50 years old and newly diagnosed

I don't believe this has been offered in Canada. I am in Nova Scotia. What are the costs associated with this procedure

i don't think you get used to AS. I think you are either wired for it or are not.

Here is what Dr. Scholz has to say about GS 6 and low volume.

http://prostatesnatchers.blogspot.com

Thanks everyone for all the advice and comments. I go on Aug 27 for a second biopsy. I will have to wait and see those results. My emotions have settled so much since joining this forum. Knowing I am not alone is making this easier. I think I am very content with whatever decision needs to be made over the next few weeks. I am truly scared to leave this in there but with the new information I have received on here I might just be able to live with it.

Please keep posting information for me to review. Too much is never enough

Well I want to thank everyone here for all the advice that I have been given since I joined this group a few months ago. I have checked in everyday and have become very educated by this forum about PC. After my most recent biopsy I was informed that there was nothing found, however my first biopsy found 1 core out of 12 @ 7 %. I started in May getting healthy and have walked and dieted everyday since I was given the news. I have went from 248 lbs to 216 lbs. I feel my PC was found early so I can make a decision on how to get treatment.

After discussing this with my family doctor, my family and well over 100 friends they have all given me the same advice (get this thing removed from my body.)

I have prepared myself all summer for this and it has basically consumed my everyday thinking. I have decided to have an open radical prostectomy done by a highly regarded eurologist who has done about 4000 of these procedures

I fully understand the side effects associated with this procedure and am prepared to accept whatever happens after that. At least I will be alive to deal with them.

My wife is fully supportive and we have discussed this at great length. I have talked to my son and daughter and they both agree they want their dad around for a long time no matter what.

I am not a church going man but strongly believe in god and feel he has given me this early warning to gain control of my life and get healthy again.

I do believe this will cure me.

Am I wrong to think any of this

Thank you all so much for the knowledge you have given me to come to this decision

Wade, I have to admit that I was thinking exactly what Yooper posted but he beat me to it. Per our rules we will of course respect your decision. Nevertheless I would certainly encourage you to get those second opinions on the biopsy slides to which Yoop is referring. You may be considering treating a condition that does not exist.

You may also want to consider some type of advanced imaging like MP-MRI. I understand that you feel prepared to deal with any side effects but you may not need to do so at all.

Again, it's your decision and I also wish you the best. But PLEASE do your due diligence on this -- and, even if you decide to treat this, you would do yourself a favor to review your case with other disciplines beyond surgery so that you clearly understand your options. With all due respect to your PCP and hundred friends, they may not be as knowledgeable as other doctors and they certainly are not the ones who will have to live with your decision.

Jim

Peter: You are right and to the point. I agree with you completely. and I appreciate your straight forward approach. However I have made my mind up about the surgery and I am going through with it.

I just talk with a friend of mine who right now has been diagnosed with PC that has moved to his bones. I have known this man my whole life and his symptoms started about 6 years ago and he made the mistake of not doing something about it. His final words to me as he left me this morning was get it taken out

I am not a gambling man and feel surgery for me is going to be my best option.

I think my friends are not mirrors but uneducated about PC and only hear the C word.

I hope that I didn't disrespect anyone on this site with my previous ramblings

I have gotten so much information from here.

So there it is I am having surgery and I will have to deal with the challenges as I move forward, I hope I can count on the support of this site as I go forward with this journey

Wade

Wade, there are undoubtedly members here (including me) who feel that you have not done the due diligence required before making such a decision. Nevertheless, it's YOUR body and YOUR decision. I respect your choice and wish you well. There are lots of men here who have had surgery and I hope you will ask lots of questions of them as you progress along your journey.

Going with an experienced surgeon will increase your chances of cure and lessen the chances of side effects. I'm glad you have chosen one.

Best of luck,

Jim

Wade, I think there is something unexplained about your situation. The biopsy found only one positive core, small percentage gleason six. But in 12 weeks your PSA moved from 5.1 to 8.9. In a young guy without a lot of benign prostatic hyperplasia, there is a disconnecting between what the PSA is telling you and what the biopsy is telling you. One possibility is that you have a prostatic infection or other issue that is generating more PSA than what corresponds to your biopsy. Another is that the PSA test is simply a fluke this time. A third probability is that there is more cancer lurking somewhere and the biopsy is not actually reflecting of what is going on. (This happens sometimes.) It is important that you figure this out.

here are some things you can do to get to the bottom of this:
1.) have you slides reviewed by Epstein or Bostwick. It doesn't cost much, there's no pain, and you'll rule out an error in the biopsy grading.
2.) have your uro put you on a short course of antibiotics to rule out infection and retake the PSA in a month to see if it has fallen. Make sure there is no DRE, no sex, no bike riding etc. within 48 hours prior to the PSA because that can give a falsely elevated reading.

If neither 1 or 2 results in alignment between PSA and Biopsy I would either go with the endo-rectal MRI or color doppler ultrasound, both of which could detect additional cancer that might have escaped the biopsy. Or you could ask for one of the advanced biopsies that are guided by imaging or a template to do a more thorough job.

I agree with all the others who said that you are a great candidate for active surveillance if you are indeed a G6 with 1 small positive core. But you should verify that. If not, then a good fallback is to monitor your PSA extremely closely at 1-2 month intervals for a few months just to make sure that your rapid 12 week rise is a one-time thing not a trend.

Hello Wade .. I am a new member myself here at HW, but wanted to tell you more about my history, as it might be helpful for you.

I went through the very same process you are now in. I had a PSA jump end of 2011, and had a biopsy Jan 2012 that showed two sites of G6 (3+3), at 5% and 20%. My diagnosis was at age 56. After MUCH deliberation, reading and research over 4 months and talking with 3 surgeons, a radiologist and an oncologist, I decided to pursue Active Surveillance (AS). I think there is growing agreement that G6 "cancer" may in fact be "indolent" in nature, and may NEVER grow into anything of concern. The side effects from surgery and radiation (incontinence and ED) are very real and were of high concern to me.

I enrolled in a clinical study for AS called PASS (Prostate Active Surveillance Study) sponsored by Canary Foundation. This is underway now at 9 locations around the US and Canada -- Google it. I wanted to be in a formalized program so that I wasn't keeping track all by myself. Many large research institutions or hospitals will also "enroll" you in an AS program with formal criteria and processes.

I was in AS for 18 months, and then had a repeat biopsy, as defined in the study protocol. This one showed progression in my case -- 5 of 12 cores positive, 2 were G6 (3+3) and of much higher concern 3 cores were G7 (3+4) this time. I had the biopsy slides confirmed at a separate pathologist (Univ of Texas Health Sciences Center) and they confirmed G7 in multiple sites. This was in Jan-March 2014, and I had robotic prostatectomy earlier this month (9/8/14). I got my catheter out 1 week ago, and so far I seem to be one of the highly fortunate ones that are dry from the beginning. I chose my surgeon very carefully... and he seems to have had a really good day.

I would have very happily stayed with AS for many years, if possible. Avoiding treatment and potential side effects is really important to me. My PSA was stable at 2.5-3.0 range. I had no reason to suspect any cancer progression until this repeat biopsy. If you enter into an AS program, you'll have this also .. or, you'll have PSA rising or other indicators, and you'll know about disease progression. Then, you can take action with an intervention. That was my plan .. and I had 2 years of trouble-free experience before I chose surgery. I am so far fortunate in my recovery from surgery, but I have a long way to go to understand my new normal. I would absolutely choose this path again. AS, or watchful waiting was the right choice for me.

Of course, all of us here will actively support you with any choice you make. Please do keep us posted, we'd like to help.

Wade,

I respect your choice to not risk Active Surveillance. However, I believe you owe it to yourself to at least make sure you will be undergoing a radical prostatectomy of a prostate that is actually cancerous. According to Jonathan Epstein at Johns Hopkins University, 2% of the biopsies he examines as part of his second opinion program turn out not to contain cancer. If I were you, I would get a second opinion on your original biopsy; the process is relatively simple, reasonably cheap, and can be done expeditiously. 

My date for surgery has been set for October 28. , I have chosen my path. wish me luck. I know I will be back on here asking for more advice over the coming months. To all those that gave me advice thank you. I hope no one gets offended that I may not have taken their suggestions.