Newly Diagnosed

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NavyWife
New Member


Date Joined Mar 2011
Total Posts : 4
   Posted 3/15/2011 9:58 AM (GMT -6)   
My husband just diagnosed Friday from bx: Gleason 3/3 1 out of 12 cores pos. with less than 5%. PSA 8. Urologist very kind, mentioned AS, since he feels PC dx at earliest level. He did make us an appt with a DaVinci surgeon here in Austin, and would also help with setting up something with a radiologist. Our heads are spinning, and my husband doesn't want anyone to know. I've ordered Dr. Murphy's book, and been on the pertinent websites.
Concerns: Do we have to do something now, do we have months or years? Even doctors don't seem to know!
I'm very close to both sides of family, and not being able to reach out is hurting me. Thanks for this anonymous forum. I don't feel like I'm betraying his trust. He is my whole world, and I want the very best for him!

tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2842
   Posted 3/15/2011 10:02 AM (GMT -6)   
navywife -
- you are not betraying your husband's trust - you are doing your best as a partner to help the both of you in this new journey.

-you have time to research and learn what is best treatment for your husband whether that be Active Surveillance, Radical Prostatectomy, Radiation Treatment to name the main ones...

- as had been said by others, " find the best treatment, find the best doctor, find the best hospital.. there are no do-overs"

-gleason 6 is good - one of 12 samples is good ....
-there is a hot of information at the top page of HW - a good read for you and your husband...

-questions - age of husband - any previous prostate problems - any family history of prostate cancer or breast cancer -

- wishing you all the best in your journey - very pleased you have found HW -
- it has been a great support for men with prostate cancer and their wife / companion / spouse...

- here is the HW link to a list of women's support -
www.healingwell.com/community/default.aspx?f=35&m=1584686


hugs,
BRONSON
Age: 55 - gay with spouse of 14 years, Steve
location: Peterborough, Ontario, Canada
PSA: 10/06/09 - 3.86
Biopsy: 10/16/09- 6 of 12 cancerous samples, Gleason 7 (4+3)
Radical Prostatectomy: 11/18/09
Pathology: pT3a -Gleason 7 -extraprostatic extension -perineural invasion -prostate weight -34.1 gm
PSA: 04/08/10 -0.05 -Zero Club
PSA: 09/23/10 -0.05 -Zero Club
PSA: 03/24/11 - TBA

Post Edited (tatt2man) : 3/15/2011 10:15:48 AM (GMT-6)


NavyWife
New Member


Date Joined Mar 2011
Total Posts : 4
   Posted 3/15/2011 10:02 AM (GMT -6)   
Forgot to add he's only 55 and in very good health!

knotreel
Veteran Member


Date Joined Jan 2006
Total Posts : 654
   Posted 3/15/2011 10:21 AM (GMT -6)   
What to do? The good news is that he appartently has a very low evidence of a tumor which can a problem in itself. Most people have much clearer paths in front of them with more limted options. You on the other hand, have pretty much the whole scenerio of treatments as viable options, from AS to the max. No one can tell you or your husband what's best for you, and I am not trying to do that when I offer this sugestion. If it were me, I would get a second opion on the slides from the bioposy to first be sure that you have the best info you can as you decide what to do. Sometimes, not that often, we hear about people who were told they had a G6 only to find out that they had a G7 and that does change things, like the time they have to make a decision and maybe AS would be off the table.
Then I would try to relax, that sounds hard but the shock does wear off after a while. I would then do what you are planning, read up on the subject.
It appears that there should be no rush to decision but again that is a personal choice.
Anyway I am sorry that you have this bad news and hope you and your husband the best.
Ron
06-08 1st biopsy neg psa 4
10-09 psa 5.5 2nd biopsy 1/12 pos. 10%, G(4+3) age 65
12-15-09 RRP Tulane NOLA Dr Lee
Path, 1%, clr marg, no EPE, no SVI, nodes cl, G(4+3)
100% incontinent @ 12 months
ED, pre-op severe, post op total
10/10 Dr Boone, Methodist recomended AUS
AUS/ IPP performed 1/11/11 Methodist Houston
post op psa's 0.04,<0.1,<0.1,<0.01@12 mo.

GTOdave
Regular Member


Date Joined Oct 2010
Total Posts : 175
   Posted 3/15/2011 10:22 AM (GMT -6)   
Take heart NavyWife, there is much hope for you and your hubby.

Last September (on my 52 birthday), I was given the identical diagnosis as you got. I had surgery (robotic) 11 days ago and aside from my scars, nothing hurts. I have experienced virtually no incontinence, and the "little general" is starting to reawaken. I am the posterboy for early detection, taking time to consider options and then plunging ahead.

This cancer does not require expedited medical intervention. You want to consider the wide variety of options open to you, and to find a doctor with the experience, caring and technology to cure your husband.

Take a breath, you will both be OK.

Dave
52 yr old, PSA 3.5, Gleason 6 with 3 of 4 top nodes (0%;1%;10%;1%) cancerous. Bottom 2 floors are clean.

DaVinci surgery at Yale 3/4/11.

45 gram gland weight
Gl 3+3
T2C
margins clear
no metastis
5% of gland aedenocarcinoma

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4223
   Posted 3/15/2011 10:40 AM (GMT -6)   
Navy wife.
1 core of G6 is considered low risk prostate cancer and many doctors feel that this type of PC should not even be labeled as cancer but renamed as something else.
Your husband has months and most likely years to make a decision.
The facts about the statistical group of low risk PC:
1. Only 30% of these types of cancers progress, reflected by either rising psa or an upgrade in Gleason from a follow up biopsy. This is very consistant throughout all of the Active Survelience programs currently being run in the US. The odds are stacked in your favor.
2. If later treatment is necessary years later because of progression then treatment results are similar to being treated immediately.
3. Studies at UCSF with control groups show that diet, excercise and mediation significantly affect the rate of progression. The diet group has had no progressions in three years.
Appropriate steps to take:
Have biopsy slides resampled as a 2nd opinon from Dr Epstien at John Hopkins or Dr Bostwick at Bostwick Labs.
Find a doctor that is experienced in monitoring Active Surviellence patients.
Read "Invasion of the Prostate Snatchers" by Dr Mark Scholz for an excellent program of monitoring those on AS.
Take your time in making any decisions and research all treatment options throughly. All treatments for this low risk class of PC have similar results, but differing long term side affects.
The younger a patient is the more he has to lose in being treated as the long term risks of death is very low and he may have to live with permanent side affects for a great number of years.
Death or matastisis from low risk PC is rare, well under 1% so don't make decisions based on fear or the need to do something soon.
If he chooses to be treated the cure rates are in the high 90% range whether treated now or years in the future.
JT
65 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, no side affects and psa .1 at 1.5 years.

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4149
   Posted 3/15/2011 10:52 AM (GMT -6)   
NavyWife:
 
Sorry you have to be here and we all understand your angst.  You should feel free to ask ANYTHING and you will get answers.
 
Other than a welcome I would just to like reempasize the advice you just received from JohnT.  This is very sound in my opinion.  Also, if for some reason, AS is not something you are comfortable with I hope you will take the time to review all of the options available to your husband as not all treatments are created equal...especially in terms of side effects.
 
All the best and please keep us posted.
 
Tudpock (Jim)
Age 62 (64 now), G 3 + 4 = 7, T1C, PSA 4.2, 2/16 cancerous, 27cc. Brachytherapy 12/9/08. 73 Iodine-125 seeds. Procedure went great, catheter out before I went home, only minor discomfort. Everything continues to function normally as of 12/8/10. PSA: 6 mo 1.4, 1 yr. 1.0, 2 yr. .8. My docs are "delighted"! My journey:
http://www.healingwell.com/community/default.aspx?f=35&m=1305643&g=1305643#m1305643

NavyWife
New Member


Date Joined Mar 2011
Total Posts : 4
   Posted 3/15/2011 11:18 AM (GMT -6)   
Thank you all so very much. The kindness offered here is medicine at its' best. I do believe our urologist is excellent. Slides originally read in San Antonio lab, which he sought out after looking for excellence. The slides are now also being read at MD Anderson, so we'll have that opinion next.
The core that was positive, even though very small, is at the left apex. As a retired RN, that makes me a little more nervous than a transitional zone location. He had a negative CT( not related) so that is heartening. DRE was normal.
Much to think about, and the nagging inability to determine the actual aggressiveness of these early tumors is really frustrating. I can't thank you enough for the words of encouragement. I'm hoping he will have the time to delve into this as much as I am. His job is all consuming right now. You men and work!:-)
I admire you all so much, and I will keep you in my thoughts and prayers. The men that are fighting the aggressive PC, and those afflicted by the various complications, are remarkable in their courage!

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3738
   Posted 3/15/2011 12:39 PM (GMT -6)   
Dr. Murphy? You might want to read "Guide to Surviving Prostate Cancer" by Dr, Patrick Walsh and /or Gerald Chodaks book, "Winning the Battle against Prostate Cancer"..

I am not a big A.S. fan,, just my opinion of course.. You just never know for SURE just how dangerous the cancer is... It is quite likely that SOMETIME during the next 20 years, your husband will require treatment. With cancer, any cancer, the sooner you treat it the better. A PSA test every six months and a biopsy every year gets old after a while..You become a slave to that next PSA test, spend a lot of time worrying about it, trying to decide what you are going to do if the cancer proves more aggressive than you thought..Hubby's PSA at the moment is fairly high at 8. It can't go up much more before some sort of treatment will be needed...

But time IS on your side, research all your options carefully, the potential side effects, traveling for treatment, costs, you have to look at the entire picture..Read the books, learn the nature of the monster you are facing and how to defeat it...
Age 68.
PSA age 55: 3.5, DRE normal.
age 58: 4.5
61: 5.2
64: 7.5, DRE "Abnormal"
65: 8.5, " normal", biopsy, 12 core, negative...
66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
67 4.5 DRE "normal"
68 7.0 3rd biopsy positive, 4 out of 12, G-6,7, 9
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT. 2-15-'11 PSA 0.0

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4223
   Posted 3/15/2011 12:49 PM (GMT -6)   
To ease your concerns about the Apex tumor your husband should consider a color doppler ultrasound scan or an endorectal MRIS . These can identify if it close to the margin to be a concern. They can also establish a base line in which future tumor growth can be monitored if you choose the AS path. In either case it will give you more information about the particular tumor that you don't have now.
JT
65 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, no side affects and psa .1 at 1.5 years.

DaSlink
Veteran Member


Date Joined Feb 2011
Total Posts : 713
   Posted 3/15/2011 1:20 PM (GMT -6)   
Navywife,
First of all welcome but sorry you are here. I can only give this advice,tell his and your family what is going on. He has Cancer not cooties( I saw that on a shirt) so it's nothing to be ashamed of. Your immediate family should know and they will be a big support.
Good Luck and keep us informed.
Every minute you fish or ride,adds an hour to your life!

Age 52 Dx age 53 daVinci surgery
prostate volume 24gms
Biopsy 12 cores with 7 positive
Gleason score of 7
1st PSA 38.7 10/05/2010
2nd PSA 49.9 11/23/2010
CT neg.
BS Negative
RRP on 01/25/2011
PT3a -40% involved
margin involved-Left anterior
lymph nodes -clear

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 3/15/2011 1:24 PM (GMT -6)   
As pointed out to you A.S./W.W. is a real option for many men and written about in many PCa books by experts in oncology of PCa, too. My brother has stats comparable to yours, no treatments at all for 7 yrs., stable psa...looks pretty sane and tame thus far, but would need montoring.  John Hopkins-Brady Urology Div. has a definition of indolent PCa you should search the internet, I used to have it handy. Here is one mention of it elsewhere:
 
June 9, 2010, 6:42 AM CT

Surgery in men with low-risk prostate cancer

VIEW IMAGE <!-- add image description -->
Johns Hopkins experts have found that men enrolled in an active surveillance program for prostate cancer that eventually needed surgery to remove their prostates fared just as well as men who opted to remove the gland immediately, except if a follow-up biopsy during surveillance showed high-grade cancer.

Active surveillance, or "watchful waiting," is an option open to men whose tumors are considered small, low-grade and at low risk of being lethal. Given the potential complications of prostate surgery and likelihood that certain low-risk tumors do not require treatment, some men opt to enroll in active surveillance programs to monitor PSA levels and receive annual biopsies to detect cellular changes that signal a higher grade, more aggressive cancer for which treatment is recommended. Yet, according to the Johns Hopkins experts, there is concern that delaying surgery in this group until biopsy results worsen may result in cancers that are more lethal and difficult to cure.

Bruce Trock, Ph.D., associate professor at the Johns Hopkins Brady Urological Institute, and his colleagues compared the pathology results of men in an active surveillance group at Johns Hopkins who later had surgery with those who also had low-risk tumors and opted for immediate surgery.........
        (NOT FULL article here I posted-so do not take this out of context )

rhb47
Regular Member


Date Joined Mar 2010
Total Posts : 208
   Posted 3/15/2011 2:51 PM (GMT -6)   
Hi Navy Wife,

I can't add any other advice-just wanted to welcome you. My husband was diagnosed one year ago March 17, had robotic surgery Aug. 8th and is doing great. I know how over-whelming it can seem at first, but you have plenty of time to research you husband's choices and there are so many wonderful people here that can help you thru it.

Kind regards,
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 and lymph nodes
No seminal vesicle and angiolymphaic invasion
perineural invasion present
Both nerve bundles spared
No ED or incontinence
6 wk. PSA .01

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 3/15/2011 5:33 PM (GMT -6)   
Welcome Navy Wife.

I am ex Navy myself, Viet Nam and my father was ex Navy WW2 and Korea.

You have been given such good introductory info, can't really add to it at the moment.

Glad you found us, please keep us well posted.

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 2/11 1.24
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10,

Mike H
Regular Member


Date Joined Jan 2010
Total Posts : 72
   Posted 3/15/2011 7:09 PM (GMT -6)   
Navy Wife,

My stats were very similar to your husbands. I opted for surgery. Take a look at my very first post at the link below:

www.healingwell.com/community/?f=35&m=1684312&g=1684312#m1684312


You and your husband have time to make a decision. In my case I chose to remove the tumor early before it could spread and risk a worse outcome years down the road. I think my first post lays it out pretty clearly from one man's point of view. The doctors at Sloan Kettering told me that when they see a more severe case they really feel badly that the patient didn't take a more aggressive approach earlier. Granted they are a major cancer center and tend to see the worst of the worst, but for me I could support their line of thinking.

FYI I'm a little under 1.5 years post op and I'm zero PSA and doing great. I don't regret my decision. The problem is there is not always a single clear right answer and everyone is different.

I'm happy to talk to you or your husband if you like. Best of luck and welcome.

Mike
8/12/09 Diagnosed at 49 years old. DOB. 6/11/60

12/2/00 PSA was 4.9

5/5/03 PSA was 5.4 - Biopsy Negative

6/10/09 PSA hit a all time high of 6.9

7/23/09 Biopsy Positive. 10% cancer in 1 of 12 cores. Gleason 3+3=6.



10/29/09 Surgery at Memorial Sloan Kettering Cancer Center, NYC
11/25/09 Catheter Out (4 weeks)
99% continent the day the catheter came out
Wore the pads for 2 weeks to be safe but had minor drips at most.
12/16/09 First PSA (7 weeks) < .05 Undetectable

Post Surgical Pathology:
Gleason 3+3=6
Tumor confined to prostate
Seminal vesicles not involved
Bladder neck not involved
Surgical margins free of tumor
Lymph nodes not involved

6/16/10 6 Month PSA < .05 Undetectable
1/5/11 12 Month PSA < .05 Undetectable

Post Edited (Mike H) : 3/15/2011 7:15:14 PM (GMT-6)


Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4106
   Posted 3/15/2011 7:58 PM (GMT -6)   
NavyWife, So happy that you have found this place. We are all here to support both you and your man in this trip with prostate cancer.

You can find a welth of info on this site. I wish I had found this place in my early decision days. Would I have done much different. Probably not but I would have been better iinformed. Do not hesitate to ask questions. There are guys here that seem to know more about Prostate Cancer than the Uros that treat us.

Do keep us informed pleased.

Cajun Jeff
9/08 PSA 5.4 referred to Urologist
9/08 Biopsy: GS 3+4=7 1 positive core in 12 1% cancer core
10/08 Nerve-Sparing open radicalSurgery Path Report Downgrade 3+3=6 GS Stage pT2c margins clea
r3 month: PSA <0.1
19th month: PSA <0.1
2 year PSA <0.1
Only issue at this time is ED but getting better

brampy
Regular Member


Date Joined Jan 2011
Total Posts : 42
   Posted 3/15/2011 8:57 PM (GMT -6)   
NavyWife,
I'm 54 and chose robotic surgery and now am undergoing followup radiation. My diagnosis was aggressive (a gleason 8...and then a gleason 9 after they removed and dissected it). Sounds like your husband found this early and thus has alot of options and time to figure out his best course. I also chose not to keep it confidential because I figured the rumors would be worse and I wanted to increase awareness of this curable cancer. I have received nothing but support and more new friends. regards, <bobr>
--------------------------------------
Age: 54
Routine Physical on 10-20-2010 DRE Normal
PSA 4.3, up from 0.6 5 years prior
PSA 0.6 on 10-25-2005
PSA 0.4 on 7-30-2004
PSA 0.5 on 5-9-2002
Followup with Urologist on 11/10/2010 after elevated PSA; DRE noted slight bump
November 30th, 2010 had prostate biopsy.
December 9th, 2010, Biopsy results 3 of 12 cores positive.
LLB: Gleason's 4+3=7, 11 MM Tumor Length/15MM Core Length (73%)
LLM: Gleason's 4+4=8, 12 MM Tumor Length/15MM Core Length (75%)
LM: 0.1 MM Tumor Length (1%)0.1 MM Tumor Length
RALP Surgery 12/27/2010 Released: 12/30/2010
Thunderbird Banner Hospital, Glendale, AZ
Post-Surgery Pathology: GS 4+5=9
Pathologic Staging: pT3a, N0, MX; location: Left Side; Volume: 10%
Margins: Left posterior inked margin focally involved
Extraprostatic Extension: Observed
Seminal vesicles: Not observed
Lymphatic/Vascular Invasion: Not observed
Catheter: Removed 15-days after surgery

Post-OP Followup on 1/11/2011; Catheter/Staples removed
Adjuvant IMRT 8 Weeks Post-OP.
No exercise for 4 Weeks Post-OP.

Radiation Oncologist Initial Consultation on 1/18/2011

Calypso Procedure on 2/17/2011; PSA <0.1; Bone Scan Clear
341 Testosterone

CT Simulation on 2/24/2011.
Calypso IMRT started on 3/8/2011 - 40 Treatments.

GOP
Veteran Member


Date Joined Dec 2010
Total Posts : 657
   Posted 3/16/2011 10:01 AM (GMT -6)   

Navywife,

Read any of the books that you want, but for both your sakes, please thoroughly research two things before making any final decision: Watchful Waiting, and Brachytherapy. As for books, I would recommend Surviving Prostate Cancer Without Surgery by Bradley Hennefent. In that book, Hennefent explains, among many other things, that while defeating the cancer is the first concern, one does not want to get into a situation where the cure is worse than the desease. At least be aware that this can be the case.

The good news is, there are many ways to treat this very treatable disease (if and when it needs to be treated). If there is bad news, it is that there are so many options that a decision can be difficult. Do your best to get objective advice. That is not easy, but if you visit a facility that offers multiple solutions, you may be more likely to get just that.

Best of Luck, and May God Bless


creed_three
Veteran Member


Date Joined Jan 2007
Total Posts : 762
   Posted 3/16/2011 3:26 PM (GMT -6)   
Hi Navywife,
My husband had a lower PSA (3.5) at diagnosis but a similiar pattern with initially a Gleeson 7 (4 + 3), then Gleeson (3 + 4 = 7 after surgery. He too had all options and made the decision on the basis of the agressiveness of the gleeson score. If he had been Gleeson 6, he may well have chosen another path including watchful waiting. However the Gleeson 7, like the Gleeson 8 is different and less predictable so we had to think it  through.  In answer to your question do you have months or years or have to act now with the 5% so far - we asked the same question... At the time on this board, we were among those who waited a more lengthy period of time (4 months) - did not have additional PSA testing during this time so I don't really know, but it allowed us to see 3 specialists, research all options in depth, make a careful decision, and consider conflicting opinions in the process. In the end, taking some time to decide did not make a difference for us but it was one question we asked every doctor we spoke with. All encouraged us to take our time which for us was 4 months, then surgery. My husband has made a full recovery physically - emotionally we will never get over it, but we have learnt to live with it, and see the positives. Give your husband time and he'll come around slowly - meanwhile gather all the info for him for when he is ready to discuss it, and write all your questions down, asking the same sorts of questions to each person you consult for consistency.  It is a shock but it gets better - try not to rush your husband or allow others to rush him. Even if you act early on this, there is no reason not to add another few weeks just to make sure, and allow him to get his head around it, so check out the first opinion you get with at least one other specialist or doc or professional. Soon the world will stop spinning for you both and it will settle as you gain more information about your unique situation. Hope this helps. The people here will support you both with any information you need. Take care & Kind regards, Lana
Creed_three (Lana) - with husband "CJ" now aged 53 yrs (49 years at diagnosis). PSA (2006) 3.5. 1 x 5% core of 12 positive at biopsy (Gleeson 7). open Radical Prostatectomy with nerve sparing April 2007 Sydney, Australia. Gleeson 3 + 4 = 7. Small multifocal lesions contained within prostate. Current PSA February 2011 = 0.03 (unchanged in 3 years)

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6945
   Posted 3/16/2011 6:27 PM (GMT -6)   
Navy Wife,
 
Check this site for an USToo chapter nearby.
 
 
Even if your husband doesn't want to go to a meeting (my chapter has a number of newly-diagnosed men come to meetings), you might ask the coordinator if they have books/materials they might loan you.
 
Check the library for the Walsh book. There is also a new edition of "Dr. Peter Scardino's Prostate Book" that would be a good reference.
 
You didn't say where you were located (I just presumed Texas). USToo does not have chapters in all states, but there are other similar groups. You might check with a local major hospital to see if they have one.
 
The numbers are as good as they come for a PCa diagnosis, and that gives you some research time.
 
I'm sorry you have to be here, but welcome just the same.
DaVinci 10/2009
My adjuvant IGRT journey (2010) -
www.healingwell.com/community/default.aspx?f=35&m=1756808

cupcake25
Regular Member


Date Joined Jan 2011
Total Posts : 24
   Posted 3/16/2011 6:46 PM (GMT -6)   
I am also a nurse and my husband was diagnosed with PC gleason 6 with 9 of 12 cores positive last Oct. It definitely was a shock. At first my husband was just like yours. He didn't want me to tell anyone about it. I think this is the first stage DENIAL. If he doesn't talk about it he doesn't have to deal with it. My husband was 59 and we decided to go with the DiVinci robot. He had it done in Jan 2011. The first week was rough but he is doing great now. He does have some incontinence which seems to be getting better with time. His doctor said he was cured with negative margins. He gets his first PSA in June. If it was my husband I would probably go for treatment because I would not want to think about cancer everyday for any period of time. I could not stand it.

Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 3/16/2011 8:08 PM (GMT -6)   
Navywife,
I also live in Austin and had DaVinci surgery with Dr, Fagin who by the way is no longer doing them. Your husband has very low amount of cancer and low Gleason, he can certainly be on Active surveillance and avoid the side effects of surgery. There are other options beside surgery available to him. Get as much information before deciding on any treatment.

clocknut
Veteran Member


Date Joined Sep 2010
Total Posts : 2666
   Posted 3/16/2011 9:20 PM (GMT -6)   

NavyWife, whatever course you decide to take, I would encourage you to review two recent threads by Diamonds3 as you make your decision.  Not every case of Gleason 6 is the same.  Theirs was a case of Gleason 6, reviewed by Epstein and confirmed as Gleason 6; but after they went ahead with surgery, it was found to be Gleason 7, 3+4, with margin involvement at the apex, which is now causing them some concern.  When dealing with cancer, caution can't be overemphasized, IMHO.  Good luck to you. 

I worked for the Navy for 30 years as a civilian public information officer.  Is your husband a Navy retiree?  In any case, be sure to thank him for his service (and thanks for yours, too!)

 


NY-Sooner
Regular Member


Date Joined Sep 2009
Total Posts : 463
   Posted 3/17/2011 6:17 AM (GMT -6)   
In 2007 , I had almost the same exact diagonosis as your husband when I was 54,  but with even a lower psa of 3.5  and 2 of 12 cores with <5% cancer at Gleason 6.  I was very seriously pondering AS, but one thing kept comming into my mind over and over again.   I read in many different articles that the biopsy is usually a conservative estimate of the cancer in your prostate.  When the actual pathology is preformed after surgery, the amount of cancer is usually worst then what showed in the biopsy.
 
Also because of my young age and excellent health and physical condition, I felt that if I were to have surgery, it would be better to have it now when I was younger so I could  recover quicker, then to wait a few years on AS then have it. 
 
I finally dicided to go with surgery, but with the best surgeon i could find so at least to give me the best odds possible for a good recovery. I picked a surgeon in Rochester NY with over 1000 surgeries at that time in 2007.
 
I had my surgery in 9/2007 , and just as the all the articles predicted, my cancer was worst than the biopsy had shown. The patology came back at still Gleason 6, but with 20% canacer found, and  not <5% like in the biopsy.  Also the one big thing that really impressed me and made glad I had the surgery when I did  was that the surgeon told me that the cancer was 3mm from the margin and escaping the prostate, and if I had opted for AS, more than likely the cancer would have escaped the prostate in a few years.
 
Today my psa's come back at 0 and I have no ED issues and am 99% continent, so I am very happy with the dicision I made and when I made it.

NavyWife
New Member


Date Joined Mar 2011
Total Posts : 4
   Posted 3/17/2011 8:21 AM (GMT -6)   
Once again, I can't thank all of you enough for your generous sharing of your own journeys, and helping me in the process.
We are still waiting for the second opinion on the biopsy. I think my husband is really leaning towards AS. I have done quite a bit of reading on the subject, and it's definitely a possibility at this stage. His urologist says that he would check his PSA every 3 months, and he'd have another biopsy in a year. I do believe my husband is quite bowled over at the thought of being incontinent or impotent. Every one of these treatments has that as a possibility, ie.." Do you want it now(surgery) or later( everything else)?
I know about complication rates and how to interview for a great surgeon, and I want to be sure he's alive in 30 years, but I do understand there are some devastating complications here. According to his doc, we have time. I'm going to let him read Walsh, and the other mountains of info I have bookmarked.
Yesterday I drove our 2 daughters downtown to get wristbands for SXSW. That's a big film and music fest they have here in Austin. I had time to read the Blum book because they waited in a 2 1/2 hr. line!! He had some interesting points. I am trying to be very clinical in looking at people's opinions. He was fortunate to have access to care that most men wouldn't. His roller coaster PSA's would've disturbed me. Reading Ornish's book now. We don't eat red meat, but now we're revamping our diet for sure. We've eaten very well, but I think we'll go even more vegetarian now.
There's a good series on MD Anderson's Prostate Cancer Website with John Davis,MD. Even though he's a DaVinci guy, he talks a lot about AS. Yes, we are in Austin, We are in the Urology practice that Fagin is leaving. More than likely, if my husband needs or chooses treatment, I'd tell him to go to MD Anderson.
Just going to let him soak all this in for now. I'm not sleeping...he sleeps like a baby!:-)
Much Gratitude...Kathy
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