Prostate cancer diagnosis and decisions

Posted by jrubicon @jrubicon, Dec 21, 2019

I finished radiation treatment for my prostate cancer in January, 2019. I lived with the cancer for about seven years (active surveillance) before the treatment, but the numbers started to change slightly from the biopsies and felt it best to treat the cancer. During that entire time, my PSA never exceeded 3.0. In reading several of the posts, it concerns me that many who say they've been diagnosed with prostate cancer sound almost panicky. Relax. Even though no one can say for sure how cancer will act, it's not an automatic death sentence. There are many causes for elevated PSAs, and a lump on your prostate may not be cancerous. My urologist said that if you're a male and you're 70 years old, you probably have prostate cancer whether you know it our not, and you will likely die from something else before you even know you have prostate cancer. So, be cool. Yes, it's not the best news you've heard this year, but almost always you have time to consider the choices, from active surveillance to surgery. Your Gleason score along with the percentage of biopsy cores with cancer will help you and your caregivers determine the best course of action. If your urologist won't take the time to sit down with you, and your spouse, and discuss the options, get another urologist. But, don't ask your caregivers to guarantee the success of any option. There are a lot of unknowns. High power MRIs, new blood tests, bone scans – all will help with your decision. But, remember, the decision is yours, along with your significant other. I read in some the posts that folks had trouble with the biopsies. They are not comfortable, and have some risks, but I found them tolerable. I had four of them with only local anesthesia, and survived.
My advice is to accept the diagnosis, confirm the diagnosis, look at the Gleason score, and the core percentages, and any other tests you may want, and then decide. Don't let the diagnosis rule your life. If you decide to use active surveillance, then do just that. Get on with your life and periodically have a PSA and perhaps a biopsy to check the numbers. Whatever you do, don't rush the decision. With the exception of very aggressive scores, there are lots of options. I had a new DNA (I believe) test done which measures aggressiveness. The urologist called and said that it came out pretty aggressive – like the 90 percentile. I asked him what that meant. He said that I had a 10% chance of dying of prostate cancer in the next ten years. I started to laugh. He asked me what I was laughing at. I told him I was 78 years old and that I had a 50% chance of dying from anything in the next ten years. However, that test did convince me to start radiation treatment. Have my decisions to wait, and finally have treatment, been correct. So far, but one never knows. You make the best decisions you can with the information you have, and then move on. If anyone has read this far, thanks. Good luck. Remember to live life to its fullest. Don't let a little glitch of prostate cancer keep you from enjoying life.

@jrubicon Thank you for your comprehensive post. Your experience is encouraging to me, as I begin radiation in a few weeks. I appreciate your positive perspective. 😊

REPLY

With new genomic testing to establish probability of metastasis or progression to higher level disease, it may be even easier to examine, in consultation with treating doctors, the feasibility of continuing active surveillance and avoiding, as far as possible, repeat biopsies and depending instead on biomarker and imaging based confirmation of non-progression.

Liked by jrubicon

REPLY
@vernonkent

@jrubicon Thank you for your comprehensive post. Your experience is encouraging to me, as I begin radiation in a few weeks. I appreciate your positive perspective. 😊

Jump to this post

Thanks. I wish you the best of success.

REPLY

Thank you for the great
article you posted. I really like your ending statement
That reads: Don't let a little glitch of prostate cancer keep you from enjoying life.

Liked by jrubicon

REPLY
@peekaafighter

With new genomic testing to establish probability of metastasis or progression to higher level disease, it may be even easier to examine, in consultation with treating doctors, the feasibility of continuing active surveillance and avoiding, as far as possible, repeat biopsies and depending instead on biomarker and imaging based confirmation of non-progression.

Jump to this post

Good to know. Anything accurate that will make decisions easier is great.

REPLY

wow thanks for that post i,m 57 yrs old and i had my prostate removed last october. the surgery went well, i begin radiation therapy starting this friday and after reading this post i,m not as as scared as i was before thank you again

REPLY

I'm happy what I said reduced your concerns a little. You are doing what is important – availing yourself of the best treatments. So, my thoughts are that those treatments then become a small part of your life, and the vast majority of your life is other than your cancer and the treatments. Don't think about your radiation until you are there, and don't think about it after each treatment. Every moment you're thinking about your disease and the treatment is precious time taken away from the more pleasant things in life. My best to you, and those with you on this journey.

REPLY

Is anyone taking Eligard injections as part of ADT harmone therapy? At one hospital this is preferred and at another place they are giving Lupron. These are two different brand names of the same base compound Leuprolide Acetate. I am scheduled to start on Lupron shots tomorrow. Just wanted to see anyone has a opinion as to which one is preferred?

REPLY
Please login or register to post a reply.