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Recently diagnosed with prostate cancer: What questions to ask docs?

Posted by solesky @solesky, Jun 28 7:14pm

I was recently diagnosed with prostate cancer, I have a Gleason score of 7 in 3 areas and a 4 in another spot, I'm scheduled to meet my new oncologist, surgeon, and hormone Dr early next week to discuss my options. What I got from my talk with my urologist was because of my age, 73, I'm at the in between age of what option for me is best. He basically said I could have radiation treatment or surgery to remove my prostate and hopefully be cancer free after surgery. So many side effects and things to deal with after surgery, but I'm leaning towards the surgery just to be done with the cancer. but honestly, I know absolutely nothing about this. Got any questions I can ask these Dr's during my meeting? I'm pretty much scared to death of this whole thing. Help.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

clandeboye1 | @clandeboye1 | Aug 2 9:52am
In reply to @pieperfarm "Erections, continence, life expectancy. Pick a solution that works for you. I had HIFU at 57...." + (show)
@pieperfarm

Erections, continence, life expectancy. Pick a solution that works for you. I had HIFU at 57. Surgeon wanted to remove prostate, which normally does not cause continence issues until age 80, because it had a 86% survival rate for me (I also had markers & DNA tested). When pressed HIFU with active surveillance had a survival rate of 84% and could be repeated as necessary. You will lose erections and continence with surgery, the only question is when (60, 70, 80). I have a PSA test this week, and my first MRI after the HIFU. The HIFU took care of the Gleason 6 and Gleason 7 on one side of the prostate. I still have Gleaon 3+3 on the other side.

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What country are you in and where did you have your HIFU Procedure ?

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westernflyer | @westernflyer | Aug 2 10:23am

After the second biopsy, I decided on proton radiation, as mentioned. Loma Linda did a scan (cannot recall what type, but no doubt the best available) and confirmed the location(s) according to the biopsy(s). This is how targeted proton radiation therapy is designed to maximize effectiveness.

Being at Loma Linda for 2.5 months plus several days before and after, I learned much about this type of therapy.
Initially, proton radiation at Loma Linda Children's Hospital was for children with brain cancer. Targeted and precise without damaging surrounding tissue is the main attribute of the proton option. By the way, each morning under the machine cost TriCare for Life $3800. And, that was 14 years ago. RH/Leesburg, Fl

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clandeboye1 | @clandeboye1 | Aug 2 5:31pm
In reply to @westernflyer "Can only comment on my experience. Mine was localized; Gleason 3+3; T1 as slow-growing prostate cancer..." + (show)
@westernflyer

Can only comment on my experience. Mine was localized; Gleason 3+3; T1 as slow-growing prostate cancer diagnosed after two (2) biopsies. The first question is how much the cancer has spread. If the cancer is well-defined and in a specific localized within the prostate, then the option for proton radiation therapy might be an option. I went through 2.5 months of proton radiation therapy at Loma Linda Hospital in 2010.

If the cancer is throughout the prostate gland, then other more radical options are available to include surgery.

The question from what I understand from my experience and reading volumes on the issue is the "intensity" or the scale of cancer. PSA is the "marker" usually, but not always, but usually so. The steps to validate the locations and intensity would be perhaps the PET scan followed by a biopsy. Then the options for radiation, surgery, or other are considered. THIS IS JUST MY VIEW-ALWAYS OBTAIN A SECOND OPINION OR MORE.

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As I previously reported my 1st Biopsy came back negative . My 2nd Biopsy 6 cores out of 16 were Gleason 3 + 3 = 6 .
The 2nd Opinion of my Gleason 6 slides just came back , not G6 , but all Gleason 7 .
What next : A 3rd Opinion of my 2nd Biopsy pathology results . -- Put them all in a hat and draw one out -- Just joking . But which one do you believe ?

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westernflyer | @westernflyer | Aug 2 6:04pm

The difference between the first biopsy and the second is alarming. Especially, if the cores were taken from the same location.

What you are saying is that the interruption of the cell slides differs, Hence, a matter of professional opinion.

National statistics say one (1) in 8 (8) men will have some form of prostate cancer. That being said, the precision at "reading" the cell configuration should not be so varied. So, you are 16 "pinpricks"!

First, make certain the pathologist who read your cell configuration has the experience. One can watch YOUTUBE and see what cancer cells in the prostate look like. So, it is not "rocket science".

But, lastly, I would assume you have prostate cancer of some degree.

The next question is what to do about it. Much depends on lifestyle, age, health, and all the things you have already read about. There are so many options. It seems to depends on the cancer and if the cancer has spread or remains localized. You read my comment about proton radiation, so that is one option. Keep in touch and if I can provide anymore factural support info from my experience, let me know this medium.

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westernflyer | @westernflyer | Aug 3 6:22am

Dr. Patrick Walsh's Guide to Surviving Prostate Cancer Kindle Edition On Amazon for $12.00.

THIS IS AN EXCELLENT BOOK. FOR MANY THE ISSUE AND CHALLENGE IS WHAT QUESTIONS TO ASK TO GET THE REPLIES NEEDED TO MAKE THE RIGHT DECISION. THIS BOOK TAUGHT ME A FEW THINGS I THOUGHT I KNEW. PLEASE PURCHASE THIS FROM AMAZON. AND PASS IT ON, PLEASE!

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1 reply
northoftheborder | @northoftheborder | Aug 3 9:47am
In reply to @westernflyer "Dr. Patrick Walsh's Guide to Surviving Prostate Cancer Kindle Edition On Amazon for $12.00. THIS IS..." + (show)
@westernflyer

Dr. Patrick Walsh's Guide to Surviving Prostate Cancer Kindle Edition On Amazon for $12.00.

THIS IS AN EXCELLENT BOOK. FOR MANY THE ISSUE AND CHALLENGE IS WHAT QUESTIONS TO ASK TO GET THE REPLIES NEEDED TO MAKE THE RIGHT DECISION. THIS BOOK TAUGHT ME A FEW THINGS I THOUGHT I KNEW. PLEASE PURCHASE THIS FROM AMAZON. AND PASS IT ON, PLEASE!

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The reason I'm hesitant to buy a book is that I've written a couple of them myself (in a non-medical-related field), and I know how long it takes from contract and advance to publication.

I was diagnosed in fall 2021 and the prostate-cancer landscape has already changed significantly since then, so any book — no matter how qualified and brilliant the author — will already be out of date to some extent by the time it hits the presses (the same problem exists with computer books). 🙁

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westernflyer | @westernflyer | Aug 4 1:27pm

Knowledge is power..and in some cases with this topic the "meaning of life". There is much to learn and as mentioned, the challenge is to ask the right questions.

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kenporter | @kenporter | Aug 5 10:44am

Dr. Patrick Walsh's “GUIDE TO SURVIVING PROSTATE CANCER” is amazingly informative. The Revised and updated 5th edition was written in October of 2023 and printed this year (2024). I would recommend this book to anyone dealing with prostate cancer. I think it was about $12 on Amazon.
Ken

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