of p ca. 
My psa starting age 40: 1.4, 1.3, 1.43, 1.74, 1.7, 1.5, 1.5
 

proscapt
Veteran Member


Date Joined Aug 2010
Total Posts : 644
   Posted 8/22/2010 7:01 PM (GMT -6)   
Judy - My situation was very similar. I chose the surgery, which was done about 6 months ago and it went well. Once the surgery is done and you have the pathology report you will have a lot more information to go on; if you are on the good end of outcomes in terms of margin status, capsule-confined, etc. you will have confidence that your husband has better than 90% chance of never having to deal with PC again. If not so good, you will have a much better idea of the appropriate next steps.

If you would like to read a good professional article that will likely be of some comfort, please see:

Prostate Cancer–Specific Mortality After Radical Prostatectomy for Patients Treated in the Prostate-Specific Antigen Era
Andrew J. Stephenson, Michael W. Kattan, James A. Eastham, Fernando J. Bianco, Jr, Ofer Yossepowitch, Andrew J. Vickers, Eric A. Klein, David P. Wood, Peter T. Scardino

"Conclusion Few patients will die from prostate cancer within 15 years of radical prostatectomy, despite the presence of adverse clinical features. This favorable prognosis may be related to the effectiveness of radical prostatectomy (with or without secondary therapy) or the low lethality of screen-detected cancers. Given the limited ability to identify contemporary patients at substantially elevated risk of PCSM on the basis of clinical features alone, the need for novel markers specifically associated with the biology of lethal prostate cancer is evident."

http://jco.ascopubs.org/cgi/content/abstract/27/26/4300

Once you have the pathology report from surgery you may also be interested in the online Sloan Kettering nomogram calculator: http://www.mskcc.org/mskcc/html/10088.cfm

Everyone's psychology regarding the surgery and recovery process is different, but I agree with what people have said that the surgery is not such a big deal. I was helped by a pre-surgery meditation tape that they offered at the hospital. They are great with pain control nowadays. The most annoying thing was actually walking around with a catheter for a week or so, but you can easily put up with it since you know it's coming out soon. My best advice is to make sure your husband has plenty to take his mind off the situation: favorite music, books, DVD's, calls from friends etc. during recovery.

Good luck!!!!
DX 10/2009
Robotic assisted RP 2/2010
Pathology: pT2c / Gleeson 3+4 / margins neg. / seminal ves neg. / capsule confined /
PSA - Pre-op 5.6 / last post-op 0.01

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3887
   Posted 8/22/2010 8:55 PM (GMT -6)   
Backing up what Proscapt said, on page 200 of Walsh's book, the Han Tables, M has a 91% chance of having no detectable PSA at the 10 year mark.. So this isn't the end of the world..It's just a nasty bump in that highway we call life..
Age today: 68. Married, 6', 215 pounds, active, no health issues.
PSA at age 55: 3.5, DRE negative. Advice, "Keep an eye on it".
PSA at age 58: 4.5
PSA at age 61: 5.2
PSA at age 64: 7.5, DRE "Abnormal"
PSA at age 65: 8.5, DRE " normal", biopsy, 12 core, negative...
PSA at age 66 9.0 DRE "normal", BPH, Finesteride. (Proscar)
PSA at age 67 4.5 DRE "normal" second biopsy, negative.
PSA at age 67.5 5.6, DRE "normal" U-doc worried..
PSA at age 68, 7.0, third 12 core biopsy positive for cancer in 4 cores, 3 cores Gleason 6, one core Gleason 9. Finesteride discontinued, still no urinary symptoms, never had any..From age 55 to 65 I had no health insurance.

I have a date with the robo surgeon on Sept 3 but I'm keeping my options open. I'm also looking at seeds combined with IGRT which seems to be having good results with high-risk patients..

An38
Veteran Member


Date Joined Mar 2010
Total Posts : 1152
   Posted 8/23/2010 3:08 AM (GMT -6)   
Hi Judy,

i am sitting next to my husbands hospital bed, he has just had a RP. I know how angry scared and confused you are feeling and the information overload is something else!

All I can say is that the worst time in this whole situation was 1-4 weeks before the surgery. There were plenty of moments when I was stressing about whether we had made the right decision, whether we knew enough to make the right decision. The surgery and post-surgery period has been mentally easier.

There are many threads here on preparing for the surgery. This takes out a whole lot of stress relating to logistics and planning. I have added you to the august surgery thread and if you wish you can post your experiences there.

Wish you the best and enjoy your time away.

An
Husband's age: 52. We live in Sydney Australia.

In 2007 my husbands PSA level was 2.5.
In Feb 2008 it was 1.7
In Oct 2009 it was 3.67 with a free PSA ratio of 27
In Feb 2010 it was 4.03 with a free PSA ratio of 31.
In June 2010 it was 2.69

DRE normal.
Biopsy 28/4/2010: results, negative for a diagnosis of PC however 3 focal ASAPs on left side of prostate at base, apex and at transition resulting in the conclusion "...small acinar proliferation is suspicious but not diagnostic for prostatic adenocarcinoma."
Review of biopsy by experienced pathologist, results,
1 out of 12 core diagnosed with 10% of Gleason score 3+3 cancer (left transitional)
1 out of 12 cores with ASAP (left apex), suspicious but not diagnostic of cancer

Next steps: Nerve sparing RP on 20th August 2010.

My husband's maternal grandfather died of prostate cancer at 72. His maternal uncle died of prostate cancer at 60. Because he is the third generation to be diagnosed he has hereditary PC.

Post Edited (An38) : 8/23/2010 2:11:47 AM (GMT-6)


TryingToStayCalm
Regular Member


Date Joined Aug 2010
Total Posts : 53
   Posted 8/23/2010 9:33 PM (GMT -6)   
Wow. You all are an amazing group of people. I feel .. overwhelmed by support. This is a good thing.

One thing I can see is that based on stats in your collective signatures and experiences that each man's case is unique. No telling what the after effects of the surgery will be. As mentioned above.. these are the most difficult days .. after Thursday is over .. it's a question of fact.. what was the pathology and what are we dealing with in the here and now ..

Thanks for the rundown .. the smiles ... and the perspective... .. thank you to those going through it .. offering comfort and a shoulder.. thank you to the wives who are dealing with the after-effects .. my prayers and thoughts go out to all .. going to make my list of post surgical things to buy right now and head out tomorrow .. thanks for the links and the articles ... boy this is like having another job, isnt it?

NEIrish
Regular Member


Date Joined Aug 2010
Total Posts : 245
   Posted 8/23/2010 10:43 PM (GMT -6)   
To Trying:
I'm a new member who found this site in one of my long, long, late-at-night online searches for any info to make all the grayness of prostate cancer more black and white for my beloved husband, diagnosed after a 6 core biopsy Aprils Fool Day. It's a miserable time, confusing and frightening with no clarity of path. This site is great for support and general info you don't find in the med lit. We are now 7 wks. post surg and waiting for his first psa reading (calling the office tomorrow). Don't stop talking with him, keep others well-meant but sometimes addle brained comments and advice in perspective and trust yourselves to know what's right after you ask the experts, get your second opinions, do your reading. And then don't look back. I still can't believe it's almost fall since we lost the spring and summer in the appointments, research and now slooooow healing. Enjoy the moments you can, take those deep breaths and if you tend towards being physically active, get out and walk/jog, play tennis, anything like that for your own peace of mind. Girls lunches with caring friends are the best therapy!

TryingToStayCalm
Regular Member


Date Joined Aug 2010
Total Posts : 53
   Posted 8/23/2010 11:34 PM (GMT -6)   
NEIrish,

Hope the news tomorrow is good! (fingers crossed for your entry into the zero club) I totally get the comment "addle brained comments and advice" from well meaning friends .. I am amazed at how stupid some of our very intelligent friends are .. comments about .. it's a nothing surgery ..or .. best cancer to have .. or .. who cares if you can ever have sex again .. or if you dont do the surgery at sloan kettering you are idiots .. shall I go on? ..we DO feel confident in our decisions .. one foot in front of the other ..

I thank God every single day that we do talk with each other . there are no taboos on our communication .. and we have a history of intimacy that does not involve sex .. I dont mean the gushy romantic kind but simple loving touching and understanding .. it will serve us well going forward..

I cant imagine being 7 weeks post op .. it seems like forever away .. but we are right behind you .. I look forward to seeing your posts tomorrow and praying for the best results ever!
Judy
Husband DX on 6/30. Age 56. PSA 5.8 and 1 month later 7.9. Biopsy showed 6 out of 12 Cores Adenocarcinoma. 5 = 50% - 90%, 1 = 10%. Perineural invasion present. Gleason 7 (3+4). RRP scheduled with Dr. David Samadi Mt Sinai. NYC. 8/26.

Retire1965
Regular Member


Date Joined Jul 2010
Total Posts : 38
   Posted 8/24/2010 2:56 AM (GMT -6)   
Folks:
 
I have an RP scheduled for 9/20.  I wanted to say that everyone's willingness to share their experience and perspective is an enormous help to those of us in the earlier stages of treatment.
 
I do believe the worst part of this disease is the psychological aspect.  The medical world is at a cross roads in the disease so there are few black and white decisions for patients.  We have to make decisions with incomplete information and face outcomes that are also somewhat uncertain.  The disease strikes at the core of what it means to be "men" in our culture and then drags in our family to share our anguish.
 
All of you contribute much to the world simply because of who you have become.
 
Retire1965
 
 

Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 8/24/2010 6:16 AM (GMT -6)   
As our dear friend Zufus says, knowledge is power. I found that the fear of the unknown - those infernal "what ifs" that haunt us in the days and weeks after hearing that someone you love has prostate (or any) cancer is the worst part. Once action is taken and a plan is in place, I found myself calming down and looking forward to seeing my husband "on the other side" of his surgery.

As with any serious illness, it changes your life forever. The "what ifs" are still there for me but not nearly as loud or as frequent. After 2.5 years of living with the words "your husband has prostate cancer," I have learned that there is nothing I can do to change the situation but I do have control over the effect it has on my life.

Some of you may notice that there's no mention in my post about John (that's my husband, for all you new guys). From day 1 he was cool and calm. He trusted in his doctor and used his faith to get him through it. Me, I boxed with God the whole way but finally learned that that is one fight I can't win.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (solitary focus of extraprostatic extension). Perineural tumor infiltration present. Apex margin, bladder neck and SVs negative. Final Gleason 3+4. PSA: 0.0 til July 2009. August 2009 - 0.1, September 0.3, October back to 0.0, December 0.0, March 2010 0.0. Next PSA in 6 months. Thank you God!

TryingToStayCalm
Regular Member


Date Joined Aug 2010
Total Posts : 53
   Posted 8/24/2010 10:08 PM (GMT -6)   
I wish you luck Retire .. you expressed yourself beautifully .. I so totally agree..

"We have to make decisions with incomplete information and face outcomes that are also somewhat uncertain. The disease strikes at the core of what it means to be "men" in our culture and then drags in our family to share our anguish."

Life is just not black and white and medicine is less science and more art .. combo therapies .. choices in terms of what types of surgeries .. one from column A and two from column B .. and we always wonder .. what if we chose the pu pu platter from column C ... always wondering ...

Sephie .. you made your peace with your struggle and now you are winning the war ..
At some point you have to know you made the right decision and go along for the ride.. that's where we are at for today.. with the help of the people here!

Judy
Husband DX on 6/30. Age 56. PSA 5.8 and 1 month later 7.9. Biopsy showed 6 out of 12 Cores Adenocarcinoma. 5 = 50% - 90%, 1 = 10%. Perineural invasion present. Gleason 7 (3+4). RRP scheduled with Dr. David Samadi Mt Sinai. NYC. 8/26.
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