Concerned and needing advice

This is not quite accurate. Cancer of the prostate does not behave like many other cancers. For instance, if a 65yo is diagnosed with a Gleason 6 then it would be wrong to assume that not having surgery or hormone therapy risks it spreading.

i do agree with one point if you're. That is, not to wait six months when a diagnosis should be made sooner.

Hi Barney, Interesting you mention this, I was just reading today a paper on medscape... several extracts...

"Extension of disease beyond the prostate is extremely rare in men with contemporary Gleason score 6 (GS6) prostate cancer, according to a database study."

"GS6 (grade group 1) prostatic adenocarcinoma rarely, if ever, has the ability to metastasize, yet about half of men diagnosed with GS6 still undergo treatment with radiation or surgery." and in summary....

"Active surveillance is safe and effective for men with Gleason 6 prostate cancer on biopsy based on large series," he said. "However, ongoing follow-up is important to identify higher Gleason scores if they are present at baseline or subsequently develop. If higher Gleason scores are identified, treatment with surgery or radiation is typically recommended."

It seems the key is if there are any Gleason 7+ cells hiding amongst the Gleason 6 and less. Not to mention, scoring Gleason is very subjective and dependent upon the skills of the pathologist. 

Even after reading the paper, I do not know if I would have the confidence in their findings to ignore the Gleason 6...I could be one of the few that the Gleason 6 DOES metastasize...

?Geoff 

You are correct in the fact that prostate cancer isn't like any other cancer, because there are choices with treatment. However, if you have a Gleason score of 3+4 and it is intermediate stage and you are only 57 years old, reality is, radiation will not guarantee that the cancer will never return. Surgery after radiation is  not a good thing. There will be scar tissue. It boils down to personal choice. Age and over all health are key factors. Once treatment is over and life continues, the worst thing would be to hear that the cancer has retuned after a few years. And this is is possibility with radiation. If the prostrate is gone and it was contained to just the prostate, it will not return in that area ever.

You have one misunderstanding. It seems you think that surgery - and not radiation - removes all the cancer. Often yes it does but not always.

The person's overall health is very important, as you indicate.

Before having surgery or for that matter radiation, it would be wise to have a 3T MRI if he can.

My belief is that prostate cancer that is "localized " can be treated 3 ways. Watching and waiting, radiation or surgery.  If a man is "young" for this disease and life expectancy is greater than 10 yrs and he is healthy otherwise surgery is a best option. Let's face it, cancer will not get better, it only gets worse. Why chance it? Removal at an early stage has much better chance for it NOT to metastasis. And yes he did have the the 3T MRI and a bone scan. The cancer is localized to just the prostate. Thank God!

Romney

And you are correct, it is very important to find a place with skilled technicians to create good MRI images and radiologists who can read them.

I chose my urologist based on a number of factors. My urologist runs master classes for other urologists at symposiums on reading prostate MRI images, and he teaches prostate surgery and is a practical guy that talks with you and not to you.

Geoff 

Hi Geoff,

my apolgies in advance for this book.. forgive me for coming to you too on this forum but you seem wise on the topic..and Aussie!! im sad, worried, scared, havent spoken to my wife or any friends about this yet and just cant wait until Jan 20..

i googled mens forums for prostate cancer, having just got, well what i think is bad news at Xmas, wasnt a great one this year..

Im in Australia too, and spot on with the MRI info above, no subsidy and $590 later just this week..

basically i went to my local GP for a right teste being bigger than the other, what was diagnised about 7 years ago as a cyst and nothing to worry about.. well i just thought now being 44 and well thinking why not get it removed, off to the GP before Xmas and then got the referral to a urologist..with xray appt... thinking ok... turn up to the urologist after xrays if Rh teste..and inspects the nuts so to speak.. then pokes the finger and then the chat starts.. the RH teste is a hydrocele.. no big deal.. but there is a little lump on the prostate.. as he draws a diagram of the plumbing, I already know what is being said.. my stomach turns and I feel sick and pale (like so many others before me, Im sure)

"do you smoke, and do you drink?" yes about 4 stubbies a day with a couple of alcohol free days a week most weeks, and smoking well only about 6 or 7 a day, with some days none at all but a smoker no the less.. "family history" yes.. Pa died of prostate cancer, at 93 mind you, nothing that could be done, detected too late, too old and too far gone.. terrible thing to watch happen (RIP Pa).. Dad diagnosed at about 64, and removal, and all good 6 years on and strong as.. as a smoker and family history.. up to 15 times more likely to get it.. and too much alochol dont help.. 4 or 5 stubbies is about 7 standard drinks, 4 too many im told..

always eat well and requested a prostate test last year, just after what happened with Dad, Pa and then my father in law about 2 years ago.. didnt get the finger, GP just told me only needed a blood test (asuming they were looking for PSA level, (now that Im getting up to speed on all this..) got the results last year, fit healthy and must be fed well by the wife, all good levels, try to give up the smokes though.. (got patches, didnt quite get there, sorry I have digressed..)  anyway.. urologist (well known local urologist who is very good ive since been told) says hydrocele is easy fix, but we need to find out what else is there.. looks at  my face and says "please dont panic.. i know thats easy said, but trust me, you panic when I panic, and Im not panicking".. but please quit smoking! needless to say, cold turkey done, havent touched one for a month and cant ever think i will again and wished i so never had!

no real problem with urinating, maybe its a little slow at the end? but i think im being paranoid now about that because of the situation.. sometimes after drinking a big water intake after footy training, pee like a train!.. no blood in urine or semen or every any pain anyway in that region.. none of any of the symptoms but have read it means nothing.. can still have the C word.. 

anyway urologist sent me off for blood and urine test, MRI and Xray of bladder kidneys and prostate.. a full book! and reappointed to see him Jan 20.. $hite im nervous.. I look at my son and daughters and think, I have alot of living to still do (and dont things become very clear in this situation.. havent done extra overtime since.. straight home and ejoying the family.. and ginger beer and green teas!) and just want this tp be over.. clear.. BPH.. anything of the good type.. but if he has put me through all these tests, there must be something  bad there right? and of course its likely the C thing none of us want..?!

I know its a slow cancer, high survival rate etc and for me, i think i would do like Dad, remove it.. pads, diapers, erection problems, i can cope with (maybe not) but i just want this gone and off my mind, and to relax and be the best husband and father i can, and to look after my health finally..

I dont know why I wrote all that, getting it off my chest I guess, I hope any other guy in the same situation reading this does what I should have done a month ago and talk about it.. to close friends and the wife.. she knows there is something wrong and what its about but is letting me absorb it and waiting for me to get it out.. but I feel I just want to know what the score is on Jan 20 and then sit down and tell her.. I no thats wrong..

Please give this man a reply and tell him stop being stupid, a drama queen and that whatver is, is and that its not a life sentence (which some unfortunately do have..) 

whatever wisdom you or anyone else can offer, I need to talk to people about this and feel normal again..

Happy 2017 Geoff and everyone on this forum and God Bless 

Jason

I have no problem about your long posting, except it isn't responding to Schoolbusdriver, although he may benefit from knowing he's not the only one needing support! Hopefully you have answered your own questions by expressing what's going on for you. The only thing I want to add is: let your wife do what most wives want - to support you, listen to your worries and reassure you that they will cope whatever happens!

Jason,

Hey man, don't worry about the long post because your situation is somewhat the same as mine. Only a few differences; age, I don't smoke or drink and only a few thousand of miles. I'm in the US. Like you, I have witnessed exactly what PCa can do to a person when it is caught late in life. I guess with that in my mind makes me freak out even more than I should. I know most see my questions and reactions as simple and way out of line but knowing that I may have only a 25-30 chance of actually having PCa is about 25-30 percent too much for me.

I too, have a wife and kids. Son is 22 but has Aspergers Disorder; cousin to Autism. Daughter is 15 and will always need her daddy; LOL. And wife; well she is my support and she knows this is killing me. Got good news yester day that PSA had dropped but for my age still high. Free PSA on borderline of high risk and moderate risk at 15.7, she was elated and I was even more concerned and couldn't share in her happiness. I was really hoping the numbers would be lower but it is what it is. Like I told her yesterday; Just tell me to suck it up you big baby! Enough said and time to go pee again; for the millionth time!

thanks.. Im new and stressed so didnt even think about I was posting in your question with my problem.. apologies..

thanks for your update, it makes me feel not alone and just good to converse with someone about both our situations...

great to hear the PSA dropped, lets hope it continues its downward way.. all the best for you in 2017 man, and i hope life is kind to us both.

J

Four things done to mind.

a) As your post is not a reply to others, it would have been better to start a new discussion because then you will attract more responses and not just responses from those interested in this particular thread;

b) Great at you stopped smoking. Now stop drinking I suggest. I don't mean less, I mean zero alcohol. 

c) Hopefully the MRI bladder and prostate was/will be reported by a specialist in prostate reporting and not just a regular radiologist.

d) Ideally the scans will show you are cancer free. If not, remember that treating bladder cancer must take priority over prostate cancer.

A)yes, as i said im sorry.. didnt mean to put my post up on the existing discussion.. im prety average at online stuff and dindt realise i was meant to start a new thread..

thanks, i no longer smoke or drink... well i have a couple on friday after a weeks work and maybe one after mowing the lawns on the weekend.. but if you say zero, then zero it is.. C) hope so too and D) finger crossed its neither and clear..