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Posted 1/23/2015 9:59 PM (GMT -5)
Received news today of PC. I suspected it based on PSA of 40, but was not ready for diagnoses.

Not sure how to get started, but this is what I know:

1. Prostate, left - benign prostate tissue with no morphological evidence of malignancy.
2. Prostate, right - prostate adenocarcinoma, Gleason grade 5+4, with tertiary 3 present in 12 of 12 cores, involving 75% of the needle core volume.
- Perineural invasion is present
- Focal lymphovascular invasion is present

Bone scan and Ct to be done on Monday. What comes next.
Posted 1/23/2015 10:16 PM (GMT -5)
Its advanced, probably beyond a cure, but can be managed for decades. IMO.
Posted 1/23/2015 10:29 PM (GMT -5)
What comes next is probably hormone therapy to keep the cancer from progressing while you figure out what comes next. Depending on the results of your upcoming tests, and maybe a few more tests after those, your doctors may decide that Logos is right and your best course is simply to manage the disease -- which can usually be done for years and years. On the other hand they may also decide that aggressive treatment may be worth a try to see if you can get a durable remission (with Gleason 9 cancer the doctors don't like to use the "see you are eee" word.) If it is worth a shot your best option would probably be radiation -- maybe high dose rate brachytherapy and some sort of external beam radiation.

One other question, come to think of it... how old are you? It can make a difference in the treatment options.
Posted 1/23/2015 10:47 PM (GMT -5)
I should have mentioned my age is 49, with a wife and two kids 15 & 17.

No major problems at this time medically either.
Posted 1/23/2015 11:06 PM (GMT -5)
Welcome, Mr Magoo..

Sorry to hear of the news, but glad you found this group.

There are a bunch of guys here who can offer you a wealth of information.

Todd1963 has a blog of his journey starting when he was in his early 40's. It's found in his signature and worth a read.

Lucky new drugs are popping up everyday for PCa ..

Where are you from?
Posted 1/23/2015 11:26 PM (GMT -5)
Welcome Mr. Magoo,
So sorry you have to be here. You will find lots of support and information here. Glad you found HW. Some of the G9 guys will be along as well as those in your age range. You aren't alone. We're all friends here.
Posted 1/23/2015 11:30 PM (GMT -5)
Magoo, welcome, sorry to see you in this position, but you've come to the right place for support and information.
Stay tuned Youll get plenty of answers to what's next as the next day or two rolls on.
Posted 1/23/2015 11:45 PM (GMT -5)
What comes next depends on the bone scan and CT. If there's evidence it has metastasized, the treatment goal will be long-term remission. If it hasn't metastasized, a cure may still be possible. In a 49 year old, I always get suspicious of rare forms of PC that may respond to out-of-the-usual treatment. That may entail further pathological studies of the biopsy cores.

If cure is possible, you should be talking to a radiation oncologist, if it's stage 3 (you didn't say the stage). If long-term remission is the goal, a medical oncologist is a better choice.

- Allen
Posted 1/24/2015 8:09 AM (GMT -5)
Welcome Mr Magoo! Glad to see you're getting the scans Monday, they will help with your decision for the next step. Hang in there and keep us up to date!

Cheers, Doug
Posted 1/24/2015 8:39 AM (GMT -5)
Mr. Magoo, I've only been here since mid-December, and I'll echo the thought that we're sorry you need to be here, but we're glad to meet you. This is a good place. The guys (and the wives) who are here have a wealth of information and insight. Reading the posts here (especially the two sticky's at the top) talked me off the first ledge I was on. Here's the most important concept I learned about: GFMPH, which means "Good For My Prostate Health".

That means, anything in your life that gives you the strength to whip PC's butt. In your case, you're younger than most of us, you have kids at home, let them inspire you. Resolve to truly LIVE life. I know I spent the first weeks in a fog, gathering information. learning everything I could. I resolved to enjoy Christmas and will be traveling later this week to visit my first grandchild. Also, this week, I'll be making the call to schedule my surgery. And the journey continues.

A warm welcoming embrace to you, Mr. Magoo.
Posted 1/24/2015 8:42 AM (GMT -5)
Hi Mr. Magoo,
Your treating doctor will receive a report and likely the images from the CT and Bone scan. If both are clear, you may have some options presented to you. It will likely be multi-modal with ADT as part of the treatment. You may have other options such as radiation to the prostate bed or perhaps surgery. Every treatment has its own benefit and consequence and it would be a good idea for you to begin familiarizing yourself with the various options.

Wishing you a very good outcome and a long life ahead.
Posted 1/24/2015 2:33 PM (GMT -5)
Mr Magoo,

There is hope!

This disease can, many times, be managed for a L_O_O_O_N_G time if you are aggressive in treatments. We don't use the see-you-are-eee word, we speak of Durable Remission, which is a fancy way of saying that you are going to outlive the disease.

As others have stated, ADT is probably your first step. It will slow the cancer's growth and reduce your PSA level quite rapidly. If your bone scan & CT come back good, you are probably a candidate for radiation in one of it's many forms. It's what I did, and it has worked out well (so far...).

Use the time between doctor visits to read up on the treatments and side effects. Dr Patrick Walsh has a well-respected book 'Surviving Prostate Cancer' available from Amazon:

http://www.amazon.com/Patrick-Walshs-Surviving-Prostate-Cancer-ebook/dp/B00B73T208/ref=sr_1_1?s=books&ie=UTF8&qid=1422127558&sr=1-1&keywords=patrick+walsh%27s+guide+to+surviving+prostate+cancer+third+edition

Once you and your doctors decide on a course of treatment that will have the greatest benefit to you, things start progressing, and your mind will become more settled. This is not a sprint, it's a marathon. Keep focused on the end results and you will do fine!

All the best in your journey - you are in good company here with a large group of fellow travelers.

Bob
Posted 1/24/2015 2:45 PM (GMT -5)
Mr Magoo, let me add my welcome and I'm sorry you got such a sucky diagnosis. But there's lots you can still do and plenty of time to watch those kids of yours grow up. As Peter suggested, hormone therapy is probably your next step since it can often freeze everything in its tracks and give you time to plan your treatment.

In the meantime, ask as many questions as you'd like. There's a lot of very knowledgable folks here, including those that have already weighed in with their initial thoughts and we're all here to help.

Good luck with the bone and CT scan and please keep us posted.
Posted 1/24/2015 10:09 PM (GMT -5)
And I apologize on behalf of Logostupid.. Who has no filter nor sympathetic / empathetic feelings.. For a first time poster..
Posted 1/25/2015 8:09 AM (GMT -5)
Mr Magoo, let me welcome you to our forum. The guys have already made most of the important points for you to consider right now. This is a wonderful group of people, united by a common sucky disease, but usually all with the best intentions to help, especially our newcomers. (Pardon our occasional jabs at one another, it just happens.)

I was diagnosed at 55, so also was pretty desirous of aggressive treatment. My radiation therapy coupled with ADT is intended as a shot at a cure. Maybe, if the bad cells were still all in the local treatment area, we burned them out with radiation and starvation. "Treated with curative intent" they say. It's possible, but usually we're really hoping at least for a durable remission. For you, they'll be able to tell better after the scans whether aggressive local treatment is likely to help enough to be worth doing.

You have the added honor of joining the Gleason 9 Crew, the suckiest chapter of the least desirable club anywhere! We have a thread for those of us facing this diagnosis, since it can be rather scary. Most of the folks there are still doing pretty well. Read through the stories there, note some of the names, even consider reaching out through email to some of them. The G9 diagnosis puts us into a "how do I survive this" mindset, somewhat more so than the low or intermediate risk versions. Sometimes our options are more limited too, so it's helpful to talk to others in similar situations.

Here's a link to the G9 Crew thread. I've added you to the roster (even more specialized, you're our newest in the very small 5+4 group). Again, it's nothing exclusive or separatist, it's just a gathering place for information more focused on your situation.

www.healingwell.com/community/default.aspx?f=35&m=3182035&g=3182504#m3182504
Posted 1/25/2015 5:13 PM (GMT -5)
Magoo:

Sorry you're here ... 2 1/2 years ago i was where you are 49 years old., two teenage daughters, and a 36 PSA, so i get what you're going through.

First, you found a wonderful resource In HealingWell. Although you might not find the answer here every time, there are brothers that have been through a lot and can advise and give you options.

Second, get ready for a fight ... you've got an aggressive disease and it will require aggressive treatment. Many doctors may not be used to fighting aggressively for younger patients like us ... overtime, you'll want to build a team that is. (including your GP, your oncologist, an RO, and your family and friends). It's a fight that is worth it ... and you can gain many many years, I certainly plan to.

Third, as part of the fight your biggest allies are happiness, love, and friendship. The more you have worth living for, the easier the fight will go. So spend time on that as well -- spiritually and relationships. And spend some quality time with your wife right now ... the therapies will make that more difficult.

More will be clear after the scans come back, keep checking in with us. You can see in my signature that we went at it with a vengeance. There are a lot of options for treatment -- and more coming in the pipeline. I used to kid that i could always use 'blow torch and pliers' if needed as well.

You can email me if needed at any time ...

Ray
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