Well a lot of you have met my husband now and I am so glad he joined in. We went to the urologist today and found out the the bone scan was negative (he told us it would be but you still feel better when you know it). We also got all his records sent to Beth Israel Hospital in Boston where I did some research and some calls to friends there and found an Oncologist who can at least review his records and have a consult with us so Chris can decide what is the best treatment for him by an unbiased Dr. The uro is a surgeon who we are unfamiliar with (his uro is away) and he said in his opinion he would recommend radiation or surg but because of the enlarged prostate causing issues he would seriously consider surgery open or robotic 50/50 (he does open). He also stated that he would like the surgery scheduled if that's what he chooses no more than 2 weeks after the MRI. The MRI is scheduled for April 9 but we have not made a decision regarding what treatment yet. We asked about a TURP with radiation and he said it was possible but felt with radiation the risks are higher in 10-15 years and because his age. He also said that no lifting after surgery more than a gallon of milk for 8 weeks with open 6 weeks with robotic, huge concern of Chris because he lifts at work as well as truck driver. We found out his short term disability will not work for cancer awesome news, you can buy a separate policy for cancer, before diagnosis cool! I don't want him deciding treatment based on when he can work! We will get through this journey so many questions with so many variables. Looking forward to seeing the onc waiting for a call with that appointment. By the way how do you guys deal with the response "oh thank God it's only prostate cancer, that's very curable" and everyone knows someone who has had prostate cancer and "they're Great" ugggg I understand positive attitude but as a wife of man who has prostate cancer and a 27 yr cancer survivor myself (of a highly curable kind) I want reach across the room or reach through the phone and smack them! The best response so far was from our best friends "anything we can do for you we're here". Colleen
I don't recall if I've commented to you in other threads, but your husband's situation is somewhat similar to mine, except that his PSA is much higher than mine was.
My comments, of course, are only those of a layman with no medical experience other than that of a PC patient. With this in mind, I'll relate to you what happened with my own case and what I have learned throughout this process.
I also had 3 positive cores, all Gleason 6. Two were 20% involvement and one was 5%. My local urologist (who DXd me) said that he would have recommended active surveillance if I had less than 3 positive cores. But, with three positive cores he said he believed in an "aggressive" approach and recommended da Vinci surgery.
He then sent me for a nuclear bone scan and abdominal CT, which he assured in advance would both be negative. He was correct.
As I later learned, three positive cores is pretty much the cutoff for AS consideration, so I had one positive core too many.
As luck would have it, I already had been scheduled for my annual physical at Mayo Clinic, which was only a month away. So I took my stats to Mayo to get their opinion.
Both the Mayo radiation oncologist and Mayo urologist agreed that I needed treatment. The radiation oncologist said my case was curable by either external beam radiation (EBR) or surgery. He ruled out brachy for my case because of my greatly enlarged prostate. This is because the seeding needle would not be able to reach every corner of such a large prostate, which tends to sprawl out in all directions, behind bony structures, etc.
The radiation oncologist also noted that he could cure the cancer but could not do anything about
the severe urination problems I was having. So, going against his own specialty, he recommended that I consider da Vinci surgery to kill both birds with one stone.
As my signature, down below, notes, I ended up having surgery with the Mayo urologist I consulted with after seeing the RO.
So far so good. After the surgery he was very confident that I was cured despite a tiny positive margin. And within 2-3 months after surgery I was back to any physical exertion I wanted to do. I was 100% continent within a couple weeks after the surgery and am able to urinate like a brand new firehose.
As with all patients, I was not allowed to lift anything heavier than a gallon of milk (10 pounds) for the first month, then more & more as I felt able. Within 2 months I was carrying heavy, old picture tube based televisions up and down my basement stairs -- as if I had never had any surgery.
The surgery and catheter were painless for me.
As for other people, I also had people shrug off my news by saying, "Oh, that's easily curable these days, no big deal at all." I think that some of these people were probably trying to sound very upbeat and positive to help me feel better.
And others, on the other hand, probably think that it is a walk in the park. They do not realize that even PC must be caught and treated very early or it can be just as devastating as any other form of cancer.
I hope that some of my situation is applicable to your husband's so that it might be of use to you.
Please feel free to ask any other questions that might come to mind.
Resident of Highland, Indiana just outside of Chicago, IL.
July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA Sept. 2011 was 5.7.
Local urologist DRE revealed significant BPH, but no lumps.
PCa Dx Aug. 2011 at age of 61.
Biopsy revealed adenocarcinoma in 3 of 20 cores (one 5%, two 20%). T2C.
Gleason score 3+3=6.
CT of abdomen, bone scan both negative.
DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
My surgeon was Dr. Matthew Tollefson, who I highly recommend.
Final pathology shows tumor confined to prostate.
5 lymph nodes, seminal vesicles, extraprostatic soft tissue all negative.
1.0 x 0.6 x 0.6 cm mass involving right posterior inferior,
right posterior apex & left mid posterior prostate.
Right posterior apex margin involved by tumor over a 0.2 cm length, doctor says this is insignificant.
Pathology showed Gleason 3 + 3, pT2c, N0, MX, R1
adenocarcinoma of the prostate.
Prostate 98.3 grams, tumor 2 grams. Prostate size 5.0 x 4.7 x 4.5 cm.
Abdominal drain painlessly removed morning after surgery.
Catheter painlessly out in 7 days. No incontinence, occasional minor dripping. 100% continent after 3 weeks.
Post-op exams 2/13/12, 9/10/12, 9/9/13 PSA <0.1. PSA tests now annual.
Brief, firm erections on occasion, still hoping for more improvement.
Post Edited (HighlanderCFH) : 3/4/2014 10:08:29 PM (GMT-7)