It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Cancer: Prostate Message Board
Post New Thread   Closed Thread
LinkBack Thread Tools
Old 07-09-2012, 08:41 AM   #1
Newbie
(female)
 
Join Date: Jul 2012
Location: Parkersburg wv usa
Posts: 2
elibra HB User
husband just diagnosed last week

My husband is 43 years old and was just diagnosed with prostate cancer. His psa is 6.4 and has a gleason score of 6. Cancer was only found in 1 of the 12 biopsys done. The urologist did say also that his prostate was small during the ultrasound. We have decided to have prostate removed b/c of his young age. We are not sure if we want to go the robotic or open. I have heard pros and cons for both. The urologist we saw said he believes he would also qualify for the nerve sparing. Any thoughts or suggestions would be appreciated.

 
Old 07-09-2012, 10:11 AM   #2
Inactive
(male)
 
Join Date: Aug 2010
Posts: 689
Tall Allen HB UserTall Allen HB UserTall Allen HB UserTall Allen HB UserTall Allen HB UserTall Allen HB UserTall Allen HB UserTall Allen HB UserTall Allen HB UserTall Allen HB UserTall Allen HB User
Re: husband just diagnosed last week

Because of his young age and the insignificant amount of cancer, the first treatment you ought to consider is Active Surveillance. This does not mean doing nothing. This means going on a program where you closely monitor if there is any progression of the disease. In most cases, there will not be any. He may have years or a lifetime of living free of any symptoms of treatment.

The second option to consider is focal therapy. This means removing just the cancer and nothing else. There are only a few doctors that do this sort of thing, because of the difficulty of imaging the cancer. Also, because most PC winds up being multi-focal (the biopsy is just a sample), this may delay treatment but not prevent treatment.

Modern radiation is equally curative to surgery. HDR brachytherapy, LDR brachytherapy and CyberKnife are all proven options with cure rates over 95% for low risk PC, which is equal to surgery, with significantly less side effects. Dr. Gregory Merrick is the President of the American Brachytherapy Society and is the Director of the Schiffler Cancer Center at Wheeling Hospital. You are lucky to have him close by.

As for surgery, it doesn't matter if it's open, laparoscopic or robotic. What matters is the experience of the surgeon in that kind of surgery. The first two questions you should ask is how many of that kind of surgery has he performed. If the answer is less than 1,000 -- run!
Ask what his clear margin rate has been in the last year -- it should be in the 10-15% range. Understand that "nerve sparing" is a relative goal and never means that all nerves are spared. Ask what % of patients return to the same degree of potency after surgery. There is a standard questionnaire they should use called E.P.I.C. for measuring it. Also ask about incontinence rates, stress incontinence, climacturia and penile shrinkage.

You have plenty of time to make your decision;Gleason 6 on one core isn't going anywhere anytime soon. Do a lot of research, consult with many doctors (I talked to 5 before making my decision), and especially take trips to centers of excellence.

- Allen

 
Sponsors Lightbulb
   
Old 07-09-2012, 10:31 AM   #3
Newbie
(female)
 
Join Date: Jul 2012
Location: Parkersburg wv usa
Posts: 2
elibra HB User
Re: husband just diagnosed last week

Quote:
Originally Posted by Tall Allen View Post
Because of his young age and the insignificant amount of cancer, the first treatment you ought to consider is Active Surveillance. This does not mean doing nothing. This means going on a program where you closely monitor if there is any progression of the disease. In most cases, there will not be any. He may have years or a lifetime of living free of any symptoms of treatment.

The second option to consider is focal therapy. This means removing just the cancer and nothing else. There are only a few doctors that do this sort of thing, because of the difficulty of imaging the cancer. Also, because most PC winds up being multi-focal (the biopsy is just a sample), this may delay treatment but not prevent treatment.

Modern radiation is equally curative to surgery. HDR brachytherapy, LDR brachytherapy and CyberKnife are all proven options with cure rates over 95% for low risk PC, which is equal to surgery, with significantly less side effects. Dr. Gregory Merrick is the President of the American Brachytherapy Society and is the Director of the Schiffler Cancer Center at Wheeling Hospital. You are lucky to have him close by.

As for surgery, it doesn't matter if it's open, laparoscopic or robotic. What matters is the experience of the surgeon in that kind of surgery. The first two questions you should ask is how many of that kind of surgery has he performed. If the answer is less than 1,000 -- run!
Ask what his clear margin rate has been in the last year -- it should be in the 10-15% range. Understand that "nerve sparing" is a relative goal and never means that all nerves are spared. Ask what % of patients return to the same degree of potency after surgery. There is a standard questionnaire they should use called E.P.I.C. for measuring it. Also ask about incontinence rates, stress incontinence, climacturia and penile shrinkage.

You have plenty of time to make your decision;Gleason 6 on one core isn't going anywhere anytime soon. Do a lot of research, consult with many doctors (I talked to 5 before making my decision), and especially take trips to centers of excellence.

- Allen
Thank you very much for taking the time to reply with all this information. I should also mention that his uncle who was 53 at the time was also diagnosed with prostate cancer but it was already in all 12 biopsys, they removed prostate and then he ended up with cancer in his bladder and has since passed away. I think this is part of the reason we are both scared and just wanting to get it out.

 
Old 07-10-2012, 02:23 AM   #4
Veteran
(male)
 
Baptista's Avatar
 
Join Date: Aug 2010
Location: Albufeira, Portugal
Posts: 464
Baptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB UserBaptista HB User
Re: husband just diagnosed last week

Quote:
Originally Posted by elibra View Post
My husband is 43 years old and was just diagnosed with prostate cancer. His psa is 6.4 and has a gleason score of 6. Cancer was only found in 1 of the 12 biopsys done. The urologist did say also that his prostate was small during the ultrasound. We have decided to have prostate removed b/c of his young age. We are not sure if we want to go the robotic or open. I have heard pros and cons for both. The urologist we saw said he believes he would also qualify for the nerve sparing. Any thoughts or suggestions would be appreciated.

Elibra

Welcome to the board. I am sorry for his diagnosis at such young age of 43.
Young patients have lot to lose with the present treatments for PCa. None of them can assure cure but all have risks and assure side effects, which may be nasty and cause permanent damage.

Radicals (surgery and all types of radiation) may provide cure to guys with the status of your husband with a contained case. However, both can cause incontinence and ED which is the less one young male wants at the 40th.
I was 50 when diagnosed with PCa (twelve years ago) and choose open surgery after consulting 4 specialists. My wife had to sign an agreement indicating that she would accept the fact that we would not fathered more children. My case was worse than your husband with 6 out of six cores positive to cancer. Gleason score (2+3) 5 (low aggressiveness) and I also had in my mind the will in “getting rid of it”, but at the end could not succeed in doing such. RT later also did not provide me cure and now I am on hormonal treatment.
I am continent and still have sex but ED persists and nothing returned to its normalcy. RT has added its side effects and caused me sort of permanent bowel discomfort but I am continent.

With the stats of your husband (confirmed) it would be wise to research for a different approach of therapy such as AS recommended by Allen above. With a continuous proactive program of vigilance (periodical biopsies, image studies and blood tests), one can continue his life “as usual” and plan a treatment for future action. We always worry for spread however low aggressive prostate cancer (Gleason patterns of 1 to 3) is sort of “sluggish” in advancing which provide time for us to educate in the matter of PCa and the treatments. Some do get anxious at the beginning but will relax after knowing details of the disease.

Consider also on the opportunity in availing in close future, of newer drugs/treatments now with successful conclusive trials. A newer drug named Zytiga (abiraterone) is close to become a “silver bullet” to control cancer and classify it as a chronic disease.
The side effects are relatively less than the ones we could expect from radical therapies.
In any case if your husband feels peace of mind in treating the cancer now I would recommend him to get several second opinions on his diagnosis (DRE, Image studies, etc) from specialists, including a review on the biopsy samples, before committing to a treatment.

He should be aware of the risks and side effects involved with the treatment of his choice and should procure for the best care giver and facilities. The outcome depends a lot on proper diagnosis, experience of practitioners and the latest modern equipment.
Be aware of biased answers or opinions from the doctors. Prepare a list of questions to better access the pros and cons when consulting.

Wishing you luck.
Baptista

Last edited by Baptista; 07-10-2012 at 02:40 AM.

 
The Following User Says Thank You to Baptista For This Useful Post:
elibra (07-10-2012)
Closed Thread




Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off




Join Our Newsletter

Stay healthy through tips curated by our health experts.

Whoops,

There was a problem adding your email Try again

Thank You

Your email has been added




Top 10 Drugs Discussed on this Board.
(Go to DrugTalk.com for complete list)
Casodex
Cialis
Cipro
Flomax
Levaquin
  Levitra
Morphine
Proscar
Tylenol
Viagra




TOP THANKED CONTRIBUTORS



Tall Allen (174), IADT3since2000 (148), Baptista (97), Gleason9 (28), harpman (27), Johnt1 (22), honda50 (9), tumbleweed (6), flyfisher37 (6), bharlan (5)

Site Wide Totals

teteri66 (1180), MSJayhawk (1013), Apollo123 (909), Titchou (856), janewhite1 (823), Gabriel (763), ladybud (755), midwest1 (670), sammy64 (668), BlueSkies14 (607)



All times are GMT -7. The time now is 02:57 AM.



Site owned and operated by HealthBoards.comô
Terms of Use © 1998-2014 HealthBoards.comô All rights reserved.
Do not copy or redistribute in any form!