3rd opinion: How many opinions did you get for prostate cancer?

Posted by saralie67 @saralie67, Mar 29, 2023

My husband was recently diagnosed with prostate cancer. I think maybe stage four but I’m not sure. He has a 3+4 Gleason score 13 PSA he’s 54. He has of also rheumatoid arthritis and thyroid problems. His initial urologist recommended surgery he then sent us to a specialist who also recommended surgery because of his age and relative good health. I follow a Facebook group on this subject, and Majority of them recommend another opinion, so I don’t know I’m just curious what everyone else thinks. I’m told that because the guy we saw today was a surgeon that he would naturally recommend surgery which is kind of what my husband thinks but he said today that if my husband was to have radiation first and then down the line , come up with cancer again that he wouldn’t be able to do surgery so I don’t know we’ve got surgery scheduled but I’m just curious if anyone else has been through this particular scenario what your thoughts are etc. thank you

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

@shelby29

Gleason 8, with seminal invasion. Both surgeons we met with recommended ADT and radiation over surgery. Both said chances of recurrence were equal between the 2 treatment strategies. We went with the radiation.

Jump to this post

My husband has Gleason 8 with seminal invasion right, and a mild lymph node local (Just got PSMA back). He has to decide about radiation vs surgery also. He's leaning toward radiation. He had previously had throat cancer, and he has some heart issues... so surgery scares us. But your not is encouraging if results are the same. He is probably considered stage 4A (need to confirm with doc next week)

Can I ask about any side effects of radiation? Did you need to do hormone treatement, or chemo? Did you need to have markers surgically put in prior to radiation?

Thank you!!

REPLY
@hbp

I think that most cancer surgeons would recommend radiation if there was evidence of distant spread of the cancer. It sounds like you made a wise decision. My cancer had spread locally to the seminal vesicles, Gleason 9, The committee of my doctors at UCLA all passed on my surgeons recommendation of surgery. Glad that you are doing well and we all hope that this continues.

Jump to this post

Did you undergo radiation? Was Chemo and or hormone treatment involved. Husband needs to make decision about treatment. He is Gleason 8 with right seminal invasion.

Thank you.

REPLY

I had RP with 6 months of ADT and Erleada before and 6 months after. My doctors at UCLA advised that the results of surgery and radiation are about the same but surgery leaves the option of successful radiation as a treatment as the cancer returns. With an aggressive, CR , high Gleason score, cancer, the cancer usually returns and I wanted to preserve as many options as possible.Good Luck to you!

REPLY
@jaykwik

My husband has Gleason 8 with seminal invasion right, and a mild lymph node local (Just got PSMA back). He has to decide about radiation vs surgery also. He's leaning toward radiation. He had previously had throat cancer, and he has some heart issues... so surgery scares us. But your not is encouraging if results are the same. He is probably considered stage 4A (need to confirm with doc next week)

Can I ask about any side effects of radiation? Did you need to do hormone treatement, or chemo? Did you need to have markers surgically put in prior to radiation?

Thank you!!

Jump to this post

He's stage 3b. He's on elligard injections & Zytiga-oral chemo for 2 years. He also had Spaceoar and markers inserted.
He had 26 rad sessions, finished today. He was not able to maintain a full bladder, so they did a foley catheter which he would clamp before treatment to fill his bladder. That was not a good experience, but did the trick.
He is fatigued, sleeps alot during the day. Burning with bowel movement and urinating. Some hot flashed, but not bad. Overall, the worst was the catheter thing. Without that problem, I think he would have gotten through rad sessions well. Everyone's experience is a bit different. Good luck to you and your husband!

REPLY
@jaykwik

My husband has Gleason 8 with seminal invasion right, and a mild lymph node local (Just got PSMA back). He has to decide about radiation vs surgery also. He's leaning toward radiation. He had previously had throat cancer, and he has some heart issues... so surgery scares us. But your not is encouraging if results are the same. He is probably considered stage 4A (need to confirm with doc next week)

Can I ask about any side effects of radiation? Did you need to do hormone treatement, or chemo? Did you need to have markers surgically put in prior to radiation?

Thank you!!

Jump to this post

Yes! I can speak about side effects of Radiation. I had 20 fractions of Tomotherapy. Not everyone has side effects, it's just that I did. After about 15 sessions of RT, I started having some side effects, primarily issues with urine. The side effects peaked around a week after completion of my radiation and continued for about 5 weeks, basically a lot of pain and burning during peeing, constriction, tremendous urgency at time leading to incontinence on a couple of instances, dribbling (at times I would take 15-20 minutes to feel satisfied after peeing). At its worst it was bad, but then I knew it would pass, which it did. I had my last shot of RT on 19th Feb and today I am feeling good. Constriction, dribbling and the issue of incomplete voiding seems much better that pre-radiation. But not everyone has side effects.

REPLY

This site will give you the probability of remaining cancer free for each of the major treatment pathways.

https://www.prostatecancerfree.org/compare-prostate-cancer-treatments/
REPLY
@jaykwik

My husband has Gleason 8 with seminal invasion right, and a mild lymph node local (Just got PSMA back). He has to decide about radiation vs surgery also. He's leaning toward radiation. He had previously had throat cancer, and he has some heart issues... so surgery scares us. But your not is encouraging if results are the same. He is probably considered stage 4A (need to confirm with doc next week)

Can I ask about any side effects of radiation? Did you need to do hormone treatement, or chemo? Did you need to have markers surgically put in prior to radiation?

Thank you!!

Jump to this post

If possible to do surgery, I would choose it with an 8 score. It probably will spread at that high of a score. Trying radiation and then surgery is not an option because of the side effects of radiation. So, if possible the earlier you can get it removed the better.

Praying for your wisdom and healing.

REPLY

The surgeon was right. Surgery after radiation is quite difficult. Your husband is very young. Gleason 7 is not bad, it could be worse. You said he is stage 4. That means cancer is outside the prostate. Lymph nodes likely. That would be 4A. That is my case. A second opinion is always recommended. I trust my urology but my wife and my best friend, a doctor, told me to get a second opinion and I did not regret it. Look at options, research the topic and then decide. But you need to trust someone. It’s a long journey and your husband needs support . Best for you, him and your family.

REPLY

Hello, my husband was diagnosed last year and our situations are similar. My husband is 55yrs old, Gleason score (4+3) and PSA was 32 at diagnosis. We went to 3 doctors and was told that surgery was his best option and that preserved the possibility of radiation should we need it later. His PSA following surgery was 1.5 so he started Lupron and radiation. Side effects were somewhat mild and tolerable. It is a long journey so brace yourself for that. Take care of him but also yourself. As his wife and caregiver, a lot will be on you as well. Give yourself grace and take those moments to spoil yourself. It’ll be a rollercoaster ride. All the best.

REPLY
@roberdc

If possible to do surgery, I would choose it with an 8 score. It probably will spread at that high of a score. Trying radiation and then surgery is not an option because of the side effects of radiation. So, if possible the earlier you can get it removed the better.

Praying for your wisdom and healing.

Jump to this post

Thank you. Have been advised Surgery would not get it all due to regional spread, and would then need to be radiated anyway. ADT and IMRT suggested. Starting Eligard Friday in hopes to shrink prostate, remove catheter (post biopsy complication) then start radiation 28 sessions. Need to follow up with cardiologist regularly due to heart condition ADT combo. Anyone know if hot flashes and side effects start right away after ADT shot or does it build up?

REPLY
Please sign in or register to post a reply.