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Posted 9/30/2011 3:05 PM (GMT -8)
I just received my pathology report after my prostectomy, they show three out of twelve lymph nodes have cancer
and some surrounding tissue.
now what do i do, they mentioned hormone theropy, what is that like? it doesnt sound good.
i feel like my life is over.

jack

smhair
Posted 9/30/2011 3:36 PM (GMT -8)
Hey Jack,

Sometimes we do get bad reports. You are in the right place for support. There are several guys here that have been in your situation and they will probably come on with some good advice.

Fighting cancer requires two important things: a lot of patience and a great attitude. Patience because we seem to be constantly waiting for something to happen. Worry just makes these times more difficult. Our attitude affects not only us but also all those around us. Keep a positive envronment and you treatment will be more effective. (I have no idea how that works but it does.)

Jump in and support other cancer people. These forums are a great way to do that. Nothing gets us more positive than helping others and nothing makes us more negative than being a hermit.

Let's get well together.

Jim
Posted 9/30/2011 4:09 PM (GMT -8)
Jaxum, Remind us or tell us what was post/op gleason score, Margin situation, Pathological stage, etc. It is a long way from over my brother. I would get other opinions on just doing HT, Top urological oncologist is in order, they specialize in prostate, bladder, penis urether cancer , A rare few will specializ in PCA. I could see radiation of lymph nodes, as possibility. You will assuredly be on HT, There is a bevy of info on this forum in the HT arena. It will be coming. I'm telling you, your specific condition, is treatable to give you many, many more years left. Stay on it , stay healthy in the other areas, Plenty of opinions on what that exactly means, but we all know when we are not living a healthy life, via things we do or do not , food exercize etc. Try to "turn the corner "on the negative thoughts, it works,, Logo
Posted 9/30/2011 4:10 PM (GMT -8)
Hi Jack,

I am also Jack. I didn't have surgery, but assume that with my statistics I am likely to have lymph node involvement as well. Many have and they have done well. The key is to have the best doctors, the best support, and the best winning attitude.

I traded a message with a brother earlier today that had bone mets and PSA of 4,900 when diagnosed over ten years ago amd he is going strong today. No need to give up. Rather you need to learn and make sure you have the best people treating you.

Jack
Posted 9/30/2011 4:12 PM (GMT -8)
Jack,
I'm sorry you got these results. But there is some good news still ~ you can do quite well even with that pathology. You will likely be told that hormone therapy and radiation are in your future. And it is a reasonable next set of steps.

While I am not a doctor, I am involved with multiple support groups and I have met many cases like yours. I can't stress enough about attending such groups enough and getting better educated about your disease from your peers and from oncologists.

Here are some things to consider:
1> You had 12 nodes removed in the RP. From what I have seen in presentation and in my case your doctor was well informed and by dissecting lymph nodes during RP there is clear evidence of better PSA control and better survival. Some say to remove even more nodes however...

2> You might want to ask at your upcoming visit to a radiation oncologist about radiating additional nodes. This too has some great evidence to follow.

From there you will likely have to make the decision to be aggressive or less so. Morbidity increases with each therapy, but I did very well with all three, RP/RT/HT, in combination. I was told about the possibility that a clinical trial could be a good idea and I shied away from it out of fear of the unknown. After five years of this stuff I have a different perspective than I did when I started out. Even though I am doing well so far, I kind of wished I looked into them more.

Catch your breath. You're in this ride for the long run. But again, stay positive and hopeful because there is plenty of great reasons to do so.

Tony
Posted 9/30/2011 4:30 PM (GMT -8)
Thanks for finding us I wish you could have chosen a different group of friends but under the circumstances you will find this group is awesome.
I too had 3 lymph nodes on both sides positive. i was a gleason 9 and had radiation and two years of ADT3. Even though the hormones were tough life went on. Today I am pretty darn normal and I have been off the hormones for two years. My advice is to take it easy and start educating yourself. I would also advise you to exercise your way through the hormones, I know it helped me a lot.
If you would like feel free to email me and we can discuss this more in depth.

peace to you
Dale
Posted 9/30/2011 4:54 PM (GMT -8)
Jack,

I certainly echo Tony's advice. He is our resident sage. This cancer hits you up front like a Mike Tyson left hook. Once the pain subsides and you shake off the fog you realize that you have to get down to business. Not all will agree but I advise enlisting consults from the best doctors in this speciality that your resources allow. I have bone involvement and research directed me to Dr. Charles (Snuffy) myers in Virginia. His treatment plans are individualized and tailored to your situation and his track record is impressive. So far I like the way he's planning my approach.

Email me if you need to chat.

Jim

Posted 9/30/2011 7:13 PM (GMT -8)
Jack,

I can suspect that adjuvant radiation will be suggested. It has some side effects, but consider the potential advantages.

This PCa affair is not a passing skirmish, but a war for the rest of  our lives.

I'll also speak for Tony's advice.

Your doctor did well by taking the lymph nodes.

Someone said "It ain't over till it's over". Hang onto that thought.

Posted 9/30/2011 7:20 PM (GMT -8)
jack,

while the news about cancer in your lymph nodes is not a good thing, your life is far from over. there's still a lot of ways and options to fight your next battle with prostate cancer.

there are several here in your situation that have done well for years, and hopefully, you will too.

we are all here for you, every step of the way. if you need to vent, vent, if you need to ask a million new questions, just fire them away, we can take it.

good luck to you, as you re-group your situation and get some new advice and directions from your doctors.

david in sc
Posted 9/30/2011 8:21 PM (GMT -8)
Jack,

While HT is no picnic, I have found it manageable and am successfully coping. Like others have stated, I am a big proponent of exercise while on HT. I have a fitness trainer and I am probably in the best shape of my life at this point, even though I am on HT. I am also fortunate in that my libido has pretty much hung in there.

Take some time to adjust the news. I had a lot of emotional swings for a while when I started HT but things have settled out quite nicely as of late.

Posted 10/1/2011 3:46 AM (GMT -8)
Jack, last night around 11:00 pm I jumped off the couch and told my wife I was going on the computer to see if Jack resolved his cath issue.I was really taken back when I seen your new post. I've never met anyone on this forum but your post really hit me hard.I'm pretty new with this whole PC so I can't give any advice, all I can say is that you went after this PC with surgery which tells me you are a fighter and you will do whatever it takes to beat this.
Posted 10/1/2011 4:00 AM (GMT -8)
Jack, I am so sorry to hear your news. It is not good that that the lymph nodes are involved but it is definitely not the end of the story. As others have said RT and HT are very probable next steps.

Many guys have gone there before you and can help guide you on that next step of the journey.

Cmetalman mentioned that he has not met any of the guys here face to face. I am just back from the GFMPH and have met man of the guys on the board. All are so much support and friends in a new detention.

Know that we are here to walk with you in the journey.

Cajun Jeff
Posted 10/1/2011 4:05 AM (GMT -8)
Jack,

Your life is far from over, you just have another battle to fight and win against this enemy we all call cancer. I can not add much more than what has already been posted by so many knowledgeable guys in this thread. Make sure you get a copy of the pathology report from your doc and post that information in detail with us so the experienced guys here can help you choose the best route for your PC journey.

We are all here for you so please use and abuse us as much as you need.

Terry TWG

Posted 10/1/2011 10:21 AM (GMT -8)
Jack

I know the "I feel like my life is over" I was there in July until my Urologist said...

This is Treatable and Survivable.

Take a breath - relax - we are all here for you.

Bud
Posted 10/3/2011 5:22 PM (GMT -8)
Thank you Guy's i love all your posts, most excellent you guys are Great! I just had my catheter removed (for the second time) i feel good , i can pee freely
so far so good now back to my pathology report post Davinci RP
prostate weight 39g and size 3.5cm
gleason pattern primary grade 4, secondary grade 3, tertiary grade 5
gleason score 7 (4+3)
tumor size 2.4cm
seminal vesicle invasion present
extraprostatic extension present
lymph vascular invasion present
perineural invasion present
metastic tumor identified in three of twelve lymph nodes

we are going to check blood for PSA reading six weeks after surgery to get a baseline reading
then probably start with Lupron hormone therapy , i don't know for sure, i will do the blood work
on November 1st.
thanks again
Jack
Ca.
Posted 10/4/2011 5:31 AM (GMT -8)
Jack:

I had surgery over 5 years ago with post pathology worse than yours (4+4(+5), 2 nodes positive intra-operatively, 5 positive at pathology, as they teased the nodes apart. 6 weeks after surgery psa was 2.7. I have been on and off of HT since then and am currently at 0.05.
The one thing I might have done differently was to wait to start HT until I had established a doubling time. It is possible to delay HT if the PSA-DT is extended, (and with my excellent response to HT it may have been) and I could have delayed the start of HT. That would not have complicated healing with Hormone treatments, It would have given more time for ED recovery, more time of mental stability (whew, and how) and time for another consultation and consideration of options. Nonetheless, What happened is done and I have no regrets.
The very BEST thing I have done is to find the very best oncologist I can afford to cover me.
Best wishes and you will be with us for a long time.
Posted 10/4/2011 11:21 AM (GMT -8)
oh yea, i like your post! thanks so much!

jack
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