I just found out my dad has a gleason score of 8. I called him from work. I was feeling pretty good because his bone scan revealed no mets, and his PSA was only a 5.5. He had a biopsy last year and it came back negative so this is a recent growing cancer..
I have to talk to him later. I am not sure what I should tell him or what his prognosis is He seemed to indicate that he may not want to get the surgery. Should he get the surgery? Why would someone not get the surgery?
Any thoughts would be appreciated..
Last edited by panthers78; 04-24-2006 at 03:16 PM.
One good source of information on prognosis is Patrick Walsh's Guide to Surviving Prostate Cancer. Check out the "Partin Tables" in that book, which present the odds for a cure at the various levels of PSA and Gleason scores at biopsy. Gleason 8 is high, so it would probably be advisable to get a second opinion on your dad's biopsy slides. They can be sent to Johns Hopkins urology department for a second expert opinion.
Surgery is mainly a treatment for relatively young men who have a good chance of only having localized prostate cancer. The advanced forms of radiation, sometimes with or without hormone blockers, are also used with success. Check out the book for more information on the pros and cons of the various treatments.
How old is your Dad? Gleason of 8 is a little high. PSA of 5.5 is too. I've heard of PCs w/PSA in the 2ish range. My Gleason was 6 w/PSA 7.1. Had robotic surgery on 3/24 w/good results, no sign of any spread.
What course of treatment your Dad decides on is dependent on a lot of factors. Age, life expectency, Gleason score etc. Your urologist should explain all this to him. I'm 56 so for me surgery was the best choice after careful thought & research. Robotic surgery certainly made the whole process easier. Minimally invasive, very little pain. Some continence & potency issues, but improving. Also heard of good results w/radiation/seeds/proton beam radiation. But again the decision is ultimately up to your Dad & Family.
Also, this is not the time to panic. Take the time to research and learn. Public library is a great place to start. Ask your urologist lots of questions too. Take Care, keep us posted. God Bless.
Thanks for your responses. I am feeling a little better but still a little scared.
His doctor said he has 54% chance of recovery without the hormone treatment, and supposedly that would increase by about 15%. They did catch it relatively early. I am kind of angry though. He shold have been at the urologist last fall-his doctor received the news that his PSA was elevated-but never referred him. His PSA was 5.5, and when they did the in office exam of the prostate they would have never known it was cancerous. It otherwise felt normal..the biopsy came back positive obviously though.
He is going to do the pellets and the radiation. He is going to the UPMC cancer cancer which is one of the finest in the Northeast.
He is 59 and in perfect health other than this. He works out every day and watches his diet...
I am 27, going to be 28 in may. This may sound crazy, but I may choose to have my prostate removed at a certain age even if I have no signs of cancer yet. My maternal grandfather and his brother (my great uncle)died of it, and now my dad has it. I would rather not be worrying about a ball ready to drop on me at any time. I am surprised more people wouldn't consider doing that, especially if you are in a high risk group such as myself.
Whoa, hold on! Surgery is not like preventative maintainence on your car. I don't know of any urologist who would remove a healthy prostate just because your family has a history of PC. Granted, your chances of developing the disease are higher, but regular testing is the way to go. Side effects like incontinence/impotence that a man shouldn't expose himself to if it's not necessary. Too many people don't get tested at all for various reasons, but you know you've got to be vigilant! So don't think about anything rash. My Best to your Dad & Family.
Given your family history, you would be wise to aggresively monitor your PSA and get a DRE on a regular basis. I would also insist on knowing your PSA numbers, going to the same lab every time you get it checked (for protocol consistency). Some doctors do not give you the specific numbers, and some doctors are ignorant about interpreting PSA data. If I were you, I would record the PSA number each time I did the lab test. The results are usually available within 3 or 4 days of the blood test. If you see any increase, start seeing a good urologist rather than a primary care physician.
Hopefully there will be some new tests, and some less toxic or less invasive treatments for prostate cancer within the next 10 to 15 years. With the new advances in molecular biology, I believe this will happen. Some day people will read about the current treatments of surgery, radiation, and hormone blockers, and they'll say, "How primitive!" I hope you will be able to benefit from these new advances in your lifetime.
Good advice All Sevens. There are many good people working on ways to prevent and treat PC. I read an article in a recent Readers Digest about some experiments with a carbon based "tag" that is injected into a gland and attaches to the cancer cells. The gland is then subjected to radio waves which heat and destroy only the tagged cancer cells. It sounds very promising as a future treatment for PC. If only I had been born a decade earlier.
Avoca: Yeah, and there is now a theory that certain forms of prostate cancer are linked to a virus, which opens the possibility of a vaccine, similar to the work that is being done with cervical cancer. There are other researchers honing in on how to suppress the expression of cancer-causing mutations. And, now that there have been such huge advances in understanding cells at the molecular level, there will be new and more effective indicator tests, similar to the PSA test. Cancer control is going to change a lot in the next several decades.