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Old 01-17-2009, 05:09 PM   #2
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Join Date: Jul 2007
Location: North Carolina
Posts: 575
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Re: My Husband has Prostate Cancer - now what?

Originally Posted by Wildewoman View Post
The urologist told my husband that we need to meet with the Cancer Team - a urologist, a radiologist & some one else he can't recall in February & discuss my husbands options. He was told he has 3 options:

1. Surgery to remove the prostate
2. Radiation
3. Do nothing
I'm trying to find out as much as I can before the appointment ~ my husband said - "lets just do what they recommend." Heavy sigh . . . .
Sorry that you have to join this "club" but you have lots of company and
the outlook can still be very positive. There are many good choices these days, and refinements in treatments can lead to a good outcome. It is an
initial shock for many of us, but once you get over that, it's time to do some
reading and talking with others.

One of the more difficult things to come to accept is that there is no one best solution. We're often used to hearing what a doctor says and then following those recommendations. Not so with prostate cancer. It's a rare
doctor that will not have a bias towards his own specialty-- urologists almost uniformly want to use surgery. As far as radiation, there are many forms of that, from seeds (brachytherapy) to several types of external beam radiation. I chose a form of radiation called proton beam therapy. At first it's probably best just to try to understand the range of choices available. You should have a decent period of time to choose.

The fact that one of the options quoted is "do nothing" must mean that your husband does not seem to have a high-risk case. There are some key things you'll need to acquaint yourself with, and one of these is the Gleason
score, which "grades" the aggressiveness of the cancer. There are two figures that add up to the score-- and the ranking of seriousness is on a 1 to 5 scale. The first number represents the score for the characteristics of the most prevalent cancer cells in the biopsy (I'm not saying this in a very technical manner, and when you read more, you'll understand, hopefully). The second number represents the next most prevalent. A typical common score is 3+3, for a score of 6.

When one has a Gleason score of 3+4 or 4+3, it's more aggressive, and higher than that even more so. (The highest and worst score would be 5+5, and that is rare.) It's not just the Gleason score, but information on staging from the physical exam, the person's age, his PSA-- all these factor into the perceived seriousness. If you post some additional information (some of this would be on the biopsy report, which you should get a copy of), you'll get some additional info on this board.

It's really too early to even try to make a treatment choice. At this time, I'd suggest getting some books on prostate cancer, to learn more about the disease and the alternatives. Most have a certain point of view, so that's why it's good to read more than one. If you read some of the posts on this
board for those going through what you are now, you'll get recommendations of some good books. On my list as a general overview is Dr. Patrick Walsh's latest book. There a quite a few internet sites too- and you can get some good ideas of questions to ask.

Wishing you well as you sort through some of this---- and again, don't feel you need to make a choice right away. Using this board can help a lot as you go through this.