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Newly Diagnosed - Advice Needed

I was diagnosed with prostate cancer a few weeks ago. I am 56 years old. My PSA is 6.29. I had a biopsy then sent for an MRI and then a fusion biopsy. Gleason score is 3+4=7. Stage 2.

My doctor, through a Telemed call, said that based on my numbers, surveillance is not a good option. He is suggesting that my options are surgery or radiation. He also stated that radiation does not always get all the cancer and said that surgery would be the best option for me. I am not sure if I should consider radiation and speak to a radiologist or have the surgery. Any help is greatly appreciated.

  1. I am 55 Gleason score of 9 , I had the surgery in April am on hormone therapy and wrapping up day 10 of 35 of Radiation . I was diagnosed with stage 3 (b?) . Which meant my cancer was slightly outside the prostate.

    I don’t regret my decision, I did my homework and checked all the options and focused on what gave me the best chance for the long term. My quality of life has not diminished , it just needs to be done at a slower pace and so far relatively easy to handle. I am weaker and a little more fatigued at this stage but I accept it as a part of the therapy. the most important thing I have is my mental attitude. I made it a point to rely on my faith and prepare for every phase during treatment(kegels, diet , exercise, etc)

    Every situation is different So I urge you to do as much research and ask as many questions as you can .

    Good luck !

    1. I am 55 Gleason score of 9 , I had the surgery in April , on hormone therapy and wrapping up day 10 of 35 of Radiation . I was diagnosed with stage 3 (b?) . Which meant my cancer was slightly outside the prostate.

      I don’t regret my decision, I did my homework and checked all the options and focused on what gave me the best chance for the long term. My quality of life has not diminished , it just needs to be done at a slower pace and so far relatively easy to handle. I am weaker and a little more fatigued at this stage but I accept it as a part of the therapy. the most important thing I have is my mental attitude. I made it a point to rely on my faith and prepare for every phase during treatment(kegels, diet , exercise, etc)

      Every situation is different So I urge you to do as much research and ask as many questions as you can .

      Good luck !

      1. Hi scubafrog. The good news is that it sounds like your cancer was found pretty early. Having a Gleason 3+4=7 does open up treatment options. It also gives you some time to do a little research (not that you don't want to get on with treatment). For your protection, we cannot give medical advice over the internet, but I can say that with your Gleason score there are options for radiation, such as Cyberknife and Proton therapy. This article from our editorial team gives an overview of radiation treatments for PCa: https://prostatecancer.net/treatment/radiation-therapy. A radiologist could provide you with additional information. There is also a relatively new treatment known as cryotherapy (see: https://prostatecancer.net/treatment/cryotherapy) you could inquire about. My point is that there are options and it is o.k. to check them out and decide what is best for you. Best, Richard (ProstateCancer.net Team)

        1. Dear . We posted this to our Facebook community, and many people responded. I wanted to share with you a couple of the responses and link out to the Facebook post for you to read the entire thread: https://www.facebook.com/prostatecancerdotnet/posts/1052339351847597.

          Richard E.: "I weighed my treatment plan heavily in the year of active monitoring. I was told that there is only one door to open when it comes to treatment. My major hang up was what if the radiation does not cure it? They can't go back and remove the prostate. I would have been stuck with more radiation or something else. I opted for surgery and had it removed. I am doing well in the over 2 years since. I still leak a tad when coughing hard or wait too long to urinate. I do wear a pad when going for long car rides just in case. I can't get a full erection but it is better than it was since surgery. I am blessed! There are a lot of men a lot worse off than me and I feel for them. This cancer robs people of a pleasant life!"

          Advocate, Bob: "My approach was to study all of the options available given my Gleason Score, and biopsy results. Age plays a role in making a decision. For example at age 69 I was diagnosed with T2C prostate cancer and my urologist reviewed all of my optionw, Radiation, Cryotherapy, DaVinci Robotic surgery, Brachytherapy,, and implications of delaying more than six months. I recommend those diagnosed read Surviving Prostate Cancer by Dr. Patrick Walsh .https://prostatecancer.net/living/book-review-surviving/

          I also wrote a book The Prostate Chronicles - A Medical Memoir which is a step by step approach to my decision to have my prostate removed. With regard to radiation it is recommended depending on your stage that in my case to hold it in reserve if the cancer should reappear later in life. https://www.amazon.com/Prosta.../dp/109516001X/ref=sr_1_1... Bob Tierno, Moderator ProstateCancer.net"

          Ann: "Given all options we chose focal cryoablation. Very happy with outcome so far!"

          Peter: "Surgery, over and out. 12 years now, no problems."

          Mike: "There are multiple options for PC treatment. Depending on your specific condition some may be better than others.
          My advise is simple. Get a second opinion or a third if you are still unsure."

          Gerry: "My first thought was get this crap out of me. I was 12 of 12 all above 70%, 3+4 or 4+3. So, I elected surgery, because it is safer to do surgery first and radiation second. After radiation, the prostate and the colon surface can become difficult to separate. Also, the colon can be damaged by radiation during treatment of the prostate; making it weaker for a period of time. Somewhere I read no colonoscopy's for 3-5 years after radiation of the prostate. If salvage surgery is necessary, its more difficult.
          In my case, there is no urethra under my prostate. That made it unsafe to remove my prostate. So, 23 lymph nodes were taken out to be tested for metastasis; none was found. Radiation was my best option at that point. In hind sight, given that the end results are pretty much the same. I think I might have chosen radiation to begin with. Then again, because of the exploration of my abdominal cavity to determine if removal was possible I was beat up pretty bad inside. Dr. said I am one in about 300.
          My surgery was 15 months ago. Radiation was 12 months ago. Still waiting for Hormone therapy to wear off; although I am much better. Not thinking I will do that again."

          We hope these responses give you some insight you were looking for. We are wishing you the best. Please keep us updated!

          Best,
          Amylyn (ProstateCancer.net Community Manager)

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