New to board husband diagnosed at 47

Sorry you and your husband have to be here.  I know these first weeks can be overwhelming.   Here are a few thoughts as you work with your physicians and do your due diligence.

>  If you have access, try to go to a major medical center with lots of practitioners (medical and radiation oncologists) experienced in this disease.  I do not think there is any substitute for depth of medical resources.

>  In choosing among treatment options, do not assume your husband's Gleason will stay as is.  Lots of men on this Board have seen their Gleason scores upgraded in post surgery pathology.

>  A recent and major study (1000 men, 10+ years) out of Europe reports significant advantages to immediate radiation (Adjunct) after surgery, as opposed to salvage radiation (SRT) down the road in a few years. May want to talk this over with your providers.  Here is the abstract in the Lancet: 

http://content.nejm.org/cgi/content/full/358/12/1250

 

Whatever course of treatment you choose, not you, your husband, or his physicians will ever know if that course was optimum in his case.  I am afraid we live with uncertainty every day with this disease.

 

Best wishes to you both!

 

Newspaper Lover

Age 68

DaVinci surgery 11/09. Clean margins, clean seminal vessels.

Rising PSA noted 06/11

Gleason 8

Time to recurrrence 18 months

Three month doubling time (summer 2011).

PSA rose from .07 on 06/11 to .17 on 11/11.

MRIs and bone scans negative so far.

Started hormone therapy (Lupron/Casodex) 12/11

Began radiation (SRT) 02/20/12.

Finished SRT 04/16/12

Last Lupron shot 03/12

PSA and testostorone "undetectable"  07/12

Next PSA and testostorone test early January

 

 

Thanks to everyone who responded.  I am truly appreciative!

The reason the suggestion of surgery was made was taking into consideration my husbands young age and the fact that if there were a reoccurance radiation/homones could be used as a secondary treatment.    The biopsy partin table showed an estimate of 6% escape and 12% Hpn.  He is very much in the 50/50 range so we're basically taking a shot I guess. Also, they don't know the extent unless they remove the lymphnodes and prostate.

I am very interested in seeing what the surgeon says, we can always follow up at Fox Chase for a second opinion.

Phila-wife,
I'm very sorry that you are here but so are all of us! You have 2 fights on your hands..The "anger" and "depression" that you and your husband are experiencing for a situation that "didn't have to be" has to be overcome..I experienced the same feelings when I learned that my doctor favored the "conservative approach" and didn't tell me of a high psa reading more than 11/2 years before and my pca was basically diagnosed by symptoms...What a ride...
At my tender age of 68 when diagnosed I did my homework and elected to do the "whole enchilada" by having high dose IMRT and hormones for 3 years..I didn't want to suffer surgery and then radiation with hormones...For me it was the right choice..If I was younger, I would have wanted to know the status of my lymph nodes prior to making any decision...I wish you and your husband the best!
Bill--Age 70--a "seasoned" vet
Dx'd--Sept 2010--psa 4.89--ct & bone scans negative--5 g8's and 4 g7's out of 10 cores with high volume and ece..79.2g's IMRT completed Feb 2011 with 3 years lupron...06 after rads and now<.03..1 year to go on lupron (?)

My husband was diagnosed at 39 years old, almost coming up on his 2 year anniversary of his surgery. He has some stress leaking and has ED issues, but the cancer is out and his PSA is undetectable and he lives a very active life. I am blessed to have him ONLY dealing with the minimal issues that he deals with on a regular basis. I found this site very soon after diagnosis and continue to look at the site on a daily basis. The people here are wonderful. There are many different personalities here and sometimes they argue, just like a family, but you will always find someone who has a similar situation. This disease is different for each person, and because of that you will need to gather as much info as possible and then have him make the decision that will be the best for him (you have input but he has the ultimate decision). Make sure to take care of yourself in the process. As women we tend to caretake and forget ourselves completely. He is going to need you to be rational and calm and assist him in the fog that you are both in. Once you make a decision on treatment he will need you to help physically as well. YOU NEED TO CARE FOR YOURSELF. Do not forget about doing something to recharge your battery. this is a disease that effects the couple, so be as easy on yourself as you are going to be with him. Ask for help, dont be afraid to let others help as well.

I recommend taking notes, keeping a notebook with DR appt, questions you come up with, attending all appts with him, since each appt will have SO much information. Come here to ask questions and to vent as much as you need. We have all been through the same phase you are in right now and can help bring up stuff you dont even yet know to ask about.

So sorry you are having to deal with this but you have found the right place with fantastic people here at Healing well.

Let us know how we can help.
Susan

Have you had your husband talk with others who have had prostate cancer treatment? I've found that to be very helpful - people are supportive.

I, too, was diagnosed at age 48, relatively young. Fortunately, it was all very early. Got 2nd & 3rd opinions. In the end I opted for surgery (DaVinci) given my general health, age and expected life expectancy. Just got out of the hospital and am recuperating.

Gleason = 3+3
Diagnosed at age 48
Surgery - DaVinci 12/05/2012

Thanks Ed for posting the excellent article by Andy Grove. I first read it after I decided on HDR brachytherapy and it confirmed my choice.

Phila-wife, I suggest you and your husband read it and seek out multiple opinions. If surgery is best for you, the multiple opinions will confirm it. I am amazed how many peopele will religiously shop around for the most insignificant items, yet they accept the first suggestion for something as life altering as surgery. Do your reaearch and talk to several different doctors. And appreciate that you are high risk and will need the approproate high risk treatment. With each doctor you should have them explain how many men they have treated that were more advanced than you and learn how they are doing. You want to be the average patient, not the highest risk one.

Welcome to HW.

You are involved in a decision that is based almost as much on opinion as it is fact, mainly because we don't know all the facts. A lot of guessing going on. Is the PC contained, where has it spread, ?? Unless you do surgery, you will never know some of the answers. And, I don't offer that as a reason to have surgery.

After almost 4 years of dealing with PC, I have come to view it a little differently than I initially did. I have arrived at the assumption, particularly with a Gleason 9, that I will always have PC. So now I look at it in terms of time, quality of life, and trends.

The surgery bought me 3 1/2 years of time, with good QOL. When the trends showed a probable reoccurrence, I did RT, which so far has no side effects and has had no impact on my QOL.

If and when I see a rising trend in my PSA, I will once again plan when to start another treatment. As I watch the new developments in new drugs, I am hopeful that the magic bullet will be developed.

I say all this to say, that there is no absolutely right or absolutely wrong decision. Whatever decision you make, with a medical team you trust and have confidence in, will be OK. If you choose surgery, and see a reoccurrence, it can be dealt with. There is no absolute certainty that radiation would get it either.

Good luck to both of you. I think multiple opinions will help you as you make your decision. Hopefully you will find some agreement amongst the opinions. Ultimately, it will be your choice.

Welcome,as many have said, there are quite a few of us dxed at an early age with high numbers. Mine included.
Take a deep breath, relax, it is what it is. It took me a while to except this myself. If you let it,this silly disease will eat up your brain. If that happens, when the zombie apocalypse occurs, you will be defenseless.

Phila-wife,

You and your husband should meet with a highly-qualified radiation oncologist, to get his/her perspective on the best treatment alternative for your husband. 

Your husband may decide to do surgery.  But at least you and he would get the benefit of a different perspective before committing to a treatment approach.

Radiation is a perfectly valid alternative to surgery, as a primary treatment.  You can do seeds (there are a couple of different types of seeds) or external radiation, or sometimes both.  Sometimes they add a hormone treatment too, for a period of time. 

I am not trying to talk you out of surgery.  But it is an important decision, so it is worth some due diligence before making a decision.

Best wishes,

Medved

Phil Wife,
I agree that you should definitely speak with a radiation oncologist and carefully consider all options. The bad news is that all options have advantages and disadvantages (aka side effects). The best news is that on this site, you have people who have done every treatment available and you can review their experiences to help you decide. Also, Philadelphia is very close to NYC and Hopkins. You might consider going to one of these institutions. No disrespect intended to others, but everything I read says those two are among the best in the world in dealing with Pca. Best wishes to you and your Hub.

Fred

Bashing people for making a decision does nothing but make them angry.

where did i bash anyone? 

An additional note. Left side of prostate on biopsy showed chronic inflammation