Join Date: Feb 2009
Location: near Chicago
Re: My Husband, 43 yrs. old was just dx with prostate ca, gleason score of 6
Firstly, I'm very sorry to hear the distressing news of your husband's diagnosis. 43 is a young age for you both to have to deal with this...and it is something to deal with together. You said you just received the biopsy report "today" (yesterday), and so if he is like me he is in a state of shock right now, and perhaps you are both just realizing that you have a steep learning curve in front of you. One good thing to note here is that prostate cancer is generally a slow growing cancer, and so you have some time to study, ask, and learn before making decisions. I had a very similar diagnosis less than 6 months ago, and an identical Gleason (3+3=6). I am 49.
I, too, found this board very early after diagnosis, and have found many of the postings to be very valuable in learning a wide range of information about the road ahead. A Chinese proverb says: "If you want to learn about the road ahead, speak to those on the return path." There are many good people regularly reviewing and inputting on this board who have been down the road, and you will likely get a range of responses to your question, although many will be based largely on the path that they have choosen (as is mine).
To fully take advantage of this board as a learning tool, I would recommend taking time to scan through past postings. I had several books recommended to me (on this board) that I would pass on to you. Both of these take a balanced view of all options. The first is "A Primer on Prostate Cancer: The Empowered Patient's Guide" by Dr Stephen Strum and Donna Pogliano. The second is "Guide to Surviving Prostate Cancer" by Dr Patrick Walsh. I ordered the books online via a national bookseller and received them within days. They are both outstanding...and balanced. I recommend placing an order today.
As you have already begun to learn, generally at 43 there is more than one treatment option available. No two people have exactly the same circumstances and conditions, but since the purpose of this board is to share information and share personal experiences, I'll share some of my thought processes which led to my decision to have surgery last month (Apr09) to remove my cancerous prostate.
In your 40's, and with a Gleason of 3+3=6, you have very likely "caught it early." Through all the clinical testing (the pre-treatment testing), I eventually learned that there was a strong indication that my cancer was contained only within the prostate, and probably had not spread beyond the prostate walls (one is never 100.0% certain). If there was any indication of spread or even a higher liklihood of spread...a much higher PSA or higher Gleason score, or indications of irregular surface from a DRE, or other clinical test results...then the surgery option would have been either 'off the table' or at least less favorable. However, in my situation, every indication was that it was fully contained and indeed "caught early."
At my young age, one of my desires was to get the cancer out. Again, having "caught it early", I realized that I had the potential for having it removed and never having to deal with it again. I have kids, a busy job, and a life I wanted to get on with. One of my considerations for radiation was that it doesn't remove the cancer...it delays progression; it slows the cancer down. I learned that taking the radiation approach in my 40's would probably lead to having to deal with it again later in life. If I was two decades older and in otherwise the same general circumstances, I would have likely selected radiation or "active survelance'; one decade older and it would have been a tougher decision between surgery and radiation.
Both treatments have side effects. With surgery, incontenence and impotence set in with essentially everyone immediately after surgery, and there is a lengthy side-effect recovery period requiring much patience. (This is where I'm at now...having my patience tested regularly.) Generally, however, I learned that those who had good sexual function before surgery (again, often correlated to younger age) will generally recover best from the impotence (there are some statistics on recovery; but usually not age-weighted differentiation). My experience so far is that I am making progress in each area a little bit week-by-week...noticable improvement; however, the rule of thumb is generally considered to be 1-year.
There are different modes of radiation, but none are a "silver bullet" either; my experineces in this area are from what I learned, not lived. Incontenence and impotence are reported, but in a much smaller percentage of men than surgery...but for me one of the issues was that it's onset comes later, over time, and is generally not reversed. Also, sometimes the radiation stimulates other problems, such as bladder cancer, pelvic bone weakness, or rectum problems (depending on the mode of radiation treatment), and again these are all problems which come later, over time, as a result of the radiation. Certainly, let me stress, that these are radiation side effects that do NOT impact everyone...but the these are some of the considerations that I weighed in my decision.
Again, with my factors, my age, my having "caught it early" and the possibility to never have to deal with it again, I chose surgery over radiation. In my mind, I wanted to get it behind me, then fight my way back with better things ahead of me, rather than ongoing anxiety about the possiblilty of a worsening outlook...this was my personal perspective. Pre-operatively, I was in good health, exercised regularly and ate a good diet.
With surgery there are multiple options...the "open" or the "minimally invasive", which is mostly done today with a robot to hold tools while the doctor manipulates the end-effectors from a console/monitor. Doctors generally do one method or the other. Generally, the common advise is to get the best, most experienced doctor you can find to operate, irrespective of the method. I found a doctor I was comfortable with who had performed many hundreds of robotic surgeries at a nearby University Medical Center.
Post-operatively, I began cardio exercise 11 days after surgery. By 3 weeks after surgery I was doing 5 miles on the elliptical trainer. After 6 weeks, I started doing "core" workouts, albeit lighter than I was doing pre-operatively.
I am still on the path to recovery, but my recollections of where you are at right now are still fresh. Study, ask and learn is my advise to you. Order the books. Review more posts on this board. Stay strong for each other.
Last edited by kcon; 05-29-2009 at 11:14 AM.