Diagnosed with prostate cancer and worried!!!

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Dear all,

I was diagnosed with prostate cancer a few days ago and my urologist says, after introducing the results of the biopsy, that I need treatment. My last PSA was 5.76 and out of 12 cores, I have 6 cancerous cores. All are grade T2 and their Gleason scale score is 3+3=6. My urologist says all these cores are located on the right lobe of my prostate gland and they are confined to prostate gland. I requested a CT scan, MRI scan and bone scan to make sure that there is no spread, but the doctor says there is no need for MRI and bone scan and only CT scan is needed. I am extremely worried and confused because I don’t know what to choose for treatment, radical prostatectomy, radiotherapy (external beam, brachytherapy) or cryotherapy. Please help me, I want to hear your opinions. Any comment or advice will be highly appreciated.

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  • Posted

    I had  similar diagnosis some years ago. No treatment needed, PSA has hovered around 8. If you can live with it it’s often best to leave well alone but have regular checks to be ready to have appropriate intervention if metastasis happens. In between blood test I find I can put it to the back of my mind. I’ m pleased to have remained otherwise healthy apart from bph and Uti s, which have been far more bothersome than the cancer!
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  • Posted

    Hi John-Can,

    I would see a specialist who deals with prostate cancer patients. Your request to have a 3T MRI, and bone scan should have been ordered by this urologist. But he agreed to a ct scan? That's unnecessary. If he doesn't agree, see some else with more knowledge and experience in this field. I would ask for an Axumin PET scan instead of the bone scan. At Gleason 6, treatment is probably not necessary at this time.

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  • Posted

    Hi John,

    Gleason 6 is usually not that alarming and PSA 5.7 is not all that high. You may want to ask your urologist about "watchful waiting" with regular psa's and ultrasounds. Also, I agree with the others that a 3T MRI would be beneficial. Don't know if I would personally go for a CAT scan or a bone scan in the absence of any indications of cancer outside the prostate. You might want to discuss a 4K, MDX, or PCA3 test for PC as well.

    If your urologist won't discuss these options with you, you may want a 2nd opinion.

    Best wishes 

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  • Posted

    Your PSA is not too terrible. And the Gleason score of 3+3=6 is treatable. I was diagnosed 2 years with a non aggressive prostate cancer. Adenocarcinoma. I had time to do some research... There are many options available for you to consider. I would suggest that you slow down and don't panic. Did your doctor tell you what type of cancer cells were found? If so, is it a non aggressive type? Please educate yourself on the many treatment options that are available to you. Many men on this site will be glad to share their experience with treatments with you... even the watchful waiting. In my situation, I chose to get treated and be rid of the cancer. I looked at many options and decided on the Brachytherapy - the low dose radiation seed implant. I chose this one because it seemed to me like the easiest to do, with few side effects. Brachytherapy is a one time procedure done as an outpatient. It takes about 45 minutes and after about an hour in the recovery room, you can go home. With any treatment, there are side effects, but most  are tolerable and lessen with time. Do your research on treatment options. What ever you decided, if it is a treatment, just make sure that what ever doctor you go to for that procedure has performed it successfully many times. I wish you the best.

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  • Posted

    Yes, those are basically your options, however, in my case I had a MRI and a bone scan. I'm not sure how the Dr would know whether the cancer has spread or if indeed it's ONLY in the section of the prostate that the biopsy found.

    I had a RARP. 3+4 Gleason but it was throughout my gland and post open my margins were not clear.

    I start EBRT in two weeks

    Surgery was 14 months ago. (My PSA is slowly increasing. Do your research. Don't RUSH. Second opinion is always a good idea.

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  • Posted

    Hi Jon I was diagnosed with prostate cancer in 2007 my PSA was 9.8 because I was working at the time I opted for brachytherapy but now wished I had took time off work to have radio therapy as mine was permanent seed implants and the cancer returned and I am now onprednisone zytiga & zoldex implants, the side effects of these are not good at my PSA is down to 0.17 hope this helps

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  • Posted

    Hello John-Can, sorry to hear your news but it is not all bad.

    I was diagnosed just over 6 years ago and the cancer had spread to the bones. I was told that at my age, I was 76 that I wouldn't survive the treatment, surgery , chemo and radiation, it would all kill me. They put me on Hormone therapy which involves an injection every 12 weeks with a capsule that reduces the testosterone levels right down. At that time my PSA was 186 and every one was very upset. 

    Now my PSA has been 0.07 for the past 7 months and every one is happy. I feel OK and ready to organise my 90th birthday bash!!!!!!!  I was told that I was very lucky in that the cancer was very slow moving and the doctor in Oncology gave me a steroid and I was told it would make me happy !!!!!!!!!!! Yes I am still happy and respect all the staff in Urology and Oncology.

    Keep your chin up my friend.

    Regards

    Neil Barrow of 

    Haslington

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  • Posted

    Agree with Pepesan - no treatment needed. 3+3 is often not referred to as cancer because it is so close to being normal. Read up on it before subjecting yourself to treatment 
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    • Posted

      Thanks a lot for everyone who answered.

      I met my radiotherapy oncologist today and we discussed the risks, advantages and disadvantages of radiotherapy. I wanted to make sure that the cancer has not spread outside my prostate. He performed DRE on me and said it is impossible for a G6, PSA 5.7 cancer to have extra capsular extension. I asked for an MRI to confirm his opinion, but he said there is no need for that. He said my cancer is T2a. As for my N and M grades, he said the biopsy report doesn’t show that, but we don’t need it at this time. I also asked him about the effect of radiotherapy on cells and tissues (prostate, bladder, urethra, semen vesicle) and he said radiation stops cell division and I wonder when a cancer cell stops dividing and eventually dies, it is ok, but what about normal cells and what may happen if they all die?

      I’m also not sure if an oncologist can decide that my prostate cancer is T2a by just performing DRE?

      Is an MRI really NOT unnecessary for me at this time?

      Best wishes for all.

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  • Posted

    Hi John-Can,

    I think it's best to see another doctor who has more experience. Don't waste your time any longer with the same doctor. Not all doctors are up to speed on prostate issues. You do have time being your Gleason score is a 3+3.

    To actually see if cancer has spread, you would need either a Axumin PET scan or a PSMA PET scan. My condition started just like yours. I opted for HIFU treatment. But, 3 years later everything got worse and I had the prostate finally removed. I also had to seek out better knowledgeable doctors. Try to deal with specialist who only work on prostate related problems. Not all urologists think the same. Some could give you the worst advice.

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  • Posted

    In my research the only thing a DRE indicates is that something is going on. Per previous reply, you have time to research AND get 2nd opinion OR a new Dr.

    All treatments have possible side effects so do your homework.

    Unfortunately, there are too many people in the medical community think only their way is the only way and the rush to over treat occurs.

    Good luck. Don't rush.

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    • Posted

      I thank everybody who provided their helpful and wonderful input regarding my PC. And would like to let you know my final decision.

      I consulted a few urologists and radiation therapists and they all agreed that I have three options:

      1-Surgery

      2-Radiation therapy

      3-Active surveillance

      If I choose radiation therapy and the cancer recurred, I will have just one choice left: hormone therapy

      But if I choose surgery, I will have more than one choice available for me.

      As for active surveillance, I have eliminated it at this time because I think it is a risk. I’m not sure if the cancer will stay Gleason 6 all the time or it will jump to G7, 8, or 9. No specialist could guarantee that my Gleason 6 cancer will stay Gleason 6.

      So for the above reasons I will most probably choose Radical Prostatectomy.

      Please let me know what you think about it?

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