Need advice on next step

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dreadnought
New Member


Date Joined Sep 2006
Total Posts : 18
   Posted 12/8/2006 5:23 AM (GMT -7)   
Hello Group,
I have been waiting to post for my next MD visit.
I had Davinci back on Oct 23 and feel great.
The Path report came back with some surprises. Gleason was increased from 7(3+4) to a 9(4+5), there was more cancer in the prostate than originally thought, and there was some cancer on the margins and in musculo-vascular tissue....no other cancer detected (none in seminal vesicles, bladder neck, lymph nodes).

PSA came back to "less than 0.1."

Now, because the cancer is a Gleason 9 and much more aggressive the doctors are strongly recommending hormone therapy combined with TOMO radiation early next year. They are very optimistic of a complete "cure," (their words).

Has anyone had a similar experience? I would love some ideas and feedback.

Thanks to all for thoughts and prayers.

Dreadnought

52 male
Davinci 10/23/2006

GreenAcres
Regular Member


Date Joined Jul 2006
Total Posts : 474
   Posted 12/8/2006 7:03 AM (GMT -7)   
OH, Dread, we know what you're going through. That's a nasty surprise. When you hear that news, it's like the second freight train coming through the tunnel. While we went from a tiny little biopsy report to a huge upgrade post-path, our doc for the present is suggesting that with our chance of a 30%-50% recurrence that we proceed with regular 6-month PSA checks. I have to tell you that it will hang over our heads forever, now. While we hope for a "never," each test will be done with a bit of that original scare.

These are tough decision-making times ahead. While I'm not offering advice, just know that we're all here pulling for you - and a cure.
Husband age 65
PSA on 5/1/06: 4.2 (had doubled in 13 mos. and rising monthly)
DaVinci Surgery 8/2/06
T2a (at biopsy)
T4c (at pathology) w/cancer cell leakage into fatty tissue
Post-Surgical PSA on 10/3/06 - undetectable!
Update: 11/1/06 - perhaps bladder neck involvement; 30%-50% chance of recurrence
Future: PSA tests twice-yearly for now
 


lawink
Veteran Member


Date Joined Oct 2006
Total Posts : 621
   Posted 12/8/2006 7:51 AM (GMT -7)   
Hi Dread!
That is scary news indeed! However, the additional treatment hormones and radiation as you mention sound like they will provide the outcome you are looking for. We're all here to support you!

:o) Linda & Bob
Bob (60) had laproscopic prostate surgery on Sept 27, 2006 - 2/12 malignant biopsy samples - gleason 3 + 3 = 6.  Follow up PSA results and pathology results received Nov 14th are NO MORE CANCER!  Gleason changed to a 3 + 4; cancer completely confined to prostate; (even a second more agressive, previously undetected cancer)      PSA UNDETECTABLE.
 
Bob also takes Hydroxyurea to control Polycythemia (elevated red & white cells & platelets) has secondary condition . . Myelofibrosis) -- If anyone has experience or knowledge of these, please post us.


Tamu
Veteran Member


Date Joined Oct 2006
Total Posts : 626
   Posted 12/8/2006 7:53 AM (GMT -7)   
Dreadnought,

My post op pathology was good so I cannot provide any experience but if my path had come back like yours and my urologist made the recommendation that yours has made I would be out looking for a second opinion right away and probably from a well known cancer center. I would want to know what advantages/risks there are to following the recommended treatment versus waiting and letting the PSA checks dictate the next step.

You have a stressful path ahead. My prayers are with you.

Tamu
Diagnosed 7/6/06
1 of 10 core samples, 40%
Stage T1c, Gleason 3+3
Da Vinci on 11/01/06
56 Years Old
Post Op Path
Gleason 3+3
Approx. 5% of prostate involved
Prostate Confined, margins clear


dreadnought
New Member


Date Joined Sep 2006
Total Posts : 18
   Posted 12/8/2006 8:01 AM (GMT -7)   
Green Acres,

Yes----what a shock. Based on my pre-op informatoin, I expected to have surgery and be back to normal in 4 or 5 months. I consider this just a bump (well, a quite large bump) in the road, but truly expect to be "cured" after the treatments.

However, it appears that you have taken the "watchful waiting" route, and I was wondering about the advantages of that. We have been told that if we do nothing the chances are very high that the prostate cancer will re-occur at some point, and at that time "cure" will be highly unlikely and the treatment will shoot for control and extension of life.

My family (wife, especially) insists we do "something."

I would love to hear how you all decided to delay treatment and what advice you got to encourage this decision.

Thank you for your support....

Dreadnought

Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 12/8/2006 8:36 AM (GMT -7)   
Dread,

What a worry for you...I am so sorry. There are some good Oncologists out there doing some pretty good stuff these days. Prostateline.com is a decent information site as is UrologyTimes.com. WebMD has a prostate support group where there are a few men who have had your treatment. Prostatehelp.org is another place to seek men (lots of them) with a similar situation to yours. The support is out there...including US! Prostatehelp.org is a very good resource for locally/advanced PCa especially. Please check it out.

The treatment mode your Doc has in mind is the standard protocol for men in your situation. Many are seeing long term control with hormone and radiation when it's done very early. The Docs seem to have every confidence in their ability to control the beast so, hang in there and remember.....you have lots of support right here.

Vickie

M. Kat
Veteran Member


Date Joined Jul 2006
Total Posts : 715
   Posted 12/8/2006 10:12 AM (GMT -7)   
Dread, my prayers are with you as you have to make yet another decision. sorry to hear about it! I know there are a few people here at this site that have been through the same thing. I'm sure they'll be responding. here's a hug for you and your family! kat
Husband Jeff 56 years old diagnosed July 27, 2006
PSA 6.5, 2 positive areas in biopsy, Gleason 3+3=6
Radical Retropubic Prostatectomy August 30, 2006
pathology report - all clear - cancer gone
1st post-surgery PSA test 0.1
no more pads Oct 12, 2006
2nd post-surgery PSA test 0.1


whispers
Regular Member


Date Joined Nov 2006
Total Posts : 44
   Posted 12/8/2006 10:46 AM (GMT -7)   
Dread-
As the daughter of a daddy going thru reaccurance PC, I would recommend that you talk to an oncologist, and stay on top of the PC while you have a chance to "cure" it. We are on the other side right now-my dad is doing chemo-and we can't cure it-at least I don't think so but am hoping for that miracle. I would definitely follow the doctors advice-after maybe speaking with an oncologist also. Sounds like it could be a great preventive measure.
God bless-
Lisa

GreenAcres
Regular Member


Date Joined Jul 2006
Total Posts : 474
   Posted 12/8/2006 11:37 AM (GMT -7)   
Well, Dread, as you know - no decision is easy. Our surgeon feels that we'll take the next step only if needed and he's also 50-80% confident we won't have to face a return in our lifetime. If it does rise, in his opinion, it won't reach drastic measures within each six-month testing period. I made him swear that it wouldn't ;-) !!!

With an undetectable PSA, those little remaining cells may never, ever resurface. In that case - for us, anyway - we have avoided the hormone/radiation therapies that we chose to avoid in the first place - and for all the obvious reasons many have outlined here.

I will say that if our PSA had been anything but undetectable, we would be looking at other options.
Husband age 65
PSA on 5/1/06: 4.2 (had doubled in 13 mos. and rising monthly)
DaVinci Surgery 8/2/06
T2a (at biopsy)
T4c (at pathology) w/cancer cell leakage into fatty tissue
Post-Surgical PSA on 10/3/06 - undetectable!
Update: 11/1/06 - perhaps bladder neck involvement; 30%-50% chance of recurrence
Future: PSA tests twice-yearly for now
 


GreenAcres
Regular Member


Date Joined Jul 2006
Total Posts : 474
   Posted 12/8/2006 11:39 AM (GMT -7)   
I might add that I totally agree with Tamu. Thanks for jumping in here, Tamu!
Husband age 65
PSA on 5/1/06: 4.2 (had doubled in 13 mos. and rising monthly)
DaVinci Surgery 8/2/06
T2a (at biopsy)
T4c (at pathology) w/cancer cell leakage into fatty tissue
Post-Surgical PSA on 10/3/06 - undetectable!
Update: 11/1/06 - perhaps bladder neck involvement; 30%-50% chance of recurrence
Future: PSA tests twice-yearly for now
 


Izzyblizzy
Regular Member


Date Joined Oct 2006
Total Posts : 411
   Posted 12/8/2006 11:55 AM (GMT -7)   
Dreadnought,

So sorry to hear this. In reading through this thread, I just want to throw in an observation. You are only 52, while Greenacres hubby is at the young age of 65. That thirteen year difference may impact recommended threatments. Watch and wait for a 65 year old may be different than what might be recommended for someone at 52.

Just a random thought that popped in my head to consider while weighing your options!
Keep us updated!

Tanya
Signficant Other diagnosed: 10/30/06 (age 63)
PSA: 3.7 (up from 3.4 prior year)
Gleason: 3+3
Biopsy: 1/10 positive, 5% cancerous, right apex.
Treatment:  Undecided

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