Recently diagnosed: Treatment options for early stage prostate cancer?

Posted by jdh697 @jdh697, May 18, 2023

Im 57 and was diagnosed with prostate cancer on 4/21/23. Following a 3t mri which revealed a pirads 5 leasion I had a targeted mri fusion guided biopsy. The pathology report revealed adenocarcinoma in 2 of 14 cores. Gleason 7 (3+4), grade group 2, 30% involved. Chronic inflammation was noted as well in areas around the cancer. My PSA started in 2109 at 1.8 and went to 2.1, 3.57, 5.91 and 6.7 a couple of months after the 5.91 and before the biopsy. My PSA density is 0.15. My urologist recommended surgery and a consult with a radiation oncologist obviously suggested radiation therapy but states active surveillance might be appropriate if the second opinion on my slides didn’t change. Any thoughts?

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My prostate has been enlarged prostate a couple of years and my psa level started to increase... is now around 11. My urologist suggested having a biopsy so I did 2 weeks ago. Recieved the result of Stage 1 prostate cancer last Friday with a Gleason level of 6...the lowest. My urologist discussed several options...wait and monitor, start radiation treatments or have the prostate removed. I have an appointment with a radiologist next week to discuss..Has anyone been in a similar situation with this grade of prostate cancer?? What advice do you suggest? I know there are other treatments such as freezing or high heat to kill the cancer? After killing the cancer cells what guarantee is there that there will be a few living cells left that will grow at a later date??? In that case it would be better to remove the prostate along with the cancer. TY...

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@bolovino

My prostate has been enlarged prostate a couple of years and my psa level started to increase... is now around 11. My urologist suggested having a biopsy so I did 2 weeks ago. Recieved the result of Stage 1 prostate cancer last Friday with a Gleason level of 6...the lowest. My urologist discussed several options...wait and monitor, start radiation treatments or have the prostate removed. I have an appointment with a radiologist next week to discuss..Has anyone been in a similar situation with this grade of prostate cancer?? What advice do you suggest? I know there are other treatments such as freezing or high heat to kill the cancer? After killing the cancer cells what guarantee is there that there will be a few living cells left that will grow at a later date??? In that case it would be better to remove the prostate along with the cancer. TY...

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What is your age? How is your overall health? These are important data points for sharing ideas. Stay positive.

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@bolovino

My prostate has been enlarged prostate a couple of years and my psa level started to increase... is now around 11. My urologist suggested having a biopsy so I did 2 weeks ago. Recieved the result of Stage 1 prostate cancer last Friday with a Gleason level of 6...the lowest. My urologist discussed several options...wait and monitor, start radiation treatments or have the prostate removed. I have an appointment with a radiologist next week to discuss..Has anyone been in a similar situation with this grade of prostate cancer?? What advice do you suggest? I know there are other treatments such as freezing or high heat to kill the cancer? After killing the cancer cells what guarantee is there that there will be a few living cells left that will grow at a later date??? In that case it would be better to remove the prostate along with the cancer. TY...

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I will be 70 years of age next month and my overall health is excellent...

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@bolovino

My prostate has been enlarged prostate a couple of years and my psa level started to increase... is now around 11. My urologist suggested having a biopsy so I did 2 weeks ago. Recieved the result of Stage 1 prostate cancer last Friday with a Gleason level of 6...the lowest. My urologist discussed several options...wait and monitor, start radiation treatments or have the prostate removed. I have an appointment with a radiologist next week to discuss..Has anyone been in a similar situation with this grade of prostate cancer?? What advice do you suggest? I know there are other treatments such as freezing or high heat to kill the cancer? After killing the cancer cells what guarantee is there that there will be a few living cells left that will grow at a later date??? In that case it would be better to remove the prostate along with the cancer. TY...

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I have read in some prostrate cancer books that some doctors believe that Gleason 6 will probably not spread and will not kill you and should not even be called a cancer. I think considering your age and this gleason score that you should seriously consider active observation, subject to the advise of your doctors at an excellent cancer facility. Good luck

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@bolovino

I will be 70 years of age next month and my overall health is excellent...

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Thanks. I was diagnosed at age 41 and surgery at age 42 with a gs7, and now 52 with recurrence. So I'm not going to have firsthand knowledge of your situation, but it surely sounds like are in a good spot to get out on front of this for many years. Your self education will be important, many good resources

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@bolovino

My prostate has been enlarged prostate a couple of years and my psa level started to increase... is now around 11. My urologist suggested having a biopsy so I did 2 weeks ago. Recieved the result of Stage 1 prostate cancer last Friday with a Gleason level of 6...the lowest. My urologist discussed several options...wait and monitor, start radiation treatments or have the prostate removed. I have an appointment with a radiologist next week to discuss..Has anyone been in a similar situation with this grade of prostate cancer?? What advice do you suggest? I know there are other treatments such as freezing or high heat to kill the cancer? After killing the cancer cells what guarantee is there that there will be a few living cells left that will grow at a later date??? In that case it would be better to remove the prostate along with the cancer. TY...

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I have been diagnosed @ 2 months ago with 3+3=6 . Having surgery June 26. Father had prostate removed at 52 years old , I am turning 59 in 2 day. It is a life changing decision but I feel good about it. My decipher test just came back as high risk. I have a very experienced surgeon whom was recommended by a friend that had prostate surgery and highly recommend dr. Cancer is contained to prostate according to 3t mri. Scared at the thought of the risk of incontinace and ed but all will ok .

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@bolovino

My prostate has been enlarged prostate a couple of years and my psa level started to increase... is now around 11. My urologist suggested having a biopsy so I did 2 weeks ago. Recieved the result of Stage 1 prostate cancer last Friday with a Gleason level of 6...the lowest. My urologist discussed several options...wait and monitor, start radiation treatments or have the prostate removed. I have an appointment with a radiologist next week to discuss..Has anyone been in a similar situation with this grade of prostate cancer?? What advice do you suggest? I know there are other treatments such as freezing or high heat to kill the cancer? After killing the cancer cells what guarantee is there that there will be a few living cells left that will grow at a later date??? In that case it would be better to remove the prostate along with the cancer. TY...

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TY all for your input and I will consider my options. It's refreshing to hear from those who have experienced what I am going thru now. Good luck to all if you and God bless....

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@trusam1

A consult with a medical oncologist specializing in urology was helpful for my decision-making with a similar clinical picture. Neither a surgeon, nor a radiation oncologist, she did not have a bias either way, and thus seemed most inclined to help me choose based on not only my own values, but physical and emotional status as well.

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Wow you got good urologist/oncologist. I wish I had that expeience. I had opposite experience with my urologist and then radiologist/oncologist.

Oncologist/radiologist telling me no difference, no benefit to proton radiation and on and on about expense (they did not have proton). Went on and on about no differences or benefits. Asked about secondary cancers caused by photon and was told would not have to deal with them for at least 10 years. When you get prostrate cancer you want the information being told to you by experts what is best for you and the pros and cons of all treatments available.

I even had the urologist tell me if I had treatment at another provider would not see me for any urology consultations, second opinions. I stated realized during treatments but as follow up after treatments for opinions and information. No was the answer only if had treatment at his provider. I have been going to this provider for 17 years for all my health needs and treatments.

Then initial consultation with photon radiolotist/oncologist told me they were recommending homone therapy with photon radiation. I questioned the affect of hormome therpay on my exercising. I was told they could do for one month and see how I did.

I began to asked questions (don't think they liked questions) and they said the only reason they would not recommend hormone treatment (along with photon radiation) if I had cardiovascular issues. I told them I have heart failure and ICD/Pacemaker. Reply, "Oh then we would not recommend hormone treatment." I have been going to this provider for 17 years for my heart failure, ICD/Pacemaker, primary care, and all medical treatments. You think the oncologist/radiologist would have reviewed my file before recommending a treatment.

Did not like what I heard so went for second opinion at another provider. Immediately told me hormone treatment ruled out with my heart failure, and my age affected having surgery. They went over benefits and difference of Proton and Photon radiation. I picked this provider and started Proton radiation therapy there. At least they read my file and knew me physically and mentally.

They were informative and explaining differences between therapies and knew I was considering photon and proton and gave me all kinds of information and web sites to read to make up my mind of which was best for me. I chose them.

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@bolovino

My prostate has been enlarged prostate a couple of years and my psa level started to increase... is now around 11. My urologist suggested having a biopsy so I did 2 weeks ago. Recieved the result of Stage 1 prostate cancer last Friday with a Gleason level of 6...the lowest. My urologist discussed several options...wait and monitor, start radiation treatments or have the prostate removed. I have an appointment with a radiologist next week to discuss..Has anyone been in a similar situation with this grade of prostate cancer?? What advice do you suggest? I know there are other treatments such as freezing or high heat to kill the cancer? After killing the cancer cells what guarantee is there that there will be a few living cells left that will grow at a later date??? In that case it would be better to remove the prostate along with the cancer. TY...

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Given what I've read here, I'd get a couple more PSA tests (at least one) before I made any decision as there are quite a few things that can have an effect on that. Minimally, I'd wait 3 mos and test again, perhaps your PSA will go down a little which might indicate surveillance to be a good option at this time.

Have a couple friends that were 6's and both elected to do radiation, I'm not sure of the exact type but they were 39ish treatments and haven't had to have any other treatments and both are 10 years plus.

I sort of feel an obligation to respond to this for honesty sake "After killing the cancer cells what guarantee is there that there will be a few living cells left that will grow at a later date???" Such a guarantee will never come. I think you likely need to brace yourself for this realization. Someone put an appropriate quote on here, "You can be cancer free, but, you'll never be free from cancer" (paraphrased)

I was gleason 7 and elected for surgery, the doctor was giving me high fives after the second follow up telling me we got it all, a year later I was in salvage radiation treatment.

Every case is a little bit different. In comparison to many of our brothers here, you are in a pretty good position, but it's not like an appendix removal. You'll have to be monitoring this for the duration.

Best of Luck to you whatever you decide!

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Wow, jc76, sounds like some poor doctoring from your original provider. Sorry about that, but I have read a lot of similar experiences.

I was diagnosed in September 2022 with Gleason 6 with PSA 10.5. My Urologist explained that there were multiple treatment options and recommended Dr. Walsh's book, "Surviving Prostate Cancer". He also recommended two photon radiation doctors. He did say that Radical Prostectomy was still considered the "Gold Standard" approach. After researching options and speaking to 2 radiologists I chose to travel to Mayo Rochester for treatment with 5 doses Proton Beam. Finished in January 2023 and very pleased with result. PSA has dropped to 2.59 but I was told it can take up to 44 months to reach a new low.

Best wishes to jdh697 for a successful treatment regimen.

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