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Cancer: Prostate Message Board
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Old 05-14-2012, 04:49 PM   #1
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jcgandy HB User
How fast does prostrate cancer spread?

I was diagnosed with prostrate cancer 2 weeks ago. I was in for a physical and I was told that my PSA was normal 3.96. Since I kept my medical records because I used to travel alot, I said that that was not normal for me that it was up 400% since my last record was .9. After I was biopsied my right side was clear and my left side had 3 out of 4 samples of 4/3 for 60% of the portion taken. I've talked to people about radiation vis surgury and I've elected to have the latter. I requested a bone scan and my doctor told me that I have little time to make a decision and not to over study my condition. Am I waisting time doing the additional tests because I would like to test for the worst and know that I'm not doing surgury and find out that it wouldn't help me.

I would appreciate any responce since I amprehensive and want to make the right decision.

 
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Old 05-14-2012, 06:00 PM   #2
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IADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB User
Re: How fast does prostrate cancer spread?

Hi jcgandy and welcome to the Board!

Good for you for tracking your PSA! So many of us don't get the tests or don't know the results. Your diligence has put you in a much better situation than you would have been in had you passively gone along with the "normal" report.

As for the treatment decision, I believe most of us would feel that you are being rushed into a therapy with undue speed. Surgery may be the therapy best suited to you, but it may not. Frankly, the surgeon's attitude makes me angry. I am convinced that empowered patients generally do much better than those who totally put their fate in the doctor's hands.

You said you had talked to people about surgery and radiation. Do you know the success rates for well-done forms of modern radiation and surgery for cases like yours? (Surgery used to be superior to radiation, when doses were often too low, but now effective doses are routinely delivered safely and outcomes are quite similar for low-risk cases with radiation looking superior as risk climbs.) Do you know about tools like the "Partin Tables" and Kattan nomogram to predict outcomes?

Conventional bone (technetium based) and CT scans are of little use in virtually all cases like yours, based on research. That's because the odds of spread to bones and lymph nodes are extremely long for such cases, and medical societies advise their members that the scans should not be done unless there are special circumstances (such as a very sore back that cannot otherwise be explained, other key symptoms, etc.). There are some excellent scans for bones and nodes that are now coming into use, but the odds are low that they would show anything for prostate cancer that is very likely in its early stage, so the scans are unlikely to be worth while.

Good luck in researching this key decision. You are not wasting your time!

Take care,

Jim

 
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Old 05-15-2012, 03:13 AM   #3
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Re: How fast does prostrate cancer spread?

Hi JC!

I agree with IADT3since2000 that your Urologist or Surgeon is rushing you. I am going to assume that the Gleason came back as a 4+3 from your post. You have months to decide what is the best course of action for you to take. IMO, if you do have 4+3 you do not have the luxury to wait much more than 2 to 3 months because a 4+3 is moderately aggressive and I say why take the risk?

I am 52 and had all twelve cores come back with cancer in them. 2 cores had 4+3 and I elected, after exhaustive research via the Web and getting 2 other opinions from different doctors to have my prostate removed.

I have since learned about Proton therapy which looks very promising but I had not even heard about it until just last week while still studying up about prostate cancer. You may want to look into that. I have heard that it is very expensive and not readily available throughout the country yet though...

My advise is this: Do not let anyone bully you into surgery. The decision is ultimately yours and YOU are going to have to live with it not the surgeon.

Good luck, and I am so sorry that you have to go through this! Just keep studying, reading and talking about it but just don't get yourself to the point that you have "over educated" your self to where you get mentally paralyzed and can not make a decision at all...

Cheers!

 
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Old 06-09-2012, 02:06 PM   #4
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Re: How fast does prostrate cancer spread?

It sounds like your doctor is trying to pressure you into a quick decision. Since prostate cancer is a slow developing one, I would ask the doctor why the rush?

Last edited by hb-mod; 06-09-2012 at 02:22 PM. Reason: Please do not post unapproved Internet website(s), per Posting Policy.

 
Old 06-11-2012, 10:51 AM   #5
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Johnt1 HB UserJohnt1 HB UserJohnt1 HB UserJohnt1 HB UserJohnt1 HB UserJohnt1 HB User
Re: How fast does prostrate cancer spread?

You are being rushed and this will not result in the most favorable outcome. Bone and CT scans are a 50% proposition except in very high risk cases with high psa. If you wish to gain more information about your individual situation you should get a second opinion on your biopsy slides from Bostwick Labs and they also have a new test that can differentiate agressive from non agressive cancer.You will have to ask about this. Also a Color Doppler Ultrasound or an MRIS with 3Telsa can give you a much better idea of the volume and location of your tumor so you can make a more informed decision if surgery would be your best choice. Nerve involvement, Apex tumors and seminal vessicle invasion all have a high degree of surgical failure as well as small extracapsular extensions. These scans can identify these problem area and save you from choosing a less favorable treatment.
JT

 
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Old 06-13-2012, 01:04 PM   #6
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Re: How fast does prostrate cancer spread?

Quote:
Originally Posted by jcgandy View Post
I was diagnosed with prostrate cancer 2 weeks ago. I was in for a physical and I was told that my PSA was normal 3.96. Since I kept my medical records because I used to travel alot, I said that that was not normal for me that it was up 400% since my last record was .9. After I was biopsied my right side was clear and my left side had 3 out of 4 samples of 4/3 for 60% of the portion taken. I've talked to people about radiation vis surgury and I've elected to have the latter. I requested a bone scan and my doctor told me that I have little time to make a decision and not to over study my condition. Am I waisting time doing the additional tests because I would like to test for the worst and know that I'm not doing surgury and find out that it wouldn't help me.

I would appreciate any responce since I amprehensive and want to make the right decision.
Hi, JC, I received lots of help from this blog. John, dtreinen, thepineman and IADT3since2000 seem to support your own efforts to learn the best course for you and obtain optimum benefit from the medical profession. You will probably be sufficiently insightful that you will make a good decision...even if based on partial information. The doctor who diagnosed my PC was a highly regarded surgeon (one of the few in the area certified to use the robot). My primary care doctor discouraged surgery and made an excellent referral to a radiologist who had a very impressive cancer center in Irvine,CA. He recommended brachytherapy. What a thorough doctor. It is the first time in my entire life that I felt I could have asked as many questions as I had...and he would have patiently answered them. I went with proton therapy. I go through some of my steps with you...because I feel like I wanted more information to make the best decision. I never got it, but decided to go with a hunch after lots of reading (books and this helpful blog)...when I finally decided. I did not know as much as I wanted to know. Maybe you will. Looking back...I bet the surgery would have been okay regarding my primary concern: survival. That Irvine Clinic and Dr. Tokita really impressed me. I bet he would have taken care of me...and he would have been there during and following the treatment more than the other options. Even though I wanted more information...with a Gleason 4+3...I did not want to spend more time. That proton therapy had few side effects...like they promoted in the brochure and CD...but it apparently worked. ...so I think I made the best decision among several good ones. I bet you do the same.
If you have a question or concern not answered by your doctor, put it here and these cancer survivors will give you the benefit of their experience. They all are good....but treasure any remarks from IADT3since2000. I think Jim has read everything written in any medical journal....and share what he has learned IN DETAIL After reading remarks from Jim,...John and the rest, you will make a good decision.

 
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