newly diagnosed - advice appreciated

Don't make any decisions yet until you have seen everybody. There are also a number of trials running in which you can get involved and you will then be assessed regularly. Prostate Cancer is not one of those ones which grow quick so you have plenty of time, and read the many items on here to see results and side effects. Not the best of clubs to be in but there is light at the end of the tunnel.   Best Wishes.

David

It would help you to know if the cancerous cells are definitely still contained within the prostate - this would tell you how urgent the decision about surgery would be. Some prostate cancers don’t grow or spread, but others are rampant and fast-growing. Nerve sparing radical removal can keep erections possible but sexual function and feeling will almost surely be worsened. However most would say better safe than sorry. I’m lucky in that I seem to have minimal cancer cells which seem not to have increased or spread  over 5 years of active surveillance- your man’s situation sounds much more serious to me.

Very sorry to hear.  But as with everything, get a 2nd opinion.  Doctors are very quick to suggest surgery but there are many things to consider.  My husband just got back from 9 weeks of radiation therapy in Phoenix.  He seems a lot better but we won't know anything now until sometime in March when they will test his PSA again.  They can't test now due to the radiation.  The reading wouldn't be accurate.  Our doctor tried surgery to remove the prostate entirely but when they went in that's when they discovered it had spread to the bladder neck.  Do your own online research as well.  A good place to start is the website for Cancer Treatment Centers of America.  God speed to you both.

Thank you for the replies, it is certainly a scarey time for him.  The urologist said the cancer is confined to the prostate.  The concerning part is the number of cores affected and the volume.  His PSA over the last year has elevated from 6.4 to 9.7.

 

Hi Willie, a worrying time for you and your husband. My husband got a PSA of 12 on a blood test after I sent him to GP when he was complaining of back pain and she did a routine blood test and included PSA. He had no symptoms. He had an MRi scan and his first biopsy. We were told low grade in one side about 5% would probably be watch and wait Gleason 4+3 and T2a, but the surgeon he went on to see upgraded his MRi and sent him for a targetted biopsy.  They found more cancer in the same half but a difficult to reach area so went through all the treatments and said nothing else but surgery Still 4+3 but T2b now, it was robot assisted and we hoped they could save both sides of the nerves. After removal we were told it was in the whole prostate but was luckily still contained but could only save one side of the nerves. Final tumour score was T2c.  From  initial diagnosis to surgery took 7 months.His recovery surgery wise was brilliant. urinary wise took him a few months to regain full control but that was because he kept forgetting to do the kegal exercises before and after the op. Now erections and ability to have intercourse is another story. Tried two different pills not much help, he has regained some function down there naturally but not enough for penetrative sex, and the two times it did happen it wasn't that good. In a couple of weeks we go to try out the injections. he is 13 months post op and PSA is undetectable.  When you first get this diagnosis and have to have surgery, your first thoughts are his alive and cancer free. But in time the lack of intimacy does cause problems especially with him saying he isn't a man anymore etc. You have to have a strong relationship to get through this. You really need to know what grade the tumour is as it is in both sides. 50 is very young so you need to make the right decisions. A friend who had both sides of nerves spared has no erections at all so it isn't always about one or two sets. Definitely seek another opinion, but don't leave it too long. Be there to support your husband and make sure you find someone to talk to too. 

Hi Willie...I was diagnosed last December when I was 50 years old also. I had cancer in 9 of the 12 cores and it graded out at a Gleason 6. We read everything we could to understand all of our options. We chose to move forward with removal, just for piece of mind. I had my surgery on 7 March 2017, with no complications. Recovery felt slow, but in retrospect it has not been. 9 months post op, I have regained 98% contenance, and am able to achieve enough of an erection. The ED has been the hardest (no pun intended) thing to deal with. It's just not the same anymore for me or my wife. That being the down side, my PSA's indicate all of the cancer is gone. My most recent test (This week) was 0.03. I have confidence that I am cancer free and can move on with life. Good luck with your decision. Best wishes.

Did he get a gleason score?

Ditto - what is his gleason score?

For folks like us who have been in same shoes can only give advice from personal knowledge. EVERY case is individual. At Gleason 6, PSA at 8, its VERY low grade.  Please read the NCCN patient guidelines found here: https://www.nccn.org/patients/guidelines/prostate/. Its what every doctor should provide any patient.  Personally, I was Gleason 6 and Gl 7, age 73, watchful waiting for 2 years; eventually decided on Seeds plus a short course of hormones and a follow up of external radiation. I never missed a day of work, felt great, and tested free of cancer 8 weeks after last radiation treatment. My libido is returning, my testosterone is improving and I can actually maintain an erection.