Just diagnosed gobsmacked looking for advice

surgery may be best option, but lets see . Let us know what the PSMA PET scan says . How old are you and do you have any other health issues ? this is crucial , re- after surgery healing and options. Do you have ANY glandular cancer in family . From the rise of PSA , it appears aggressive . Not to worry to much . Get treatments as soon as you can . When did your PSA go above about 1.5 . I find 1.5 PSA to be a resistance level for cancer /non cancer . I had operation 3 years ago now . Other than a Hernia after operation , I have had no issues . Im fine! hiking everyday with dogs and wife about 7-12 KM's . No problems. PSA when from 4 , to about 0.2 after surgery . Because it never went to zero , I got EBRT ( 22 sessions no ADT ) and now PSA is down at 0.056 and going lower ! Medical advances have been huge over past 5 years ! You will be fine , just a life adjustment ! James on Vancouver Island .

I am 67 years old and was diagnosed with Stage IV, Gleason score 4+4 almost 4 years ago. Six months after starting on Lupron and Zytiga, I had 28 sessions of radiation. So far so good! It was not easy. I had a catheter installed during radiation and they removed it after a month. My PSA is 0.2 today (last quarter my PSA was 0.1) and I feel good. Been off Lupron and Zytiga for a year and a half. I feel great. I exercise daily, weight up a bit at 204 (I'm 6'1") Keep fighting and make sure you consult with your oncologists.

My situation is very similar to your, except I was Gleason 4+5=9, extraprostatic extension, Cribriform (Cp4) and Intraductal adenocarcinoma (IDC). I had NNS RARP 4+ weeks ago. The actual surgery was relatively quick to recover from, but the complications - not so much! My Urologist at Mayo in Phoenix said, "you will have reoccurance, it just a matter of when." He said this is because of the Cp4/IDC and the high Gleason score. Thigh numbness and pain from lymph node dissection and especially the incontinence is a pain in the a**. It's pretty depressing, especially knowing that radiation and ADT (have been told 18-36 months) may be in my future, but it is what it it is. I strongly believe surgery was definitely the right option with such an agressive cancer because. From everything I've read and been told, radiation doesn't always get all of the prostate/cancer tissue, and with an aggressive cancer you're possibly going to end up with a salvage prostatectomy at some point in the future. Good luck to you - we are actually quite fortunate to live in a time when so many treatment options exist!

Thanks @robertchas2003. Your path sounds like the one I have just begun. Same Gleason score, same treament. Glad to know you are faring well on the other side of things. Thanks for the enouraging words.

Thanks @stevemaggart. Good luck to you on your journey as well.

It's hard to still the mind and keep it from racing. But one can and should only make decisions once all the relevant information has been gathered.

@anosmic1, how did the biopsy go? Any news?

I'm not supposed to see my doctor for results until 8/7, but the hospital sent me results and I see the word adenocarcinoma, so I assume I'm facing a cancer diagnosis. I'll reach out to the doctor and some others on Monday to make sure I'm not jumping to a conclusion. Patience may be a virtue but it doesn't feel like it this morning.

mhreed39, I definitely agree with surgery to remove your known aggressive cancer. I was diagnosed 2 1/2 years ago at 55 years old with Gleason 7 (4/3). I opted for surgery for several reasons.
First, surgery removes all known cancer, versus relying on imperfect imaging tools to direct treatment. I did not want to manage my PSA at a low level but rather have a more definitive PSA/Undetectable PSA test.
Second, I wanted confirmation of the cancer grade and aggressiveness with a physical pathology. So many men find they have more aggressive or additional cancer when the pathology is performed. Today's scanning technology is awesome, but I just did not want to bet my life on it.
Third, I wanted to reserve all future options in case the prostate cancer came back (thankfully, PSA undetectable thus far). From my research and referencing medical professionals, it is very difficult or impossible to have surgery after radiation.

I am very high on surgery based on my research and outcome, but surgery is not for everyone in all situation. You need to assess your personal expectations for life going forward and take into account other comorbidities and age. I was healthy, relatively young for prostate cancer (55), positive, and have an expectations for 30+ additional years of cancer free life to spend with my wife, son, and family/friends.

Best of luck and I pray all goes well with the treatment you move forward with!!

Jim

Hi, @hammer101 and thanks for the reply. Unfortunately my cancer has escaped the prostate and metastasized. So surgery is off the table, will be doing radiation and ADT.

My PC when diagnosed was Gleeson 10, stage 4, with some local metastases and one metastasis to a lymph node in my chest. Most docs won’t do chemotherapy because they cite a study saying it’s not effective. However, the study did not include doing multiple steps in close succession or simultaneously, which is highly effective. I switched my care to doctor Eugene Kwon at Mayo Rochester, immediately started Lupron, had Docetaxel chemo, then eternal beam radiation. His goal was to get me clear and keep me that way for at least 10 years. I was clear within 8 months and have been clear for 1.5 years. A friend had PSA of 4500 (yes), many metastases and is now clear. If you want to live, I suggest you watch his videos on YouTube. Search under his name and prostate cancer. There should be about 4 videos. My wife found these and saved my life.