Any advices would be highly appreciated

Hi all, Thank you all for your suggestions.
Biopsy was done Jan 26/2015. Need 2 weeks to get the result. Bone scan and Ct scan are scheduled next week. I believe if there is no spread, RP maybe the first choice for me. I am wondering from now on till the date of surgery, what should I do? Any medication should I take? Is exercise good for preventing the cancer spread?
Thank you all again for your ideas and suggestions

I put my husband on a mostly vegan diet, green veggie smoothies, and fish. I won't count on it to cure or prevent cancer as some internet sites claim, but I believe it can help slow tumor growth, and maybe delay recurrence. But my husband certainly feels better than he has in years and his cholesterol and triglycerides have gone down. He lost the 10 extra pounds he's been carrying too. He takes Pom T and curcumin also. If you try the search engine there are some threads talking about diet, etc

I'll put in a prayer tonight for good results of your tests.

Sophie

Hi Andy,

As I understand it, based on your MRI you're very likely to have prostate cancer and that's why you had the biopsy. Just keep in mind that only a biopsy can truly detect prostate cancer, so as Allen says don't get too far along in your thinking. That said, given that your doctor has already scheduled the bone and CT scan (which are usually done AFTER getting the biopsy results and you know for sure that you have cancer) I can certainly see why you're already moving rather quickly.

When you get the results of your biopsy back, please post them here. I would recommend starting a new thread with that info. (And remember...until then we don't definitively know that you have cancer!) That info, coupled with what your MRI saw (and your scans) can help guide you to a treatment decision. Please don't jump to any conclusions with that yet. We'll be here for you.

Andy. Two weeks wait for your biopsy result! Sounds like you are some place where the health care is free. Not always a good thing when dealing with something like cancer. If you do happen to be in that situation then make sure you do some research on centres that deal with prostate cancer and check there track record. I live in the UK and there are some very good prostate cancer centres here, but it may mean you would have to be willing to travel outside your area for treatment.

Good luck and keep us posted.

Put the brakes on immediately, really hard! Jumping into surgery without the details of your biopsy???????????? STOP!!!!!!!!!!!

First, get the details of your biopsy and learn to understand them - we can help with that. Then, send them out to Bostwick or Epstein for a 2nd opinion.

Please, slow down, and take this step by step!

Hi A Yooper, Thank you so much for your advice. Also, Thank you very much, Michael. I am living in Toronto, Canada. Based on MRI, I am in T3a stage. In this stage, surgery seems to be the best treatment choice if there is no spread to lymph nodes and other area. I believe it is better to cut the cancer out ASAP than late before it spreads. As for the Gleason score, since my psa is over 40, I think it will be in a quite high level. Do you think so? Thanks a lot.

Andy, listen to the guys! Slow down!! I'm also living in Ontario so I can believe what you're saying but; this is being handled wrong! Your PSA of 40 doesn't mean you have a high gleason score! The highest my PSA ever was, was 3.83 and I'm a G9. Normally the higher the G score the less PSA it produces.

Surgery is not recommended with the stats you have shared so far and you are not in a position mentally yet to "jump" into a treatment. You need to remember that the final choice of treatment is yours but it has to be an informed decision, not knee jerk! You may decide to go with surgery, but not next week! You have time to make the best decision for you.

On the left of this post, wher you see my name, you'll see an email icon. Send me an email and I'll stay in touch with you through this.

Slow Down!!

Cheers, Doug

Let me also add on: PLEASE SLOW DOWN.

Your doctor sounds like the urologist I fired. He had me scheduled for a biopsy before my first consultation with him and he got VERY upset when I decided to go to Umich for a second opinion.

To me, this almost sounds like malpractice. Then, again, I am unfamiliar with the standard of care in Canada.

Maybe someone else knows more about the typical tx. in Canada.

Mel

This all reminds me of my first uro that I fired. I had the MRI but when I went back to see him he had not received the results. All he had was my PSA results. He then said "well I know we do not have your MRI results, but as we are all here lets get on and do the biopsy anyway" I just got up and walked out and never looked back.

Hi Andi,

It sounds like you are panicking, and there's really no need to. First, you need your biopsy results. Assuming it confirms that you have high risk prostate cancer, there are several steps to take.

First, I think it is a terrible idea to have surgery. Your stage T3a means that the cancer is already outside of the prostate capsule. Surgery alone will do you no good, and may do you harm. The surgeon will have to cut through the cancer, possibly thereby spreading it. You would be assured of having to go through radiation anyway, but doing that after surgery makes all the side effects worse. It will considerably increase your risk of lasting incontinence, impotence and rectal problems - all problems you might never have if you had radiation in the first place.

Because your bone scan and CT scans were negative, radiation alone may cure you.

Because you live in Toronto, I have a great recommendation for you - contact Dr. Andrew Loblaw, MD at Sunnybrook Health Sciences Centre/University of Toronto. He is one of the top radiation oncologists in North America. He is treating men with high risk PC, like yourself (presumably), with a kind of intense radiation called SBRT. This entails only five brief treatments.

If you can't get in to see Dr. Loblaw, I suggest you travel to London, Ontario and meet with Dr. Glenn Bauman at the Lawson Health Research Institute. (Call first, of course). He is doing a very similar protocol.

If you can't get to see Loblaw or Bauman in the next few weeks, it may be a good idea to start you on hormone therapy. Your urologist will give you pills called bicalutamide for about 2 weeks, and then give you an injection of Lupron, which will last for 3-4 months. This will stop the cancer from growing for now. It will give you time to visit doctors. It may also make the radiation work better.

Please let us know what the biopsy results are.

- Allen

OK Andy. You hear it? Slow down or stop. that's the message I'm hearing from these guys. Been reading posts for a while and I don't think I've come across one that said he was glad he had rushed into surgery.
The web is littered with people who have been screwed by useless or careless doctors. Devote your energy to really finding out what's going on with your health. Let your family take care of lawyers visits if you really want to go down that road. When it comes to getting screwed, lawyers don't have a better reputation than doctors where I come from. Maybe Toronto is different? After my own personal experience with my first urologist I'd rather trust a second hand car dealer.
It sounds like you are still up and about.
Good luck.

Thank you everybody for your suggestions.
Hi Allen, actually, my urologist Dr. Nam works at Sunnybrook hospital. He seems to be a good surgeon based on the internet information.
I searched the internet and seems that T3a is still a localized lesion and that can be removed completely. I am still get confused. I will discuss my situation on Monday with Dr. Nam and to make the decision after or at that time.
Thanks again.

andy-

You misunderstand the terminology, I think. Michael_T is quoting correctly - the tumor has already grown through the capsule. Because surgery only removes the capsule, it is already beyond surgery's reach. It is only "local" in the sense that it has not metastasized to a more distant location yet, and is still within reach of radiation to the local area. A stage T3 clinical diagnosis this early tells you the tumor extent is considerable and not microscopic. Radiation destroys the cancer within the prostate capsule plus a margin around it.

So to clarify that for you - for surgery to be curative, the cancer doesn't only have to be local, it also has to be contained. Contained means Stage T2 or less.

Hot dog surgeons will often say they can get it all - that is seldom the case. Why on earth would you take such a risk when there are better alternatives?

I would urge you to NOT make a decision based on a conversation with one urosurgeon, no matter how good his reputation. You owe it to yourself to investigate all the therapies relevant to your case. Who is more worth your time and effort?

- Allen

Post Edited (Tall Allen) : 2/7/2015 7:36:22 PM (GMT-7)