Confused about treatment options

2confused · New User Joined: 04 Aug 2007 Posts: 7

I'm 58 and have a PSA of 4.6. Biopsy showed cancer with Gleason of 6 (3+3). I was told the main options would be surgery or seed radiation and am curious about the pros or cons for someone my age. Also, I'm concerned that no tests were done to see if the cancer has spread at all. Is this normal?

Thanks for any help or advice.

brainman

2confused, I am sorry to hear that you have cancer! Can I ask you what grade it is? It is definitely not normal for the doctors not to do a full body check for mets. As for the pros and cons, that is a better question left to your own medical team. On this forum we can only speak from personal experience (which I do not have) or generalities (which may or may not apply to you). Surgery is generally the best option since the doctor can remove most if not all of the cancer. However, with Prostate Cancers that carries some significant risk (above the normal risks included in any surgery). Most significantly, there is the risk of ED if the nurve is damaged. I know that others with more personal experience will reply so I will end by saying that I will keep you in my thoughts and prayers as you try to make this difficult decision.
_________________
Jim
Site Administrator and long-term cancer survivor
1992 Astrocytoma grade 2, left motor strip
2005 Recurrence this time said to be an Oligodendoglioma grade 3, same location.
My Story Part 1: http://cancerforums.net/viewtopic.php?p=7350
My Story Part 2: http://cancerforums.net/viewtopic.php?t=8029
Blog http://jimhawkinsport.blogspot.com/

2confused · New User Joined: 04 Aug 2007 Posts: 7

Unfortunately, all I have is the biopsy report, and it doesn't seem to say. I do know it was found on only one side. The doctor said that if surgery were done, he would take the nerve on the right side in addition to the prostate and seminal vesicles. He also said that the prostate was 40 grams and irregularly shaped, but that's about all I have.

I'll be going for a second (and third) opinion next week, but am trying to do my homework in the meantime.

Thanks very much for your response.

johnw100

Gleason 6 is not a highly agressive cancer. With recent screening, most men are diagnosed with early stage Gleason 6 cancers.

The most important aspect is to find a top doctor: that will make a huge impact on your side effects and prognosis, and in that context it is also worth seeking a 2nd opinion and / or consulting another doctor.
Most people come to realise that in selecting a surgeon, but do not necessarily fully appreciate that aspect when considring radiation (or seeds) where it is equally important.

There are a lot of gray areas with prostate cancer: you could have further tests for peace of mind, but with a PSA of 4.6, it is very unlikely that advanced cancer would show up in your bones for example.

Most recent biopsies take about 12 samples. Your report should incicate how many of those were positive for cancer, which might also influence your treatment considerations. For example if only one or two samples are positive, watchful waiting could be an option, at least while you consider the pros and cons of the various mainstream treatments.

In any event your PC does not seem to be highly agressive: you should take time to study the subject. Both surgery and radiation have side effects and provide similar long term results, so treatment choice often comes down to considration of the potential side effects and personal preference.

2confused · New User Joined: 04 Aug 2007 Posts: 7

Thanks for the info. There were 12 samples taken in the biopsy (left x6; right x6). All was benign tissue on the left. On the right it states: Adenocarcinoma, Gleason grade 6 (3+3), involving 3 of 7 cores (95%, 90%, 30%, discontinuously).

At this point it's seeming that the biggest advantage to surgery would be the peace of mind of knowing that chances are all the cancer cells were removed. (I understand nothing is ever 100% certain though.) The surgeon I've seen so far uses the da Vinci system.

Thanks again for the response.

philip · Regular Joined: 27 Dec 2006 Posts: 11

Sorry to hear about your positive diagnosis. Being in your 50's surgery probably will be what will be recommended. Many of the newer therapies have shown a higher incidence of reoccurance after 5 years. Being younger you will recover from the surgery much faster and with the cancer on only one side your outcome should be excellent.

2confused · New User Joined: 04 Aug 2007 Posts: 7

Thanks for your response. My surgeon actually told me that seed radiation has an equivalent 10 year success rate. I believe that's consistent with what I've read as well. At this point, that's the way I'm leaning, and will decide one way or the other soon.

	Cancer Forums Forum Index -> Prostate Cancer Forum	All times are GMT - 5 Hours
Page 1 of 1

A website for discussions about any type of cancer, including lung cancer, breast cancer, mesothelioma, prostate cancer, laryngeal cancer, leukemia, lymphoma, multiple myeloma and others