1. < Prostate Cancer

Just diagnosed gobsmacked looking for advice

Posted by mhreed39 @mhreed39, Jun 24 8:30am

Offically diagnosed with prostate cancer 6/21/24. PSA is 15.25 (up from 2.8 six months ago). PI-RADS 5 score from MRI.
Biopsy score was Gleason 8 (4+4), Grade 4. 12 of 16 cores involved. Cribiform pattern present. Yes to Extraprostatic extension and Perineural Invasion. PMSA PET scan is being scheduled.
Have met with a surgeon who believes surgery is the best option. He will be taking both nerve bundles and lymph nodes. I have an appointment with a radiation oncolgist next week to get a second opinion.
At this point I know my inital decision is surgery v. radiation but with a cancer this aggressive I worry that a second or even more rounds of treatments are in my future and how my initial decision effects my later options.
Looking for advice or your experience.

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mhreed39 | @mhreed39 | Jul 18 9:47am
In reply to @northoftheborder "I *think* that both the pro and con of IMRT is that it affects a larger..." + (show)
@northoftheborder

I *think* that both the pro and con of IMRT is that it affects a larger area than SBRT or Proton — is that right?

It would be a con if you wanted to minimise collateral damage in the pelvic area, but a pro if there was concern that there might already be some local spread (if I understand correctly).

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@northoftheborder That is my understanding as well.

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stevecando54 | @stevecando54 | Jul 18 4:24pm
In reply to @spryguy "I did 39 sessions of IMRT followed by ADT. I am just finishing 24 mos of..." + (show)
@spryguy

I did 39 sessions of IMRT followed by ADT. I am just finishing 24 mos of Lupron (eligard), Zytiga, Prednisone.
It is a bit brutal (age 76). The last few mos have been better .
I found myself not giving into fatique and powering through to do the things I enjoy in my shop. I started by picking one activity then accomplish it and resting. Now I'm trying to be active from 7:30 until 11: 30, eat a light lunch, take the prednisone and try to nap. It seems to work on most days. Prednisone is a real batch.
GOOD LUCK TO ALL OF US.

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I always blame the prednisone for my fatigue, I have been on that and firmagon since the beginning. I know some have posted no bad effects from the prednisone but for me, that's what I'm going to blame. LOL, best to all

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2 replies
clandeboye1 | @clandeboye1 | Jul 18 4:29pm
In reply to @kmat "I'm heading into a prostate biopsy in two weeks. My oncologist said that at 77 he..." + (show)
@kmat

I'm heading into a prostate biopsy in two weeks. My oncologist said that at 77 he didn't think he would remove the prostate and that the MRI showed the cancer 'enclosed.' My thought is that the biopsy may lead him to a different conclusion? Also, what kind of radiation are you using mhread? I tried to bring up proton treatment but the oncologist wasn't interested in talking about treatment until after the biopsy results are returned. If I do proton, I'm looking at Orlando, FL, as closer to me in St Pete/Tampa but Jacksonville is also possible. But I get ahead of myself. Best.

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You are way , way ahead of yourself . Who knows what the Biopsy results will show .
You can certainly depend on the MRI totally even a PI-Rads 5 .
Am MRI does not grade the cancer . Multiple options will be clear based on the pathology report , and if necessary get a 2nd opinion .

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2 replies
spryguy | @spryguy | Jul 18 4:40pm
In reply to @stevecando54 "I always blame the prednisone for my fatigue, I have been on that and firmagon since..." + (show)
@stevecando54

I always blame the prednisone for my fatigue, I have been on that and firmagon since the beginning. I know some have posted no bad effects from the prednisone but for me, that's what I'm going to blame. LOL, best to all

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Thanks for the comments. My day is mostly over after I take P.
18 days left. It'll be nice to be human again.
GOOD LUCK

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kmat | @kmat | Jul 18 6:34pm
In reply to @clandeboye1 "You are way , way ahead of yourself . Who knows what the Biopsy results will..." + (show)
@clandeboye1

You are way , way ahead of yourself . Who knows what the Biopsy results will show .
You can certainly depend on the MRI totally even a PI-Rads 5 .
Am MRI does not grade the cancer . Multiple options will be clear based on the pathology report , and if necessary get a 2nd opinion .

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Thank you....my temperament to get ahead of myself. One thing at a time. Good advice. I'll keep all posted. This forum is excellent.

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1 reply
northoftheborder | @northoftheborder | Jul 18 9:02pm
In reply to @stevecando54 "I always blame the prednisone for my fatigue, I have been on that and firmagon since..." + (show)
@stevecando54

I always blame the prednisone for my fatigue, I have been on that and firmagon since the beginning. I know some have posted no bad effects from the prednisone but for me, that's what I'm going to blame. LOL, best to all

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Prednisone is the only treatment that really messed me up. They put me on it while I was still in hospital, to try to reduce the pressure on my spinal cord after the tumour was debulked, and it induced temporary diabetes to the point that I needed regular insulin shots. When we stopped the Prednisone, my blood sugar quickly went back to normal.

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stevecando54 | @stevecando54 | Jul 19 4:25am

The fatigue is probably from a combination of meds but I always blame the Prednisone. I take it twice a day, talked to the doc about it, he said I could cut it to one but I didn't want to find out the hard way it wasn't a good choice. I take Abiraterone and it's recommended to take two of the Prednisone so on we march. Best to all

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clandeboye1 | @clandeboye1 | Jul 19 7:33am
In reply to @kmat "Thank you....my temperament to get ahead of myself. One thing at a time. Good advice. I'll..." + (show)
@kmat

Thank you....my temperament to get ahead of myself. One thing at a time. Good advice. I'll keep all posted. This forum is excellent.

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Let us know your Biopsy Pathology results .
You may wish to seek a 2nd opinion before any procedure selection . YOUR RESULTS MAY BE NEGATIVE - ANOTHER REASON FOR A 2ND OPINION .
What was your MRI PI-RADS SCORE from your MRI prior to the Biopsy ?

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anosmic1 | @anosmic1 | Jul 20 8:49am
In reply to @clandeboye1 "You are way , way ahead of yourself . Who knows what the Biopsy results will..." + (show)
@clandeboye1

You are way , way ahead of yourself . Who knows what the Biopsy results will show .
You can certainly depend on the MRI totally even a PI-Rads 5 .
Am MRI does not grade the cancer . Multiple options will be clear based on the pathology report , and if necessary get a 2nd opinion .

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Thanks for this. My biopsy is next week. PSA and K4 scores were high and the MRI was “equivocal.” I hear from companies with oncology in their names - connected to my urologist - and my mind races ahead. It’s difficult to slow down but I needed that advice.

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2 replies
clandeboye1 | @clandeboye1 | Jul 20 9:27am
In reply to @anosmic1 "Thanks for this. My biopsy is next week. PSA and K4 scores were high and the..." + (show)
@anosmic1

Thanks for this. My biopsy is next week. PSA and K4 scores were high and the MRI was “equivocal.” I hear from companies with oncology in their names - connected to my urologist - and my mind races ahead. It’s difficult to slow down but I needed that advice.

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Good luck - I will be thinking about you .
Keep smiling . It's a great healing medicine -- better days ( years ) ahead .

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