1. < Prostate Cancer

thoughts on what I should do.

Posted by z1k @z1k, Mar 3 11:19am

48 years old , So How screwed am I. Dr. gave me two options radiation pellets or a Prostatectomy. Pet scan is next week. right now its panic and wait. was told if I did radiation then surgery was not an option after the fact as no dr would remove the prostate after I had received radiation first. but If I removed the Prostate and the cancer came back then I could get radiation afterword's.

SPECIMEN C: PROSTATE, LABELED AS "RIGHT APEX", CORE BIOPSY:
- ACINAR ADENOCARCINOMA, GRADE GROUP 3 (GLEASON SCORE 4+3=7)
- PERCENTAGE OF GLEASON PATTERN 4: 71-80%
- CRIBRIFORM GLANDS: NOT IDENTIFIED
- NUMBER OF POSITIVE CORES: 2 OF 2
- TOTAL CORE LENGTH INVOLVED: < 5%, 6-10%
- PIN4 MULTIPLEX IMMUNOHISTOCHEMICAL STAIN SHOWS THE ABSENCE OF BASAL
CELLS (p63 AND 34betaE12) AND IS POSITIVE FOR AMACR STAINING WITHIN
GLANDS OF INTEREST
- SEE COMMENT
Comment: The Gleason grade 4 tumor shows some nuclear stratification and
tufting suggestive of ductal features; however, the quantity of tumor
present precludes a more definitive diagnosis of ductal carcinoma.

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

graybeard46 | @graybeard46 | 4 days ago
In reply to @trusam1 "I didn't read that as a "results-based" 7 day money back guarantee, but as "satisfaction with..." + (show)
@trusam1

I didn't read that as a "results-based" 7 day money back guarantee, but as "satisfaction with the content of the program". She brings together information which is freely available, but rarely in an organized, focused manner, and then proceeds to outline practical steps to take in rehab. Not unlike visiting a PT after ortho surgery or injury. She also resides in an ecosystem of several other Aussies, with her podcasts, e.g. I found her a good place to start my recovery journey, but not the complete package. I got clues from her about where to look further. It was like getting my hand held as I blundered through Google looking for help.

Jump to this post

I will try it

REPLY
heavyphil | @heavyphil | 4 days ago
In reply to @brianjarvis "Regarding the “if I did radiation then surgery was not an option after the fact.” According..." + (show)
@brianjarvis

Regarding the “if I did radiation then surgery was not an option after the fact.”

According to data from the Mayo Clinic (in Dr. Kwon’s presentation), following initial radiation if there is recurrence, half the time recurrence is distant from the prostate so, surgery isn’t even a consideration. However if recurrence is in the prostate, there are other preferred treatment options besides surgery - like focal therapies (because the dose can be specifically targeted), brachytherapy, SBRT, and sometimes even re-radiation.

Treatments have advanced over the decades where the old-school thought used to be “no surgery after radiation.” These days, surgery should be considered as a final salvage treatment only when all other options have been exhausted.

(For a localized, 7(4+3), PSA of 7.9, I had 28 fractions of proton radiation (during April-May 2021) + 6 months of Eligard + SpaceOAR Vue. PSA now varies between 0.35-0.55.)

Jump to this post

Yes, my friend’s RO at Sloan said that if his Cyberknife treatment failed, they could then do brachytherapy…assuming of course, recurrence is in the prostate only.

REPLY
1 reply
marciandpaul | @marciandpaul | 4 days ago

Hi. My husband had a similar experience at 52 years of age. He experienced strange symptoms at about 49 and went to a urologist who said he had prostatitis. At that time nobody thought to do a biopsy, my husband nor the urologist. Fast forward to 52 years of age and his PSA screening was high. He had a biopsy and a Gleason score of 10.

If he had known sooner, the cancer may have stayed within his prostate. During his prostatectomy the surgeon removed 18 lymph nodes. Two weeks later he received a report on his healthcare portal that his cancer spread to one lymph node and into the seminal vesicles.

It’s been four years since the diagnosis. He had 33 rounds of radiation after the prostate removal and two hellish years on Lupron and Aberaterone. Now, we do have a sex life again, he runs or lifts weights every day of the week and he feels amazing. We both know the cancer could return but for now, we are enjoying the time each day.

My husband and I have two boys and a daughter. Our boys are in their early twenties and we all know their chances of having prostate cancer at an early age are high. My husband’s brothers, uncle, dad, all had prostate cancer (one at 40), all had their prostates removed and nobody had any cancer spread, except my husband.

My advice is take out the cancer source. You are young. If you find a highly skilled surgeon, hopefully you will not experience long term erectile dysfunction. If you don’t remove the prostate, it could always spread outside of your prostate and then your dealing with stage 3 or 4 metastatic prostate cancer, like my husband.

Good luck in your decision. It’s not easy but at least you are informed and know the cancer is contained within the prostate at this time.

REPLY
brianjarvis | @brianjarvis | 4 days ago
In reply to @heavyphil "Yes, my friend’s RO at Sloan said that if his Cyberknife treatment failed, they could then..." + (show)
@heavyphil

Yes, my friend’s RO at Sloan said that if his Cyberknife treatment failed, they could then do brachytherapy…assuming of course, recurrence is in the prostate only.

Jump to this post

Even if his recurrence was both local and spread, they would do systemic treatment (and perhaps local treatment as well).
The point is that guys too often jump first to surgery, when often surgery should be relegated to the final option and only if/when all others have failed.

REPLY
edinmaryland | @edinmaryland | 4 days ago

anecdotal
I had prostatectomy and believe it is the right choice for me. It is no 'walk in the park' but hopefully connects to longevity
However, I have a 96-year old uncle who has had prostrate cancer for probably 40-50 years he has the radioactive seeds , just anecdotal but in his case this seems like it was a very good choice for him

REPLY
stu6060 | @stu6060 | 4 days ago

I was 46 when I was diagnosed with prostate canceer. Had my prostate taken out.
Enjoyed 17 years of undetectable PSA, now it's starting to show up again in my blood tests (.110) I am glad I am still a candidate for radiation if cancer comes back. The other issues that go along with this crummy disease we have are not to be minimized,, but I like being alive so cancer control has been my primary concern.

REPLY
View MoreView Less
Please sign in or register to post a reply.