Newbie

As you can tell by my heading I'm a Newbie. I've visited this site a few times since I was told by my Urologist that I have prostate cancer and I've been impressed and encouraged by the support that I have read. I'll give you my prostate cancer history and I know that you guys will be offering me advice and support now that I'm a member.
I'm 68 y.o. and what I thought was in good health until this diagnosis. I had a feeling that eventually I'd be diagnosed with PC seeing my dad was diagnosed with PC in his 70s. I don't know exactly what level his cancer was at the time of his diagnosis. I know that he went through radiation therapy for 8 weeks, then brachytherapy. He did quite well with his PC, because he lived to be 92 before he passed away from liver cancer which was not related to PC.
At the time of my diagnosis, I didn't seem to have any signs or symptoms. I did urinate frequently, mainly in the morning after drinking 12 oz. of OJ and 2 16 oz. coffees. Usually, around noontime, my urination frequency seemed to be typical for a 68 y.o. guy. I have always been active physically, lifting weights, running approximately 30 miles per week until I had to have my left hip replaced because of arthritis, I play golf 3-4 times a week during the spring, summer and fall (hard to play golf in the winter in New Hampshire), and lastly, I do about 30 minutes a day on my crossfit machine. Okay, so back to my PC history. Back in 2020, I had my annual physical and my PSA was 4.2. My PCP and I agreed to monitor my PSA level and if it got over 4.8, he would refer me to a urologist. In 2021, at the time of my annual physical, my PSA was 5.86. My PCP and I agreed that it was time for a urologist to get involved. I met with the urologist and he did a DRE and felt a "nodule" on the lower right side of my prostate. We agreed that a TRUS biopsy (MRI ruled out because of hip prosthesis) should be done just to be cautious. Well, the biopsy came back positive for PC (G7 4+3). 80% of the right base and 1% of the right mid gland with the left side of the gland negative. The urologist recommended a blood work-up, bone scan and full body CT Scan. The blood work-up came back within normal limits, the CT Scan and bone scan showed a 7mm lytic lesion on the #9 left rib. Other than the lesion on the 9th rib, there was no indication that the cancer had not penetrated the prostate. A chest CT scan was ordered and the results of the chest CT scan showed that there are 2 lesions (10mm on left #6 rib and 7mm on the left #9 rib), but the lesions "are not typical of PC matastaces". This past Monday, 01/03/22 a biopsy was done on the #6 rib lesion (#9 rib lesion was not biopsied because of it's location and being identical to the #6 rib lesion). Now, I'm waiting for the results of the biopsy. Oh yeah, at the end of 2020, I injured my left rib cage working around the house. I didn't fracture any of the ribs that I know of, but it took several weeks for them to stop hurting. Even most recently, if I overdid a workout or hit a bad golf shot, my left ribs would be sore for a couple days, but the soreness would go away.
Right now, I'm waiting for the results of the most recent rib biopsy so that my urologist and I can put a plan in place. I've been doing all kinds of research on treatment modalities. Depending on the day, I feel that RT is the best option because of my extremely active lifestyle. Then other days, I feel RP is best to get the beast out of me so that I don't have to worry about it raising it's ugly head again.
Thank you for letting me into you group and I'll keep you up to date on what is going on with my PC.

Hi,
It's a struggle to decide on a PCa treatment. I'm not about to recommend one either. My own PCa treatment commences in less than two weeks.
I wish you well.

Hi Boomer, Glad you found us and sorry you’re here. Now’s the time to get fully informed and being here is a good start. You may wish to get your slides confirmed by Dr. Epstein. I’m a radiation guy and unless you’re suffering with urinary issues (BPH) as well PCa see very little value with prostate removal. I find nothing matches the cure rate with either SBRT or Proton for low and intermediate risk guys. Continue to do your homework and choose wisely.

Hello and sorry you have to join our community. I would be quite surprised if the rib biopsy comes back positive, but it's good that they are checking it out. My scan showed every injury I ever had and that's likely what's going on with you.

I second the recommendation on getting the second opinion on your biopsy slides--your diagnosis is the middle risk range, which means it has the potential to be either low risk or high risk upon second reading, which could color your treatment decision. That's actually unlikely, but it would be good info to know.

Do you have a radiation oncologist lined up for a consult yet? I'm not sure how many folks we have in New Hampshire, but I'm sure guys in Boston can make some recommendations for you.

Boomer53, our stories are similar except for the rib, hip, and golf stuff. I won’t suggest a path since others are doing that but I will commend you on your active lifestyle. As a swimmer and runner, good diet, etc. I was told over and over during my journey that I’d sail right through it because I was so healthy and they were right. No complications and I was back to serious running in about 3 months.

Boomer,
When I had my consult with Cleveland Clinic they requested I bring my slides with me. There was only some very minor differences in the scores with several different RO’s evaluating them. It was reassuring they arrived at the same scores as was as informative being part of the discussion. Medicine is an imperfect science for sure.

The slides were simply carried in an envelope…no big deal to have a couple of evaluations.

All excellent suggestions so far. Here is a link to the Johns Hopkins relevant site:
https://pathology.jhu.edu/patient-care/second-opinions

There appear to be three prostate pathologists (with Dr Epstein being the best known).

Rib biopsy finally came in yesterday, 1/15/22 and the results is benign. That was a relief. At my request, my urologist scheduled a consult with a RO on 1/25/22 and submitted a consult request with a urologist that does DeVinci surgeon.
Now that phase one is done, I will open a new topic to report on my treatment phase.

halbert, thank you and I will keep you all up to date. I will probably asking for your input as to which course of treatment you chose and what led to your decision.

That is indeed good news Boomer.

Halbert and Pratoman, Thank you and I read both or your stories. They were very informative about RALP. I appreciate your openness. Thank you again.

Boomer…Great news on the rib biopsy! Now the specific results of your TRUS biopsy samples become a very important component in helping select a treatment. Reading these slides can be subjective and it’s important to get more than one opinion. Even as a low volume Gleason 6; I got three confirming opinions. Epstein is the gold standard and it might be the best $250 you’ll ever spend. The grade, volume, and specific location will help whatever treatment team you may select and improve your odds of a successful outcome. “Knowledge is power”, and that comes from my grandmother (MumMum) who only went to the eight grade. Keep us posted. Terry