Newly Diagnosed

I was recently diagnosed with prostate cancer and am working on any and all info I can.  My urologist says I can wait to see how it progresses, but as most of you probably know, that doesn't FIX anything.

My PSA was 5.04 and my gleason score was 3/3 on each of three of 12 sectors.

I'm new here, so I'm open to opinions.

Thanks,

Chuck O.

Welcome. Assume your doctor was referring to Active Surveillance. It usually includes diet changes and later testing.
There is an injection in trials called ProstAtak that involves an injection directly into prostate, in Phase III. You might check that out.
Other options are surgery, radiation, HIFU and cryo/freezing. Some of these options include significant urinary and sexual side effects.
Sounds like you have the kind of cancer that would take 20 years to kill you, but you never know.
What is your age? Good luck making a decision.

Hi Chuck, and welcome to the forum. In order to help us, help you, it would be good if you could share more of your statistics with us - see the "signature" section on most of our replies out here to see what I mean.

While obviously PSA and Gleason scores are very important, it is hard to provide good feedback/direction to you without knowing more information, including % of cancer found in each of the 3+3's and also your age. Also if you know what size your gland is and what your cancer stage is - again all helpful for us to better provide input.

You've come to a great place in terms of gaining insight from folks that have "been there, done that" with respect to research and having treatment for PCa. You should also add to this your own research on the internet, as well as reviewing studies and reports from the medical field.

Stay with us, there's lots of help out here!

Best.

ChuckO:

Your PSA & Gleason was about what mine was when I was first diagnosed. I planned on doing AS for awhile, but my second biopsy came back a 7 about 4 months later. I decided to be treated by having 5 high dose radiation treatments by the CyberKnife machine in April, 2011. I have had basically no short or long term side effects.

Dr. Katz claim's better 5 year results than other treatments for your stats. With a Gleason of 6, you have just a touch of CaP and have many options available to you.

Send me a PM and I can give you a link to a webpage of mine that has a bunch of links, including the "AUA Clinician's Guide to Localized CaP".

What is your age ??   That's sometimes a consideration in determining treatment

Good luck on your journey.   You have plenty of time to do research and make a decision what to do.

You may want to start by having your slides read again at one of the top-notch pathology labs, if they weren't already.

WOW!
I sure didn't expect so many responses so soon. Maybe alot of questions from you all that I can't answer yet. Here are some of the things asked:

72 years old
Right Medial Apex: Prostatic adenocarcinoma, Gleason score 6 (3 + 3), involving approximately 60% of submitted tissue.

Right Lateral Mid: Prostatic adenocarcinoma, Gleason score 6 (3 + 3), involving approximately 20 of submitted tissue.

Right Lateral Apex: Prostatic adenocarcinoma, Gleason score 6 (3 + 3) involving approximately 5% of submitted tissue.

Thanks to everyone.
Chuck

I pretty much agree with what the others have said. I would in addition suggest that if you have other psa test results going back five years or so that you post them here, and take a good look at the rate of increase or doubling time. Also consider your overall physical condition. For example, if you are in excellent health and take really good care of yourself, and if your psa is going up at a rapid clip that might tip you away from active surveillance into something more aggressive, even though you are G6.

Although you are in the range of considering AS, it is not a foregone conclusion, particularly since you have 60% involvement in one of your cores. (60% of the core is cancerous tissue, which is on the high side.) The more "classic" no-brainer cases of active surveillance is more like 1-2 positive cores, no core more than 10% positive, which really does signify a cancer that is both small and low grade. I'm not recommending for or against AS, just helping you have both sides of the case here so you can take it all into consideration.

To reiterate what others have said. Take your time and research this carefully. Don't get rushed into anything. There are no do-overs.

Thanks for the added info Chuck. Based on that I would agree with what others have stated - first I would suggest getting a 2nd read on your biopsy slides - Bostwick Labs is a good choice and there are others. If the numbers come back the same or better, I would encourage you to look very seriously into Active Surveillance - at your age and stats I don't believe there's any reason to "panic" and go through any treatment at this point, keeping in mind that "ACTIVE" is the key word for that approach.

Similar to Terry/WaterGuy's friend I too had LDR Brachy about 10 weeks ago; my Gleason and number of cores involved are higher than yours which is why I chose Brachy and have had no SE's.

Keep doing your research, both here, on the internet and with medical professionals - and please don't feel like you have to rush into anything, there's been way too much overtreatment going on. . . .

My best to you.

Peter, thank you for joining in, I couldn't remember who had the G6 to G9 and your story is very valuable to the AS discussions. The one red flag IMO is that the OP has 60% and 20% G6 cells in two of the 3 positive biopsy cores. If he chooses AS he will need to be very diligent for the surveillance part.

Terry

Chuck, while you are likely absorbing more information than you ever wanted to know about prostate cancer, your own education process is very important for you to make a confident decision about your next steps.  Allow me to clarify one point about key differences between "watchful waiting" and "active surveillance" based on an earlier reply in this thread…it will be valuable for you to clearly understand the differences (and misuse) of these terms while educating yourself about your options.  These terms are often incorrectly mixed-up.   “ Watchful Waiting ” is a strategy of using less intensive follow-up (fewer monitoring tests) and relying on changes in a man’s symptoms to decide if a treatment is needed.   If symptoms appear, whether it is a lower urinary tract obstruction or bone pain from metastatic disease, treatment is introduced to relieve symptoms…so it is a palliative (not curative) therapy.   This strategy is usually applied to an individual who has fewer years of life expectancy and/or has other concomitant health problems.   “Watchful waiting” has been around a long time, but the fundamental basis for modern forms of this strategy is that one is trying to avoid receiving treatment of any type for as long as possible so that the patient may optimize his quality of life, while recognizing that it may be necessary in the long term to intervene so that he has minimal impact from the potential morbidity and mortality associated with prostate cancer. “ Active Surveillance ” is a very different strategy of proactive, prospective therapy for carefully selected LOW RISK men to measure the pace of disease progression (or lack thereof) by regular monitoring AND instituting treatment with curative intent based on pre-defined change in the monitoring test results.   Close observation over time is the best way to distinguish men who can be safely watched from the men who genuinely need treatment.   This important element of “time” as an important prognostic guide for men with LOW RISK PC is unavailable at the moment of initial diagnosis…which has led to the mantra given to newly diagnosed LOW RISK men not to “rush” any aggressive treatment decision without understanding the true “benefits” of treatment (many men are unaware of the uncertainty/controversies that aggressive treatment may not improve their survival, especially LOW RISK PC) versus the “costs” (many men are surprised post-op because they didn’t quite understand the gravity of the side effects).   “Active Surveillance” is a relatively new term as more-and-more of the experts have realized that not all cases of PC need aggressive treatment.     Anyhow, I wanted to offer—for your educational purposes—a clear definition of these two terms.   You will find these terms misused, mixed-up, and combined in various literature (and even here on HW).   With this new awareness/knowledge, you should be better equipped to navigate the PC-world.  You are lucky (and not all men are so lucky) to have a physician who supports not rushing into a treatment which would certainly be lucrative to his business; l ack of physician support has been shown to be a significant barrier to wider adoption of AS.         Post Edited (Casey59) : 11/27/2012 2:30:39 PM (GMT-7)

 

If you have a really old uro. like the one I was first refered to, you may also hear the term "observation".

My advice is if you do, get the heck out of the office and RUN !!

Chuck:

Sorry you have PCa; but glad you found us.

We were just talking in another thread about the importance of the QUALITY of the doctor and hospital's AS (active surveillance) program. A top program like memorial Sloan Kettering or UC - San Francisco can really inform good decisions. I encourage you to get to the best doctors in your area and make sure you've pushed them to be their best. There's a wide range of understanding among doctors, and this is not the place to go with the closest to hand.

God bless

Ray