I don't like these odds
I was diagnosed in the summer. Biopsy shows cancer in eight of 14 samples on both sides of the prostate, according to my urologist, which seemed odd because a prostate gland looks spherical to me, and doesn't really have "sides." PSA as of last blood work was 4.8.
3+4
3+4
3+4
3+3
3+3
That doesn't equal eight, but the last two lab results are as follows:
F. PROSTATE, CORE BIOPSY, LEFT APEX:
     - ATYPICAL SMALL ACINAR PROLIFERATION
G. PROSTATE, CORE BIOPSY, ANTERIOR APEX:
     - BENIGN PROSTATIC STROMAL AND GLANDULAR TISSUE
     - NO MALIGNANCY IS IDENTIFIED
I'm 57, normal BMI, active, no ED, and I was told my two options were robotic radical prostatectomy or radiation. The urologist and the oncological radiologist recommended surgery.
I was told my biopsy exam had a 30 percent chance of showing cancer. I thought those were decent odds, but it didn't go the right way and now I am faced with this awful choice.
10 to 15 percent chance of incontinence and 40 to 60 percent chance of impotence. Those odds would be laughable if they weren't so depressing.
Insurance covers the surgery, but I wanted to see if there was any wisdom on laser ablation or the proton therapy.
Hi
. Confusion upon first getting all the information accompanying a prostate cancer is certainly understandable and doctor often aren't great explaining. For example: the prostate actually has several lobes and when doctors refer to halves they are most often referring to the right and left lateral lobes, which are separated by the urethra (see: https://training.seer.cancer.gov/prostate/anatomy/lobes.html).
The good news is that a Gleason 7, highest of your samples (that is the 3+4 scores, with the first number being the most prominent) is relatively slow growing and leaves multiple treatment options available (this article explains the Gleason score: https://prostatecancer.net/diagnosis/gleason-score). The doctors may have leaned towards surgery because of your age, but it is important to investigate all options. You mentioned Proton therapy, which is actually a type of radiation. This article from our editorial team gives an overview of the various types of radiation therapy: https://prostatecancer.net/treatment/radiation-therapy. The side effects of prostate cancer treatment, such as ED and urinary incontinence, depend on multiple facts, such as the individual patients condition, the severity of cancer, the treatment specifics (such as is the surgery nerve sparing, any and how much hormone therapy, type and extent of radiation, etc...). Due to these variables, the stats you mentioned really don't say much about individual cases. Your doctors should be able to answer questions about your specific case and the treatment options. Also, it is often very useful to get a second opinion when it comes to treatment options to hear a few voices.
Know that many guys here have been where you are and are doing well today. My father-in-law had Gleason 8, with localized spread treated a couple of years ago (age 70) with a combination of Cyberknife radiation and traditional radiation and is doing well today, with almost no side effects. Hopefully others will chime in with their experiences. Wishing you the best and please feel free to keep us posted on how things are going. Richard (ProstateCancer.net Team)
Richard really offered some great insights and information. I was diagnosed with a Gleason 9 (4-5) and(5-4) and figured i might as well just do a will. That was in 2013 and after surgery and follow-up radiation after a reoccurrence I am still here. PSA tests still showing no evidence of disease.
If your MDs are concerned and are suggesting surgery you may want to ask why. Yes there are other options for treatment just know if you choose radiation first it most often will limit your options for a successful surgery outcome later on. None of this is easy - ask questions do your research and then do what your feel is the right for YOU . Dennis(ProstateCancer.net TEAM)
