Still in shock here.

[Hopeful203]

I had blood work done for a physical and my PSA was 8.7,  My physician said the DRE was normal  but with the PSA level he sent me to a urologist.  They did blook work and said the PSA was at 7. He said he couldn't detect anything by DRE either, but still set up a biopsy.  He took 12 cores, and of them, 2 were positive for cancer.  The Gleason score in one core was 4+4 and 3+4 in another.  He gave me a total Gleason score of 7.  In looking at my labs, I see a diagram of what looks like at prostate gland.  The corse that were "bad" are labeled ast  E an F and in the little circle they are set, it reads 13% and 14%. He has the tumor stage listed as T1c.  He recommended surgery, and the reason he gave was my age when is 57 (my mind says 27).  Tomorrow morning I am to have a bone scan.  I've deceided against surgery and decided on IMRT. In reading about my options that one seemed to feel more right for me.  Of course it could seem right because I'm weird about being put to sleep.   I'm rambling because I'm confused and having a very difficult time accepting what has happened to my body.  I have grandchildren I'd like to see grow -- the word cancer rings "the end" in my ear.  Any encouraging words, suggestions, and or comments on my decision would be extremely appreciated.

Thanks in advance

[WTL]

P.S. I found this site to be an invaluable source of information, which is what you need most right now. http://www.prostate-cancer.org/index.html

Another site: http://www.ustoo.com/

And another: http://www.yananow.net/Links.html

[WTL]

I was in exactly your position in February, except my Gleason score was 8 and my PSA was 8.8. The most important thing at that point was that the cancer was contained in two small areas on one side of the prostate - as far as could be determined by TWO biopsies (the first 12 cores, the second 24) it had not spread outside to the seminal vesicles, nerve bundles or lymph nodes.

I had the second biopsy because by then I was rejecting RP, robotic surgery and radiation because of the side effects - radiation has side effects that can sneak up on you in the form of impotence and sometimes incontinence 18 months or more down the road. I figured that if the cancer hadn't spread then I had a good chance of preserving potency and continence without going a more radical route of treatment.

My urologist referred me to a urologist who does cryotherapy and HIFU (high intensity focused ultrasound), and he did the second biopsy to get a better idea of the state of the cancer. This biopsy took cores from both the prostate and the periphery - the prostate walls, the seminal vesicles and the nerve bundle areas. It confirmed the first biopsy - the cancer was small and contained, but aggressive.

I chose HIFU, and you can read about it in my two-part post Me and My HIFU. The bottom line is that three months later I'm doing very well in all departments, and the first blood test showed a PSA of 1.5, which is good since I still have half a prostate.

The only downside was the cost, almost $28,000 up front - no insurance company in the US will pay for HIFU, and I couldn't qualify for the current national trials because they're only accepting Gleason scores of 6 or less, trying to show efficacy in what is the most common severity levels of PC (Gleason 6 and under). I had to go to Germany. But absolutely no regrets. If it didn't work I can either have it done again or try another treatment.

Blessings on you in whatever treatment you choose. I know exactly how you feel right now because I felt the same. I think the best thing you can do is to let yourself be helped by your loved ones. It's not a good idea to try to do this alone, and the love and encouragement of others can do remarkable things that you don't realize until afterwards. Don't turn away from them - they're your lifeline.

[HeinrikMD]

Hi,

Decisions can be tough, especially when there seems to be no clear winner.
While there is no distinct advantage of choosing surgery or radiation in terms of outcomes for the cancer, one way to choose is the side effects of treatment. Men with difficulty moving their bowels may be better off having surgery as the effects of radiation in the neighboring rectum. Hence, one treatment may be better in terms of making any other present problems more manageable.  If you have no symptoms at all as you say, then the decision would again be at a standstill, the acceptability of the treatment (some people are really averse with the idea of going under the knife) would be most meaningful.

[drummer87]

Im in the same boat. Im 57 and my numbers are about 1 higher on all counts.Im trying to decide on a treatment and will evaluate them all before I risk incontanance and impotence and any other complications. The main thing is that you and I keep a close eye on the beast a hope that the biopsy didn't cause this to grow or leave the prostate.Good luck brother