Father has been diagnosed with prostate cancer. How high is the chance of metastasis?

Number one - stay calm. The PSA levels are still low. Only 2 samples have traces of cancer. This is a very slow growing problem. The worst thing one can do is to over react. Get the MRI and then take a slow approach to the options. The odds that it has spread is very, very low based on the information you have given. Again, do not over react. If some action is needed in the coming months and I say months, do not jump to surgery out of fear. There are many good options that have far less unfavorable reactions that surgery has. Take a deep breath and take a couple of months to research all options. There are many that are good and can be followed to a successful end. In my case I took three months to do research and chose proton radiation and I am very please with the results. I too had similiar numbers you have described. 

Jakob, sorry to hear about your dad. This is the scariest time. Im 63, psa 6.2 gleason score of 4+3.....Pathologist said I have an aggressive form of PC.Prostate removed. ..and 13 lymph nodes and 7 weeks of radiation. All is good for past 9 months...mine only traveled out through the nerve....no other metastases. So your dad is probably going to be ok....usually metastasis is associated with higher psa values...hope this helps. Pat

Jakob: I echo the comments by others that it is best to stay calm, particularly around your Dad. But, you didn't need to be told that I am sure.

The 3T MRI will show where the prostate is affected, and if it is likely to have spread.  It sounds like the Gleason score is 6 (correct?) in which case I am not sure I would call it cancer (PCa).  

I started with a MRI. and this showed an issue in one lobe. I then had a targeted biopsy using the MRI, and this gave a Gleason score of (4+4) 8.  Not good, as it was aggressive.

I had a full body scan to see that it had not migrated to the bones (mainly). After a lot of research, where I got answers to the many, many questions that I asked two urologists and an oncologist concerning the pros and cons for various procedures.

I am now six weeks after a robot-assisted prostatectoy and all is well. I was clear of PCa on every test. The pathology testing showed the PCa was even more aggressive than first thought (Gleason 9), but had not migrated to the lymph nodes.  I am having no radiotherapy or chemotherapy, and count myself fortunate.

My advice is to stay calm, seek lots of advice from professionals, but know that PCa can be overcome.

Seems like your father followed standard urologists' processing.

psa then biopsy then mri

I think the more data you can get before a biopsy is performed the better.

I had PSA checked then a MRI performed now I am deciding who is to do the biopsy.

When arranging the MRI you must go to a facility that specialises in Interpreting prostatic images. This is not a task that can be performed by "any old radiologist".​

Assuming your father doesn't have any metallic implant, I would recommend a 3T mri and not a tradiornal 1.5T mri. A 3T uses a very powerful magnet to get an excellent image of the prostate and any tumors.

As for the cancer spreading in a month, until the MRI is performed, you don't have much to worry about I think. Remember most folk in here are patents and not physicians, so bear that in mind. Prostate cancer is slow growing. It takes years to get from a position where it is not worrisome to where it is worrisome.

 

I have had psa levels around 8 or 8.5 for many years. Also, like your Dad, 2 samples from biopsy showing cancer. No spread, no symptoms, no treatment. Over time you learn to live with the worry - as long it's monitored carefully and doesn't change, the only time I  think about it with any anxiety is when I get the psa test results. Keep calm and carry on!

 

Hello. You didn't mention Gleason score. My other half diagnosed age 57 Gleason 6 and psa 4.9 he wasn't even offered a bone scan as they said with such low results it won't have spread. It would have been nice to have the bone scan but it was not offered. He just had MRI but this does not show bone spread. Good luck.

Hi jacob

i have been through this at 55 diagnosed with prostate cancer with psa of 4.8.  I have had mine removed and two years on all clear. So please try not to stress. It is generally a slow growing cancer that does not kill the majority of men who have it. 

Its a well trodden path so your father will be in good hands.

mike

 

First off, I wan to thank everyone for replying. Really has made me feel better than any of my real life friends could have. I will talk with my parents with and try to calm them, they are much more worriesome than i am.

As for the gleason score, we don't know this. They just said:

Non agressive PCa

20% of prostate is covered with cancer

PSA has risen 0.5 from september until now.

I wasnt there, when the doctor told my dad he has PCa, only he and my mom went to the appointment ( i didnt expect at ALL that my dad could have PCa). But now we have a appointment with the urologist that said my dad has cancer tomorrow, so i will talk with him aswell as it will make everything more clear for me..

Hello Jakob,

Sorry to hear that your father has prostate cancer. The good part is the numbers look to be fairly low. And the non aggressive type is even better. That leaves many treatment options available. Some will advice going the active survailence route - and that would be okay too... I was diagnosed last October with about the same numbers as your dad. 2 out of 12 core samples of mine showed cancer cells. Also a non aggressive type. One sample was 10%, the other was 2% which my urologist said was very low. My PSA was at 5.2, gleason score of 3+3=6. He said I was in the low risk group and could opt for the active survailance option... where we would keep an eye on things until numbers changed. I thought it over and decided on getting treatment. I thought that I would deal with it now while I am younger and in good health. If I waited a year, or two or three or who knows how long, if things did change, I would be older and possibly have other health issues. My urologist told me that in the stage I was in now could be treated and curred. I saw a radiation oncologist also who agreed that treatment would be successful at this stage. I researched various treatment options. I narrowed down to two that I thought would be a good choice for me... also discussed the options with my urologist and radiation oncologist. Brachytherapy which is low dose radiation seed implants, and Cyberknife were the top choices for me. Both indicated success, and few side effects. I finally decided on the Brachytherapy as it is a one time treatment. The low dose radiation seeds are implanted into the prostate while you are anesthetized. The procedure takes about 1 hour. The low dose radiation helps prevent any radiation from harming near by issues - I had this procedure done 8 weeks ago, and there have been few side effects, and they diminish with time. I am at the half life of the radiation seeds. From here on, the radiation will become less and less until it is gone. I had a 4 week follow up with the urologist and the oncologist. All is fine. I will see the urologist next in August. The radiation doctor said I am good to go, and he doesn't need to see me again. Do some research on your options. Choose a doctor and a treatment that has been successful many times. Don't panic. This is something that can be dealt with and cured. Good luck to you and your dad.

Charles