Prostate Cancer: The waiting to get going on treatment is killing me

Posted by Bob Butler @robertjohn, Apr 8, 2015

I just received the diagnosis of prostate cancer from my urologist on March 25. PSA 4 months ago was 5 and gland felt normal. Then a month ago PSA jumped to 14 and they found a bump during the DRE. Then the biopsy. High Gleason score of 10 indicating aggressive at that spot. I have been checked yearly and at 6 month intervals for 7 years. I sit here 14 days later and still have not had a face to face with the Dr. He is on vacation. I am thinking of just heading to Mayo and get this process rolling. Shouldn't I have had more concern here from my docs to get moving? Or am I impatient? I feel the waiting is killing me and my family. The bone scan is done as well as the CT scan. Bone scan is good, CT shows slightly enlarged lymph nodes in the pelvic area. Could be just swollen. Insurance company denied a further PET scan and now I am waiting again. What an ordeal to deal with and no one seems to be as concerned as me. Any thoughts.

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

@jt3451

I am sending good thoughts to you and feel bad you had to go through this I am newly diagnosed and deciding between surgery and radiation i am a 4+4 am in buffalo ny and not confident they are the best here went to cleveland clinic saw surgeon not radiologist he ofcourse recommended surgery but i just dont no what to do i am scared to no end anyway adivce would be nice but before that once again I am wishing you happiness and a good run you sound like a wonderful confident strong person so I think you know what your doing bless you and your family life is tough

Jump to this post

jt3451: your right. It is scary so take one day at a time. I had 3+4 and isolated in the prostate with a psa of 10.2. I had multiple opinions from radiation oncologists from different centers of excellence. Did not feel the 20-30% risk of biological reoccurrence with prostate removal was worth it and the potential for side effects and quality of life, did not work for me. Many on this web site have had success with it.

Narrowed my decision down to the mridian Linac radiation machine or proton therapy. Chose the mridian machime with 5 treatments because the healthy tissue that was exposed outside the prostate was 2 mm vs 3-5 mm with proton and other radiation treatments. The mridian also automatically shut off if the machine detected the radiation was about to go out of the mapped area. It is also the only machine that has a built in MRI so real time dynamic planning and adjustment in response to internal and external body movement was important to me. Dr Himanshu Nager from Weill Cornell/NY Presbyterian in New York city has lots of prostate experience with the machine.

Use your biopsy material, which is good for about a year, to get a decipher test to test the aggressiveness.

Many people chose proton therapy and are happy with their choice as well because of its narrow beam and the radiation exit was limited.

Ask about spaceoar insertion which separates the bladder from the rectum and helps minimize health tissue exposure from radiation.

The more healthy tissue that is exposed the more potential side effects and quality of life issues.

Good luck and keep asking questions.

REPLY

Based on my experience with Mayo Jax and my RLP surgery and recovery, if you are accepted as a patient at Mayo, I would encourage you to get the first available appt for surgery. I had two 8’s and two 9’s and my Mayo Dr wanted it out asap. Had surgery two months after my biopsy. All lymph nodes, seminal vesicles and vans were clear. None of my tests showed any spread anywhere. I am nine weeks post op and waiting for my first PSA and Dr appt in mid October.

REPLY
@jt3451

I am sending good thoughts to you and feel bad you had to go through this I am newly diagnosed and deciding between surgery and radiation i am a 4+4 am in buffalo ny and not confident they are the best here went to cleveland clinic saw surgeon not radiologist he ofcourse recommended surgery but i just dont no what to do i am scared to no end anyway adivce would be nice but before that once again I am wishing you happiness and a good run you sound like a wonderful confident strong person so I think you know what your doing bless you and your family life is tough

Jump to this post

Just a caregiver, here, but I wonder what the recommendation would be if you saw a urologist at Cleveland clinic. I just know that’s how my husband started his journey at Mayo.
Also I think it’s emotionally helpful to have a team of doctors that you have full confidence in. I always remember that they call it the PRACTICE of medicine, because each individual can react so differently to treatments.

REPLY

I am Gleason 9, 76 years, in a clinical trial with lupron and Erleada 6 months, then RP, then the same meds for 6 months and now 10 months no meds. More than 2 years ago my surgery doc said that my life expectancy was 4-5 years. Then the department head in the clinical trial said 5-10 years. I believe that both are just an educated guess and no one has a reliable crystal ball! I have heard that pluvicto is presently the last treatment available, yet some Guys have been on it for several years. This is the ultimate uncertainty for us but we have encountered uncertainties over the years. We have to handle this uncertainty as we have handled other uncertainties in the past, prepare for the worst and hope for the best. Best of Luck to all.

REPLY
@andrejacques

Hello, Ellis-I’ve been on Lupron Depot for close to 10 years now, injection every 6 months. When I asked at first how long I’d have to take it, the answer was “The rest of your life.” Ok, well, how long is that? They wouldn’t answer. Side effects: said goodbye to my love life.
PSA was around 300; Gleason 9.
Since then, external beam radiation and Abiraterone, knocked the PSA down to less than 1, then went up again. Not much side effects. Chemotherapy with Docetaxel, didn’t do much except made me really sick. 7 treatments. Spot radiation to ribs for some mets.
The latest has been the full course of Pluvicto, 6 treatments. Minimal side effects. Dry mouth was about it.
The Pluvicto was more to just try to slow it down - incurable at this point.
I can’t seem to find out what comes next. Maybe Pluvicto was the last and best shot at it.
Next will be full body bone scan and PET scan to find out how much is left and where.
Considering my original PSA score 10 years ago, and the Gleason 9, I think I’ve done fairly well. Now being treated by Palliative Care. The last will be hospice at home, which my dear wife and I discussed thoroughly.
And that, dear friend, has been my journey. It certainly has been an interesting one!

Jump to this post

@andrejacques, you may be interested in this related Discussion:
- What is the recommended treatment after 6 Pluvicto doses?
https://connect.mayoclinic.org/discussion/what-is-the-recommended-treatment-after-6-pluvicto-doses/

REPLY
@jt3451

I am sending good thoughts to you and feel bad you had to go through this I am newly diagnosed and deciding between surgery and radiation i am a 4+4 am in buffalo ny and not confident they are the best here went to cleveland clinic saw surgeon not radiologist he ofcourse recommended surgery but i just dont no what to do i am scared to no end anyway adivce would be nice but before that once again I am wishing you happiness and a good run you sound like a wonderful confident strong person so I think you know what your doing bless you and your family life is tough

Jump to this post

Hi @jt3451, have you decided on a treatment plan? How are you doing?

REPLY
Please sign in or register to post a reply.