have questions; prostate cancer diagnosis

My father just got diagnosed. This was not found on DRE. His PSA last year was 2 something and this year it was 5.46. His biopsy showed cancer in 5 of the 12 cores. He had 3 that were 3+4=7, 1 that was 4+5=9 and 1 that was 4+3=7. His bone scan was ok. His CT scan showed a 1.4 cm hypodensity on left lobe of liver, several 5mm hypodensities on right lobe of liver, a mass 2.8 x 2.6 cm on right adrenal gland, nodules on left adrenal gland and multiple hypodensities in kidneys. it says that some of the hypodensities in the kidneys are too dense to be just simple cysts.

Any information that you could offer would be a great help. I am an only child and my mother has been gone for several years after a long battle with breast cancer. I told my father I would find out all I could.

Thanks for your help

[Ketan K Badani]

I am sorry to hear that.  A new diagnosis can be difficult.  Your father has a low psa, low clinical stage, which are favorable factors.  His Gleason score of 9 is his highest risk feature thus far.  That is a more aggressive type of prostate cancer.  If he is of an age and health status that he can undergo treatment, he should seek consultation by a urologist and radiation oncologist to wieght his options of surgery versus radiation, and potentially both, if necessary to maximize his chance of cure.  At the same visit, the kidney and adrenal lesions can be further evaluated.

[chrysargenziopa]

Thank you so much for your response. My father's urologist has recommended surgery (robotic). He says that he will biopsy the lymph nodes at the same time. When I asked about the kidney and adrenal lesions he said he would like to wait and redo the CT scan in 6 months. This is what concerns me. My father is in relatively good health ( some type II diabetes and hypertension) and he is 68. I would like to be as proactive as possible to give him the best chance at cure.

What are your thoughts? I am thinking to wait until the surgery is over and see what the pathology shows and redo the PSA and go from there...

Any insight you can offer would be appreciated.