Welcome to a place you don't want to be. There is a very informative post at the top of this section of Healing Well that you want to read. From what you have reported, you have a very low risk situation and watchful waiting or active surveillance might work for you so no need to stress out. We certainly understand your emotional situation, been there.

Hi BRD,
A diagnosis of cancer is always tough to swallow and that one word can overwhelm your emotions. When I was diagnosed and heard that word, the room literally went white all around me, my knees buckled and it felt like the floor was pulled right out from under my feet. My emotions ran high and low for several months and even now I sometimes get overwhelmed with my diagnosis. The good news is that there is life after diagnosis. A lot of it will depend on your perspective.

Now on to you. You have a lot in your favor such as 1) your age;2) your gleason score;3) total number of cores positive;4) your PSA. I don't want to sugar coat anything but your numbers point to a low risk disease and one that is highly treatable. What you will want to discuss is your different treatment options and fully understand the risks and benefits of each. Surgery or some form of radiation will likely be your two treatment options. You Doctor may even discuss watchful waiting or active surveillance. Some folks use these terms synonomously but I believe that active surveillance does a little more than watchful waiting.

It's a good idea for your stats to get a second opinion and most folks here recommend either Epstein or Bostwick. Maybe they're one and the same. I don't know because I never had a second opinion. No need for my stats.

At any rate sounds like you have a lot going for you despite your diagnosis and you should look forward to a long and happy life. Best wishes to you.

Welcome to HW, sorry you need to be here.

First, slow down. It's a shock to the system to learn you have cancer, but PC is a slow growing one and you're in a low risk group. That means you have time to make an informed decision about treatment. What's going to drive you crazy is that likely all the main modes of treatment will work: active survallence, surgery, radiation in it's various forms (beam, brachy seeds).

Let yourself adjust to the emotional shock and do your research. You'll want second opinions on the pathology report and you'll want to talk to a few doctors about treatment options.

Hang in there and ask all the questions you want, we're here most days,
Andrew

BRD, welcome.
You've gotten good advice here, not much on the "what to do" front to add.
But a great way to start your learning process, in addition to this forum, is to but two books...both will give you a lot of knowledge and they come from two different perspectives.

Dr Patrick Walshs Guide to Survivng Prostate Cancer
www.amazon.com/Patrick-Walshs-Surviving-Prostate-Cancer/dp/1455504181

And Invasion of the Prostate Snatchers, by Dr. Mark Scholz
www.amazon.com/Invasion-Prostate-Snatchers-Essential-Managing/dp/1590515153/ref=sr_1_1?s=books&ie=UTF8&qid=1446427635&sr=1-1&keywords=Invasion+of+the+prostate+snatchers

They will give you a good understanding of your situation, and your choices.

Hang in there, it's all a fog now, we know, we've all been there, but the haze will clear. Your biopsy results are singing to you that you are in pretty good shape, all things considered.

BRD said...

I have seen several people post numbers but I am not sure what all is important to know so I'll post some of what I have from the pathology report.

Hi, BRD. I can help you answer this question; actually, you mostly have answered it yourself at this point.

The only reason for all the numbers is to understand clearly what your RISK CATEGORY is. Please do read the "sticky" thread at the top of the page titled, "Newly diagnosed with PC - read this thread first," where the very first posting there is about RISK CATEGORY. Understanding your RISK CATEGORY is the essential predecessor to any conversation about treatment.

I'll copy & paste one section from the first posting in the sticky thread here for everyone's convenience (the formatting comes out a little different):

VERY LOW RECURRENCE RISK
o PSA < 10 ng/mL
o and Gleason < 7
o and cT1c tumor
o and PSA density <0.15
o and <3 biopsy cores positive, <=50% cancer in any core


So now let's go down the list with your info:

BRD said...
PSA two years ago was 1.5, last year 2.8 and 5 weeks ago 4.5

Less than 10 ng/mL...CHECK

BRD said...
Gleason score 3+3=6

Gleason less than 7...CHECK

BRD said...
I have had DRE ... tests since 40 years old with no concerns from my doctors.

No DRE concerns, so cT1c...CHECK


PSA density is next. Here's the one thing you didn't mention: from your biopsy, your doctor would have done an estimation of your prostate size in cc's or ml's (the volume numbers would be the same; ie., a 40cc prostate is also 40mls). If you have a printout of the report, it's probably on there somewhere. PSA density is your PSA divided by the volume. Typical normal prostate size is 30-ish for someone your age without BPH, which would yield 0.15 density. You are probably good here...CHECK

BRD said...
12 cores biopsied...1 showed cancer...two foci measuring less than 1 mm each

Only one core (it doesn't get any lower than this, and at 1mm (size of #2 pencil lead), you no doubt have less than 50% in that one core (the report may also give this number)...CHECK


So there you go...you've pretty much got all the key numbers. I do always think that a second opinion reading of one's biopsy slides by a pathologist who specializes in prostate cancer is always a good idea (unless of course the initial reading was already done by one of those experts...some doctors just send the biopsy samples directly to one of the experts). But, 2nd opinion nonwithstanding, you should now begin every conversation here or with any medical professional you consult with this summary statement: "I have been diagnosed with VERY LOW RISK prostate cancer."




One other helpful clarification...maybe you already know this, or maybe not; it wasn't clear to me that you understood what he meant when he said this:

BRD said...
I do know that he said this is one that can go either way with treatment...

Just to be clear, what I'm certain he meant by "either way" was that you really don't even need to treat this at all. The tiny bit of PC that has been found in you is generally considered a natural part of aging, and is not considered any sort of a threat to your health or well-being. In fact, many doctors are arguing that this really should not be called "cancer" at all! Their reasoning for this is that way too many men encounter an "overwhelming" fear of the word "cancer" and over-react by demanding immediate treatment...and often is such cases the treatment is much worse than the disease.

best wishes...!

Welcome aboard BRD,

All the guys have given you great advice so I have nothing more to add.

Your Gleason 3+3=6 and only 1 core showing PCa is as low as you can get and still be diagnosed. It is not like saying your are a little pregnant but you have a little cancer.

Your dad's history causes concern so you need to keep having PSA test regularly.

All treatment options will have life changing side effects so no need to rush into anything yet, if you can help it. Follow the advise the guys gave you already, have your slides looked at again, and chill some knowing your life will be changing in the future.

Bill from Florida

BRD,
I would reiterate the suggestion to take your time in evaluating your status. Your situation seems to scream for Active Surveillance. Some of the worst regrets that I've seen here and in general were from over treatment.
Best to you.