Just been told I have cancer

Dear Tworiversuk,

I remember all too well when last July I worked out what the urologist had been implying without using the word cance that I all too likely had prostate cancer. Yes it was a surprise to say the least. I had never seriously considered I would get cancer let alone such a miserable one as prostate cancer. It was not just a case of raising my eyebrows thinking "my, my! what a surprise." My anxiety knew no bounds. I was totally paniced. Happily I found this forum and my new friends with honesty, simplicity and straight talking had me acting like a rational person in a week. I was then ready for the diagnosis meeting two days later. I found my surmise was correct. The MRI scan and biopsy both indicated two substantial tumours the aggressive one Gleason 4+4. My PSA had been 7 then 10 then 18 over four years.

I was imediately put on hormone therapy and three months later had radiotherapy with the hormon therapy to continue for up to three years in all. I am hopeful of a cure.

I do hope the initial anxiety will settle down to a reasonable level. You do need to be level headed and somewhat educated in the early stages of PCa as the choice of offered treatments including Watchful Waiting will rest with you. 

I wish you the very best of outcomes

George

 

Thanks George, have you any idea how fast the form of cancer is and what's the chances of me getting through it 

Dear Tworiversuk,

The short answer is that no one can tell you. But a Gleason score of 6 is considered to be slowgrowing and may never give the patient any bother at all. Some argue that Gleason 6 should not be considered a cancer. However it does need to be carefully watched as sometimes a Gleason 6 becomes more agressive. I have read of some with Gleason 6 who have declined Watchful Waiting and gone for immediate radical treatment just to be sure. (Radical treatment means treatment intended to yield a cure.) I would also observe that even agressive PCa is fairly slow growing.

As to statistics, I cannot say that I have found them the least use in forecasting the outcome of any particular case of PCa.

I had a gleason score of 8 and I am hopeful of a cure. I should say you are in a much more favourable position than I was at first diagnosis. You may be recommended periodic biopsies to check on the Gleason score. You will need to think carefully about them as there can be serious side effects in a few cases. Those risks have to be balanced with the risk that your PCa becomes more agressive and it is not noticed until you are in a serious position. The rate of rise of PSA can be used as an indicator but that can be misleading. All these are matters that will require close questioning of your Urologist to make sure you have all the relevant information as the decision will be yours.

It might help others to make more relevant comments if you were to put some details in your profile. Age is important and also weight. Some studies have indicated that slim men have less trouble with treatment side effects and are less likely to die of PCa.

I hope this helps. Use the web to further your education in PCa. You will soon get the hang of it. The British cancer charities all provide extensive general information. More detailed information is available on the web. The purpose of this education is to prepare you to ask all the needed questions of your Urologist and not to accept evasions. The result will be that your decisions will be soundly based.

 

What treatment are you having please

Hello, my husband was done slightly different, he had no symptoms and had gone to gp about something else and they did several blood tests. Psa was 3.4 so referred to urologist. He suggested biopsy, showing less than 5% cancer Gleason of 3+3 he had an MRI straight away. We were referred to oncologist who said no rush to treat. We had to wait another 4 months to see the Brachytherapy consultant, he also said no rush to treat.

 So we waited another 2 months, my husband is worried about side effects of treatment, that is why he held off, psa is gradually creeping up. So decided to get on with treatment. We chose brachy mainly because it seems easiest while he maintains a full time job as a farmer. He can't take time off and has to work a minimum of 5 hours a day this time of year (help booked for 3 days when he first has treatment) radiotherapy seemed better in a way, but with a 4 hour round trip, not including treatment, to hospital it is just too much!

 I am sure if there was a panic for your treatment, they would have seen you quicker. But the waiting is hard!

Dear Tworiversuk,

I agree with Alfred. If there were urgency to treat your timetable would have been very different. In contradistinction, my case was very different. I was seen by the Urologist that same week. He reviewed my PSA history and did a DRE and found an irregularity. He arranged an early MRI scan followed by a biopsy.. He wished to see me again three weeks later but because one of the MRI scanners was not working decided on four weeks. I duly had the MRI scan and a biopsy. Both found two tumours. The MRI scan showed one tumour within the prostate envelope and the other which might have broken through. I saw the urologist on Friday four weeks to the day. Given the diagnosis and agree treatment. An hour later the urologist's letter was delivered by fax to my GP. (my copy in the post.) I collected my prescription that Fiday afternoon from the Surgery. The pharmacy had the hormone therapy injection in Saturday's delivery and it was in my hand by noon. At nnon on Monday I had my first hormone therapy injection. I was scheduled to start radiotherapy three months later. 

I am sure you can see the difference. Gleason 8 meant there was a high risk of the PCa spreading and the urologist intended the radiotherapy to include the tissue surrounding the prostate as there was a likelyhood that there was a spread to the seminal vesicles although too small to show on the MRI scan.

I do believe you can take comfort from the more leisurely pace exhibited in your case coupled with Gleason 6. Please do not be over anxious. But please also remain alert and engaged with your GP and specialist. PCa is nasty and not at all to be trifled with. But over reaction can lead to unneeded treatment with unpleasant side effects or treatments earlier then neccessary.

I wish you the very best outcome and a joyful fulfilling life despite this serious threat to health and quality of life.

George

Hi george

thanks for your kind and reassuring words, I will not have the prostate removed until it is the last hope, I'm feeling a bit grieved as my GP told me, 4 days before I got the letter to see the consultant, Tthat I was totally clear from any cancer, as he had received confirmation from the biopcie, sent to him from the hospital.

I would rely far more heavily on the Gleason score than the PSA because PSA is affected by so many non-relevant factors. There are tables which have been created to help assess factors (age, Gleason, PSA etc) with estimated outcomes. The tables are very crude but should offer some assurance. The most widely used are the Partin tables which can be Googled. Please see my comment above and be assured that many people have high PSA values with no or low risk cancer whereas others have very low PSA with high risk cancer - the man who discovered PSA (Dr Ablin) has gone to great lengths to stop the test being used as a screening test for PCa due to its inherent unreliability. At least you know yours is the lowest risk possible. Wishing you all the best.

thank you David for clearing that up, fingers crossed then