Husband is newly diagnosed

Just diagnosed last Tuesday at the VA.

Gleason score is 7 (4+3)

Scheduled for bone scan and CT scan in the next 10 days.

Husband is 73 and in pretty good health other than slightly overweight and arthritis -- diabetes controlled by diet, high blood pressure controlled by meds.

If he had to make a decision today he would do nothing. He's underwhelmed by the diagnosis and feels whatever happens happens. After 4 years as a corpsman and 30 years as a respiratory therapist he looks at life and death differently than I do. I'm torn between it's his life, it's his decision and trying to figure out if I should be talking him into something. We don't have kids -- grandkids, etc., so while I would make a different decision is it selfish for me to try to talk him into something?

We asked the NP what she would do with the numbers she sees -- 'assuming' no spread from the scans next week -- and she said surgery and radiation.

I guess my concern is the quality of his life if he does nothing and what to expect vs the quality of his life going through surgery and radiation. I know he's not afraid of dying, but I do think pain and debilitation would be something I could get his attention with.

Any advice, suggestions, or thoughts -- I'd greatly appreciate it.

At 73 surgery would not be a good choice. Radiation, there are many forms, external, seeds or high dose Brachy are all good options for a G7, with cure rates in the 70% or better range. Doing nothing with a 4+3 is risky, 5 to 10 years before symptoms if it is contained and not yet spread to the lymph nodes. What was his psa?
Once it spreads, cure rates are very poor, so some type of treatment is appropriate.

Hey I am a Respiratory Therapist as well. Not to many of us on this forum. I am younger than your husband but i have decided to go with Brachytherpy, and i also have a 4 plus 3 in 2 cores. So much good advice on the forum, get all the info you can... good luck. steve

As to SBRT therapy -- we're VA patients, so I doubt it's available there.

We're happy with the treatment at the VA -- have been going there for a decade now for one thing or another -- but new technology is not always their strong suit.

Good Morning glad you found this site cause we got some great individuals on here with a lot of knowledge and common sense and once in a while a little humor cause this darn disease can get you down in the dumps sometimes.. If your husband is having urinary problems already I'm almost positive that you won't find a doctor that would do surgery at your husband's age as this would for sure add to it, unless they are in it for the money. Take your time check out all your different options, our expert's as I call them will be along in a while they will probably want to know your location as they know good doctors all over the country. Wishing you the best in whatever decision you make.

Larry

Hello

Sorry you have to be here. I also get my care through the VA and was an Army medic, that experience definately gives one a different point of view on the inevitabality of death. Due to my comorbidities I have chosen to watch and wait. What that means is should I become symptomatic I will seek pallitive care to relieve the symptoms of the disease but I am not seeking a cure.

I am pretty sure that both his PCP and the Urologists at the VA have made multiple attempts to get him to consider treatment. Mine have, this is the typical note they have been putting in my chart regularly for the last 12 years... "he does not want to do any sort of life prolonging measures. I even discussed that the prostate cancer could progress and become painful and very symptomatic, and he still declined ...We will have him follow up in the Clinic in 6 months where we can discuss the potential for treatment."

I know it is very hard for you to accept but it is unlikely that you will be able to talk him into anything. However, what you must do, in my opinion, is for both of tou to sit down and have a heart to heart talk so that you understand exactly where he is coming from and what his concerns are and that he understand exactly what your concerns are and where you are coming from and then make plans for your future togeather.

Whether he makes a choice to treat or not this can be a time when you come closer togeather as couple and enjoy each day to the fullest.

Post Edited (Joe1.) : 9/24/2017 6:03:32 AM (GMT-6)

Here's a form you can fill out to see, based on statistics of men with his diagnosis and comorbidities, what his 10-year and 15-year life expectancy is if he doesn't get treatment. It requires you know what his PSA was (don't worry about the meds he's taking), and his stage. Stage is based on a digital rectal exam. If his doctor felt nothing, it's stage T1c. If he felt a small lump, it's stage T2a. If he felt a big lump but only on one side, it's stage T2b. If he felt lumps on both sides, it's stage T2c. If you don't know what he felt, just put in stage T1c. (It's only an estimate anyway).

/webcore.mskcc.org/survey/surveyform.aspx?&preview=true&excelsurveylistid=4

He should take his time making an important decision like this. Even if he takes 2-3 months to decide, things are not likely to change very much in that time. Prostate cancer is slow growing at this stage.

Which VA and could you post a signature with the particulars?
The VA is a great health care system if you are proactive and can stay on top of what is happening. If you just turn it over to someone else to make the decisions for you then you will only get what someone else feels like giving you before they go home to the wife and kids.

hi,

read that for older men brachy has a bit better results.
if not agrressive cancer cell type, he should be o.k. for a long long time.
everyone is different and results can differ for the same treatment.
I recall technician tell me they killed everything . machines so precise.
who knows.

its been 2 years and my psa, which is a marker only, has slowly gotten lower and sits as of yesterday at .6
i am 75, so i figure if it does not kill me, something else will later on. we are not immortal.

todays medical knowledge and drugs means its not that death is imminent.
so, enjoy life as best you can.

as i always say, a bus can come along and kill the healthiest too.

If you are near Loma Linda, you are near City of Hope in Duarte. Both are excellent hospitals. I chose surgery at 75. Wish I hadn't. Surgery did not spare nerves. No more sex life. At 75 I guess I am done. Tried injections, sever pain. Orgazim is near nothing. Just a signal of , your done. Where are the two of you on this side of the problem. Is he ready for it to be over?

Jackie,

Here is an excellent website for High Dose Rate Brachytherapy (temporary seeds), which is what I had successfully. See, www.cetmc.com, the website of the HDRBT pioneer Dr. Jeffrey Demanes. He has used HDRBT since 1981 and is the head f the department at UCLA Medical Center, not far from you.

For Low Dose Rate Brachytherapy (permanent seeds). See www.prostrcision.com, the website from Dr. Frank Critz here in Atlanta. He pioneered the use of seeds and external beam radiation back in the 1970's.

Both will give you great information about the disease and treatments to consider.

Best wishes,

Jack

Jackiespino,
Glad that HDR brachy and radiation thing got cleared up. Like I said in that thread, this is a confusing and frustrating disease. I’m new at this myself. I was DX in 12/16 as a GS9. I am 9 years younger than your husband. With my DX, my treatment plan currently is whats called the “triple play”. ADT, Brachy, and SBRT. I started with hormone shots of lupron to desensitize the cancer cells, ADT, in April 2017, followed by LDR brachy, which is seed implants in July 2017 and last of the three, SBRT. That is radiation, which in my case was completed in 5 consecutive days. I still have a ways to go to be sure everything did its job and I’ll need the Lupron shots for about another year at least.
Speak to a surgical and radiation oncologist with your husband. The available treatments have a good chance of keeping him around a while longer...🙂. The longer we are all around, the more of a chance of research and trials making sure we all go on. Get all your numbers and diagnosis in order. Try to post them as your signature. Best of luck to you and your husband. The folks on this board are a great resource. Feel free to ask anything. We’ve all been there.

Been going to VA Loma Linda for 10 years, worst VA facility I' been to in 45 years of dealing with the VA,
Why don't you use Medicare and go to a real good doctor with out having to deal with the VA system.