Need advise for Prostate Cancer

ulnv4ever · New User Joined: 31 Dec 2007 Posts: 1

Last week my Dad was diagnosed with Prostate cancer.
He is 65 years old.
He has a Gleason score of 6(3+3).
stage T1c with a PSA of 5.9.
from the biopsy report, right prostate is benign.
tumor involves 3 out of 6 cores.
left prostate is adenocarcinoma(what is this?)
volume(20%)
He has about 80% chance for cure according to his doctor, which i guess is pretty good probability to come out alive from cancer.
my concern is that his health care is with Kaiser(rumors say that Kaiser is known to kill people, an overstatement, but I've heard some statistics mentioning Kaiser has a relative higher rate of mal-practice than other hospitals. does anyone know if that is true?) Is there a need to cross verify the results by another means of test, such as MRI..etc? I was doing some reading online, and they talked about few other test methods for prostate cancer.

his doctor recommended surgery or radiation therapy. the prefer choice is surgery by the doctor. because the pathologist gets to analyze the prostate after it is removed. if we choose surgery, which is better, open or Laparoscopic?

if anyone has similar condtions, please your outcome. thanks for your help.

best wishes to everyone.

johnw100

Biopsy: 12 samples or cores are usually tested.

With recent more extensive screening, most men are now diagnosed with Gleason score 6 T1c PC:

Gleason 6 is the least agressive cancer and T1c is early stage.

"Is there a need to cross verify the results" : there are a lot of gray areas with PC. Biopsy is regarded as the best test, although biopsy readings are subjective, so you could request a 2nd reading of the slides.

It's unusual for bone scans to show any problems with a PSA below 20. MRI tests do not usually show the black and white results often claimed.

If you choose surgery, the most important aspect is choice of a top surgeon, as he will have the most influence on long term prognosis: the method employed, open or robotic, should logically be a secondary consideration.

Replicant · Moderator Joined: 01 Nov 2006 Posts: 849

I'd agree--go for the surgeon and hospital, not the technique, as your primary consideration.

Adenocarcinoma just means cancer of a gland--in this case, the prostate. Breast cancer is another example of adenocarcinoma.

The doctor sounds like he looked things up, and didn't just guess. He's probably being a little conservative about the chances of a cure. According to the 2007 Partin tables, your dad has:

An 83% chance that the cancer is confined to the organ

A 16% chance of extraprostatic extension (the cancer is "peeking" out of the prostate)

A 1% chance of seminal vesicle involvement

A 0% chance of lymph node involvement

There is another set of tables, called the Han tables, that predict the likelihood a man will have an undetectable PSA 10 years after surgery (and therefore a good possibility of cure).

According to the Han tables, your dad has a 95% chance that his PSA will be undetectable 10 years from now if he has a prostatectomy. That's reason to cheer! Very Happy

I don't know anything about Kaiser, so I don't have any suggestions in that regard. Your dad has, at least from the information provided, an excellent chance of beating this. He needs to have an excellent surgeon who does LOTS of these procedures, in a a hospital that does lots of them each year.

I hope he's considered his other options, as well (radiation in various forms). There are pros and cons to every treatment modality.

Best wishes.

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