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Posted 10/24/2016 11:56 AM (GMT -5)
To begin with, I would like to let everyone know how much I appreciate this sight. It is an amazing sight.

Had a MRI-Targeted Biopsy on 10/03/16 at UMich. Results 5/20 3+4=7, T1c, Nx, Mx.
I have an appointment on 11/03/16 at UM with Dr. Holenbeck and a RO. Looking for help finding the best Doctor and treatment in Mich. or out of state.
History 2002 PSA 401 Biopsy Neg.
03/ 4.6
04/ 4.2
05/ 4.2 Biopsy neg
08/ 5.2 " "
10/ 4.5
11/ 6.4 " "
12/11/ 3.4
12/ 3.9
13/ 4.0
14/ 4.8
15/ 4.1
2/16/ 6.2
6/16/ 6.9, MRI two targets, no enlarged lymphnodes, no bones
10/16/ Biopsy 5/20, 3+4=7 Gleason, T1C, Nx, Mx, 58ml
Posted 10/24/2016 2:21 PM (GMT -5)
Hi Wdan...sorry to hear you're part of our club, but hope we can be of help to you. I can't help with Michigan-specific doctors, but others can and I'm sure they'll be here shortly.

I would encourage you to get a second opinion on your biopsy slides from Epstein at Johns Hopkins. The newly diagnosed sticky explains how to do that. (FYI, it's pretty easy.) Your G7 (3+4) makes you "favorable intermediate" risk and it would be good to confirm that as you make your treatment decisions.

My other advice would be to talk to as many experts that practice different treatment options so you can make an informed choice that works for you. You have plenty of time to make a decision so let that time work to your advantage.

Good luck to you and let us know how we can help!
Posted 10/24/2016 3:06 PM (GMT -5)
Welcome Wden.... I'm kinda new here but I'd like to welcome you and to also say I'm sorry you had the need to find us .Glad you did. This group is a wonderful place to find info and encouragement. There are many here with an enormous amount of knowledge. We all have our experience to share which can be very helpful as well.

Like Michael_T said you have plenty of time with the looks of your Dx so keep asking questions and find the best Drs available to you.

Keep us informed....


The Artistic One - Mark
Posted 10/24/2016 3:29 PM (GMT -5)
Hi, Wden, and welcome. I've only been here a short time myself, and my biopsy report is in the same category as yours - favorable intermediate risk. That means that although we have one of the characteristics of true intermediate risk PCa, with only one intermediate risk item and the rest low/favorable risk, our cancers should behave more like the low risk variety. This will have an impact on the treatment options we are offered. (Remember - a doctor is not supposed to offer you a treatment that is not likely to be effective in your case.)

Also, as others have noted, we have time to think, absorb and decide. The Gleason 3+3 and 3+4 cancers are relatively slow-growing, so if it takes us a couple of months to decide, we haven't measurably worsened our chances for a cure.

Take your time. Learn all you can absorb (all you can stand?). Then you will be more comfortable with your choices. Ask lots of questions - the folks here seem to know a LOT about prostate cancer, its impacts and treatments.
Posted 10/24/2016 3:41 PM (GMT -5)
Hi Wdan and welcome.

Might I suggest that the first thing you do is read the sticky thread at the top of our forum - this is designed for newly diagnosed members. Then I would strongly suggest that you forward your biopsy slides to Epstein or Bostwick so you get an expert view of your pathology.

It is likely that your cancer can be cured by a number of means including surgery, LDR Brachy, HDR Bracy and SBRT. You should consult experts in each of these disciplines (once you get your true pathology) before making a decision.

Jim
Posted 10/24/2016 7:01 PM (GMT -5)
welcome to HW, sorry you need to be here.

Get those appointments done, more info the better.

It won't be fun to do, but you have every reason to hope for a positive treatment outcome.

What's going to drive you crazy is deciding what treatment to do.

Andrew
Posted 10/24/2016 7:08 PM (GMT -5)
Wdan, how old are you? Pick up a copy of "Guide to Surviving prostate cancer" by Dr. Pat Walsh.. It's the information bible...
Posted 10/24/2016 7:15 PM (GMT 0)
Just want to add that experts in their field are just that "in their field". You are the only real advocate for yourself and must live with your decision. Research will reveal that favorable intermediates stand a good chance of cure from LDR, HDR, Surgery, SBRT, and EBRT. That said, talk with professionals, acquaintances who are directly or indirectly involved with PC, and do the research.

Keep us informed and the best to you.
Posted 10/25/2016 8:00 AM (GMT -5)
. . . And combine the wisdom of Fairwind and browntrout. When you read Dr. Walsh's book, remember that this book is written by a surgeon. In his mind, surgery is the only "best" treatment for PCa. He does devote some ink to radiation, but at least in his 3rd edition, he still considers many of the newer treatments, including SBRT, to be experimental. IIRC, his comment about SBRT is something like ". . . too new. Has no history and should only be used in clinical trials." That is no longer the case, so do your own research for current status of any treatments you may find. Books are usually on the store shelf a couple of years after they are published, and they are often written some time before they are published. To get the current status, do your own research. This board has a wealth of information and tour guides to help you find your way.

To give you an idea of why I'm advising caution (at the risk, I guess, of being flamed) is that current studies indicate that properly administered radiation, using up to date equipment and methods, has the same cure rate over time as surgery. It also has fewer and less burdensome side effects than radiation did just a few years ago. What I mean is that there is no clear-cut "best" treatment. Those of us in the low-risk and favorable intermediate risk groups should look more at the side effects profile of potential treatments and choose the one that offers good odds of cure (that's about all of them) and that has side effects that we, the individual patient, feel we can tolerate for however many years we expect to live.

Now, most of this is just my opinion, and you know what opinions are worth, but I do advise you to think. Do not be shepherded into a treatment because the doctor says it will work for you. You have choices, but only once, so make a choice you will be comfortable with for the rest of your life.
Posted 10/25/2016 10:26 AM (GMT -5)
Hi Wdan, just welcoming you to HW, sorry you have to be here. You got some great advice already so just keep us up to date on your treatment decisions. I wish you well on this journey. Take care. -JR
Posted 10/25/2016 8:05 PM (GMT -5)
Thank you all so much for the timely replies. I have requested UofM to send my slides to John Hopkins for a second opinion. Made an appointment today with Dr. Martinez in Troy Michigan, got his name from a post on this sight.
Having been dealing with high PSA of 4 or above since 2002, I am wondering if the chances of it spreading outside the prostate are higher. If so, then would surgery be the better choice?
I was diagnosed with ankylosing spondylitis in 2000. Which causes enthesitis, prostitis and iritis. So I believed my prostate problems were do to prostitis.
Read "to go big or go home" on this sight, where is that in my part of the country?
61 years old.
Thanks again for your thoughts, Dan













































r
Posted 10/25/2016 9:18 PM (GMT -5)
Wdan, one of our long time members (compiler) I think he lives in Ann Arbor, and he speaks highly of Dr. Martinez and his team.

If you google "NCCN centers of excellence", you'll find a list of the top cancer hospitals in the US. I think Henry Ford in Detroit is on the list. You're making the right moves. I'm the one who said 'go big or go home', and my experience was exactly that: I was living in a small rural town, and the local Uro gladly gave me a referral to the nearest experts (In St. Louis, MO), and I had a great outcome.
Posted 10/25/2016 11:10 PM (GMT -5)

Wdan said...
Having been dealing with high PSA of 4 or above since 2002, I am wondering if the chances of it spreading outside the prostate are higher. If so, then would surgery be the better choice?

PSA is a very imprecise measurement, so don't get too concerned about that. Focus on what you know, which is that you have a "favorable intermediate" diagnosis. You have a very good chance that you will be cured.

BTW, if you did have spread outside the prostate (which you probably don't) radiation would likely be considered a better treatment than surgery since it treats an area beyond the prostate. Surgery is most effective when the cancer is confined to the prostate.
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