Hi everyone. I am on here seeking reassurance I guess as I don't know where else to go. I don't have cancer but my 38 year brother had/has prostrate cancer. In view of his young age he was admitted into Christie's for radical surgery and was fortunate enough to have the Da Vinci robot to remove prostrate.
My brother wont let anyone go into the follow ups with him & mum & I are worried about him. He tells us he was told he has 1 or 2 cells left and high risk. He said he was told he would get it again and I can't understand how he could if the prostrate isn't there?
I've read that prostrate is the 2nd highest killer in males if not caught quickly. It took my brother almost 2 years to get a diagnosis because he really is so young to have it.
I can't imagine not having my brother around. It doesn't help that he has given up on life and very very depressed. Does anyone know how you could get prostrate cancer again if there's no prostrate.
Hmmm, I think it's really not possible. I also think that he misunderstood some details explained by the doctor. The best thing really is to accompany him so there's another person whom the doctor could explain to. You could also check and talk to the doctor if he is not around so none of you would guess what's really wrong. I wish you all well.
Originally Posted by fishmeat
I'll be praying that you have your brother around for many decades to come. Age 38 is VERY young to have prostate cancer.
Do you know any of his cancer statistics that you can share with us? Such as his Gleason score, the staging, how any other tests (such as bone scan, pelvic CT scan) came out? Also, what was his PSA and is there an earlier PSA reading to compare it with?
The way prostate cancer (also called PCa) can recur is if some of the cancer cells may have escaped the prostate prior to the surgery. The Gleason score can give hints on this because it indicates how slow growing, or how aggressive, the cancer may be. A Gleason score of 7 or less is less aggressive. A score of 8, 9 or 10 is an aggressive cancer.
If it is an aggressive cancer, it can grow beyond the prostate and into the nearby tissues such as the seminal vesicules, extraprostatic soft tissues, lymph nodes, etc. There also could be cancer cells left behind in the prostate bed (where the prostate once sat). It is possible that "salvage radiation" can finish what the surgery started -- and cure him. It all depends on how far the cancer has spread.
One thing that I would advise you about, without alarming you, is that your own chances of contracting PCa are probably double the norm since you have a direct relative who has (had) it. In my own case, both my Father and one of his brothers had it, which made me THREE times more likely to get it...
...and I got it. I was diagnosed last August and underwent a DaVinci prostatectomy (complete removal of the prostate & surrounding tissues) at Mayo Clinic last November.
If you can find out the particulars of your brother's case (once again, the Gleason score, PSA, biopsy results and post-operative pathology results), many of us on this board can give you insight as to how things might go. I'd like to take a guess & say that your brother will probably be fine because the complete removal of the prostate is not usually recommended if it has spread too hopelessly for the surgery to be effective. So things may go okay for him.
Try to give us more details & some of us will be able to comment further -- and be sure to start your own annual prostate checkups: digital rectal exam (DRE) and PSA blood test every year. Do this and you will probably beat PCa even if you get it in the future.
Good luck to both of you,
My Prostate Cancer Stats
July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA Sept. 2011 was 5.7.
Local urologist DRE revealed significant BPH, but no lumps.
PCa Dx Aug. 2011 at age of 61.
Biopsy revealed adenocarcinoma in 3 of 20 cores (one 5%, two 20%).
Gleason score 3+3=6.
CT of abdomen, bone scan both negative.
DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
Final pathology shows tumor confined to prostate.
5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left mid posterior prostate. Right posterior apex margin involved by tumor over a 0.2 cm length, doctor says this is insignificant.
Prostate 98 grams, tumor 2 grams.
Catheter out in 7 days. No incontinence, just a tiny drip on rare occasions.
First post-op exam 2/13/12, PSA <0.1.
Only semi-erections so far.
Last edited by HighlanderCFH; 04-20-2012 at 08:09 AM.
Reason: clarify some statements
Hi all thanks for your response. I am in fact a girl so I am not at risk thankfully. My brother was scored 7 made of 3s and 4s but mostly 3s. His psa was around 150 and the last one said undetectable which was fab news. As I say this has been long drawn out 3 year process and i can't now remember completely the exact figures.
he has both urologist and oncologist and at last oncologist appointment he came out saying had been told high risk and will get it again. He has been asked partake in a trial because there aren't many that young with children prostrate cancer and agreed. But on random selection he was picked for 4 monthly testing.
It's his inability to get an erection and inability to hold his wee still I think that is depressing him so much. Heartbreaking as he is single and doesn't see any future for him. He is also so very thin. I'm sure he isn't telling us it all.
Thanks again. I'm sorry to hear your tale x
It sounds like your brother may have advanced disease and is on HT, Hormone Therapy..This treatment alone can account for much of your brothers depression and mood swings..But at 38, he has been dealt a hand that would depress anybody...But if he is 3 years out from diagnosis and his PSA is currently undetectable, that's a GOOD sign! Best of luck to you both....
PSA at age 55: 3.5, DRE negative.
65: 8.5, DRE " normal", biopsy, 12 core, negative...
66 9.0 DRE "normal", BPH, (Proscar)
67 4.5 DRE "normal" second biopsy, negative.
67.5 5.6, DRE "normal" U-doc worried..
age 68, 7.0, third biopsy (June 2010) positive for cancer in 4 cores, 2 cores Gleason 6, one core Gleason 7. one core Gleason 9. RALP on Sept. 3, 2010, Positive margin, post-op PSA. 0.9, SRT , HT. Feb.2011 PSA <0.1 Oct 2011 <0.1 Feb 2012 <0.01 Sept 2012 0.8 June 2013 1.1, Casodex added, PSA 0.04 10/2013. PSA 0.32 1/14. On 6/14 PSA 0.4, "T"-5. 10/14 PSA 0.6, T-11. 1/2015 PSA 0.106. 4/15. 0.4, 9/15 1.4
Hi chuck. My brother is only 6 month post surgery. It took 2 years from the start of him needing to wee permanently for the hospital to diagnose prostate cancer. The consultant originally said it wouldn't be that as my brother was too young to have it.
We are all away in 2 weeks so I shall and speak to go then to see if that's anything more sinister bring said.
Thanks and good luck to you x
Originally Posted by fishmeat
You're very welcome. Things might turn out better than your brother thinks. I'll keep him in my prayers.
If you'd like to, please let us know if you find out anything else.
Being female certainly alleviates any risk of Prostate Cancer. However my Oncologist advised me there has been shown a genetic link between Prostate Cancer and Breast Cancer. I have a lot of Breast Cancer in my family and it alarmed the Oncologist which is what brought up the discussion. IF this is true, that would say you have an increased risk of Breast Cancer. One thing you might consider is having the BRCA test done for yourself to see if you have an increased genetic risk of Breast Cancer. My sister for example, had Breast Cancer, then afterwards did the BRCA test to have a datapoint to give her daughters on their heredity risk.
Originally Posted by fishmeat
The fact that your brother's post surgical PSA is undetectable is fantastic. There is a distinct probability that he will live his life Prostate Cancer free. Knowing his pathology, he can use the Memorial Sloan Kettering nomograms to see the statistical probability of recurrance. This is just statistics, but it does show how others with similar presentation have faired. It may be better than his doctors lead him to believe.
As for the ED and Incontinence, they are difficult. Being as young as he is, surgery is often viewed as the best long term course. I am 49, and was told by every doctor, including Radiation Oncologists, that I needed surgery due to my you age and the state of my cancer. Now that he is where he is, there are things that can be done to help out both of these conditions. If he end up long term incontinent, there are surgical procedures to put in a valve that stops the flow. There are even surgical procedures to install inflatable chamber in the penis to provide an erection when he wants it. I don't know if both can be done on the same person, but those are the extremes that can be done to get him to the most normal function if all else fails. I understand his concern about finding a mate, give him time and he will hopefully improve functionality on both side effects.
Encourage him to join the forum. There are many folks here that can help provide him guidance and support as well. You are a great sister trying to help him out. Keep up the support.
Age 49, healthy, physically very active
DRE felt nodule on right side
Free PSA 13%
Biopsy 10/24/11, Gleason 3+4, all cores positive
Pathology: T2c, Gleason 3+4, 1 mm positive margin at apex
PSA 3/9/12 - 0.01