Head is spinning

Centex · New User Joined: 03 Jun 2009 Posts: 6

I just want to say hello to everybody and thank everyone for posting their experiences with prostate cancer. I have just been diagnosed May 13, 08. No symptoms, no idea I would have PC. Just turned 50 and had first PSA test and the result was 15.2. Had no idea that was a bad sign at the time. My doctor referred me to Urology. Went to the urology doctor had DRE, doctor said everything felt fine, very slightly asymmetrical. Ordered another PSA right after DRE and got the results a couple of days later, 16.3 I am assuming the increase is from the DRE. Scheduled biopsy, had the biopsy done May 11 got results May 13, cancer in 12 of 12 cores, Gleason 7 (4+3) Was floored, wife was devastated, the fact that it bothered my wife so much hurt me more than the fact that I had cancer. Had bone scans and CT done, no signs that the cancer has spread on either test. I have decide to have the radical prostatectomy, hopefully Robotic-assisted, but if not, retropubic prostatectomy. ( I am a bigger guy, 250lbs) I know from the Partin table that I have about a 22% chance of being organ confined and I am hoping for the best. I talked to the doctor about all the if's and if it is not confined what we should do, he said the decision is up to me but he and his colleagues are suggesting going ahead with radiation and not waiting for PSA to rise if it is locally advanced. I tend to agree at this moment. Because entire prostate is involved I am not a candidate for nerve sparing surgery. My doctor and I have talked about all the side effects, will be impotent but they have many good treatments for ED and told me not to worry about that. I had already decided that I would rather have a chance at 30 more years of life and accepted that things may have to be different to achieve that. Have surgery scheduled June 22 at Scott & White in Temple, TX. exactly 6 weeks post biopsy. I hope I am making the right decisions, I just want this thing out of me. Everything I have read here and elsewhere on the internet, (mainly John Hopkins website) have been very helpful and again I just want to thank everyone for sharing.

Replicant · Moderator Joined: 01 Nov 2006 Posts: 741

Hi Centex. Welcome to The Club, as we say.

It sounds like you've been doing your homework, and everything you wrote sounds logical and like you and your doctor are thinking this through.

A prostate cancer diagnosis is hardly a death sentence, so put that out of your mind, and tell your wife the same. Your chances of dying from it in the next decade are very remote, given the information you have so far. The problem is going to be more in dealing with treatment and its aftermath.

It sounds like you're ready to go with treatment, so I won't bug you with "but have you thought of this....?" questions. I'm sure you've covered your bases.

I highly recommend Patrick Walsh's book. It's a great resource for anyone in your shoes. Packed with information, easily accessible to the layperson, and reassuring in many respects. It is just as useful after surgery as before.

I'm glad you found us, and that you'll keep us informed as you move down this new path in your life.
_________________
Replicant

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NXMX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
PSA 6/07 0.1, 9/07 (and thereafter) <0.1
http://pcabefore50.blogspot.com

Hawk · Senior User Joined: 22 Nov 2006 Posts: 406

Only one additional thought.

I am guessing that with 12 of 12 samples showing prostate cancer that there is not going to be an attempt at nerve sparring surgery.

If that is the case I am not sure that robotic surgery has a lot to offer and I wonder if open surgery would be slightly more thorough ???
_________________
History: PSA's 6.7 neg. biopsy - PSA 16.6 neg. biopsy - PSA's 8.2, 8.1, 8.7 - Biopsy. 4+4 Gleason 8. Lap RP Apr 2004, age 52 All neg margins, nodes, and structures. (T2a). Post RP PSA: every 6 mo. <.1 until Feb, 08 (46 mos) PSA .1 - I then got sensitive tests (all in 2008) showing:
Feb .06, May .09, Jun .10, Aug .10, Nov .15 -SRT

Centex · New User Joined: 03 Jun 2009 Posts: 6

That is something I will have to talk to my doctor about. I don't know how much tissue they remove, having open surgery would they be more likely to remove more tissue having a better chance of removing all cancerous cells if it has penetrated the prostate shell slightly? Going Friday for all my pre-ops and will discuss this with my doctor. Thanks.

Hawk · Senior User Joined: 22 Nov 2006 Posts: 406

Typically a skilled surgeon will tell you that open surgery gives a better tactile (feel) of cancer spread. Laparoscopic no doubt gives better visual but no real feel of tissue. The amount of tissue removes is controlled by the surgeon with both methods depending on what he determines to be needed to provide safe margins.

My surgeon did nothing but Laparoscopic. My brothers surgeon did both but had only done about 50 robotic assisted surgeries. That surgeon felt he had a bit better chance of getting all the cancer with open surgery. My brother also had 12 of 12 cores positive with Gleason 7. The surgeon told him he would not spare the nerves because it would do no good to get 99% of the cancer.

His preference for open surgery may have only been his particular skills at the time. He had done thousands of open surgeries and 50 robotic assisted so I am not sure.
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History: PSA's 6.7 neg. biopsy - PSA 16.6 neg. biopsy - PSA's 8.2, 8.1, 8.7 - Biopsy. 4+4 Gleason 8. Lap RP Apr 2004, age 52 All neg margins, nodes, and structures. (T2a). Post RP PSA: every 6 mo. <.1 until Feb, 08 (46 mos) PSA .1 - I then got sensitive tests (all in 2008) showing:
Feb .06, May .09, Jun .10, Aug .10, Nov .15 -SRT

Centex · New User Joined: 03 Jun 2009 Posts: 6

Had da Vinci Prostatectomy on Monday 22nd of June. Surgery took a long time, 8hrs, doctor said I had very narrow hips and also had a leak at the bladder connection and had to redo. Got home the next evening around 5pm, Have not got pathological results yet. Doctor felt that there was no spread to seminal vessels or lymph nodes. Said that texture felt fine and when seminal vessels were involved they were difficult to separate during surgery and mine separated normally. Keeping my fingers crossed waiting on path lab report. Pain is more that I expected. Sitting or getting up and down is really painful, lying down I have virtually no pain. Was up and walking 4 hrs after surgery. and have walked daily every couple of hours since being home. Catheter is not nearly as bad as I had imagined but still unconfortable. Have not had bowel movement since before surgery. Have had normal diet, but have not ate much. May call Friday about this.

Hawk · Senior User Joined: 22 Nov 2006 Posts: 406

Avoid constipation if at all possible. All narcotic pain meds cause constipation. A stool softener should be taked with EVERY pain pill.
_________________
History: PSA's 6.7 neg. biopsy - PSA 16.6 neg. biopsy - PSA's 8.2, 8.1, 8.7 - Biopsy. 4+4 Gleason 8. Lap RP Apr 2004, age 52 All neg margins, nodes, and structures. (T2a). Post RP PSA: every 6 mo. <.1 until Feb, 08 (46 mos) PSA .1 - I then got sensitive tests (all in 2008) showing:
Feb .06, May .09, Jun .10, Aug .10, Nov .15 -SRT

Centex · New User Joined: 03 Jun 2009 Posts: 6

Well I got my final pathology report yesterday. It was bad, T4, Gleason 8 with lymph node involvement. Have a appointment with oncology team in a couple of weeks and see where we go from here. Doctor says with my young age, 50, and otherwise excellent health they will prob recommend hormone and chemotherapy together but will just have to wait and see.

First PSA March 09 15.2
Biopsy May 09 12 of 12 cores positive Gleason 7
Bone and CT showed clear
Robotic radical prostectomy June 22 09
Path T4 Gleason 8, lymph nodes involved.

Jean222 · Senior User Joined: 14 Dec 2008 Posts: 249

I'm very sorry to read that your path report is so negative but please try to remain hopeful.

My Hubby is a Gleason 9 with node/bladder involvement, so I sure understand your feelings.

He had his RP on Jan. 9.09, is on Casodex and Eligard (injectable) and will be starting IMRT radiation on Monday for 6 1/2 weeks. (not sure why that time frame as most on here have had 8 weeks)

He's back at work full-time, it's a struggle some days but he's not about to stop. He also cuts the lawns and still helps out around the house a bit. Says he's not cutting back there either...a real trooper!

As much as things are bad, they are also good as my Hubby would tell you. He has no pain, doesn't feel ill but is quite fatigued. He is also having some mild 'respiratory distress' within a few minutes of taking his Casodex and it disipates during the morning. With our high humidity, he needs to have A/C on at all times, or he 'has to work' at breathing.

We try to keep things as 'light' as possible, he does what he enjoys and we do laugh a lot (esp. at the absurd things that others get worked up about..lol). Our weekends are quieter than they used to be, he prefers to stick close to home now but we did take a trip to California in March.

I wear a huge red "Cancer Sucks" button at all times. It just makes me feel better, will hopefully make someone give up their ciggies.... Smile

Must admit, I 'seem' to taking it much worse than my Hubby, have a lot of tearful days but he does have times when he takes himself off to the spare bedroom for an hour or so, listens to music or watches a movie by himself. New behaviour on his part but better than chasing women! Smile

I think what sets us apart from 'well' people is that we realize how fragile our mortality is while the average John/Jane may never have noticed it. We really should live every day being content as possible, happy as possible and not waste time fretting over things we cannot change.

Easy to say, I know but please try, it'll help you cope with this nightmare event.

Best wishes to you and your wife.

{{Hugs}} from one fellas' wife to another fellas' wife, I understand.

Jean

srtimmons · Posted: Wed Jul 29, 2009 8:51 pm Post subject: How are you doing?

Centex, I'm in Houston and had my RRP on 7/20. I'm progressing very well. Dr. wants me back in 5 weeks for Path results and to do an ulta-sensitive PSA. We'll see where it goes at that time.

FYI, I had PSA of 7.1 and 7 of 12 cores positive with 3+4 and 3+3 Gleasons. Also PNI on the right side. Dr. left nerves on left, but took entire right bundle and replaced with a graft. I'm 58.

I hope your treatment plan works for you. Get as agressive with it as you can.

Please keep us informed of your progress.

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