Just diagnosed gobsmacked looking for advice

Posted by mhreed39 @mhreed39, 6 days ago

Offically diagnosed with prostate cancer 6/21/24. PSA is 15.25 (up from 2.8 six months ago). PI-RADS 5 score from MRI.
Biopsy score was Gleason 8 (4+4), Grade 4. 12 of 16 cores involved. Cribiform pattern present. Yes to Extraprostatic extension and Perineural Invasion. PMSA PET scan is being scheduled.
Have met with a surgeon who believes surgery is the best option. He will be taking both nerve bundles and lymph nodes. I have an appointment with a radiation oncolgist next week to get a second opinion.
At this point I know my inital decision is surgery v. radiation but with a cancer this aggressive I worry that a second or even more rounds of treatments are in my future and how my initial decision effects my later options.
Looking for advice or your experience.

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OTTADV | @ottadv | 2 days ago

You certainly have a lot to consider. Like most people, making this decision is not easy and it usually boils down to the side effects, which there are many.

Side effects of the surgery and side effects of the cancer.

I elected surgery because it provided the best alternative if the cancer returned which it did. By having the PSMA Pet Scan, we were able to catch it before it got too far. I don't like the side effects of the surgery or the treatments, but I am pretty sure they are better than the side effects of the cancer and I would do it again.

Your cancer is aggressive with that kind of PSA increase. Mine was fast growing also. One thing I did to help me make the decision was to get the opinion of an oncologist who does neither radiation nor surgery. That too was helpful.
I hope this helps. Lastly, I would pray for wisdom.

All the best, John.