Newly diagnosed with likely stage IV
I'll try to be brief. 63 yrs. old, live in Philadelphia, no family history of prostate cancer. Went to my PCP last mo. for regular checkup and some symptoms - decreased flow when peeing, some urgency at times, waking up at night several times to pee. All within last few months or so. Checked my prostate (DRE) and concerned with what he felt. Took blood for PSA. Previous PSA (18 mo. prior) was 2.8. This came back at 28.2!
No blood in urine or semen, no ED, no pain on peeing. I have chronic back, neck & shoulder problems, so can't say I noticed pain in back or hips as have had pain there for decades.
Sent me to Urologist who checked prostate & ordered biopsy, CT and bone scan. Still waiting on results for CT and biopsy (just done 3 days ago), but bone scan came back with multifocal osseous metastatic disease. There is a large area on my scapula, spots on 4 ribs and on the hip. I was prepared to have cancer, but not for metastatic. As expected, I'm very anxious and scared.
While biopsy results are pending, seems obvious this is an aggressive cancer. I've done a lot of research (I'm a retired dentist, so do have some background) & understand implications of results.
I see urologist next week on Wednesday & will get the rest of the results (unless they show on patient portal first).
I know I'll need to start with ADT & go from there. Seems like a lot of potential side effects. Also seems like prognosis isn't too good, even if cancer hasn't spread to other organs. I guess CT might show that....
Thanks for reading & any advice would be appreciated.
If you have metastatic disease you may benefit from Lu177 Psma 617 treatment.
I would be asking my Doc about this therapy.
Apparently it works even better if you’ve had no other previous treatment.
Minimal side effects.
Plenty of research papers online.
Hi
. So sorry to hear about the potential for a metastatic cancer diagnosis. It is important to get all the information and build a plan. Also don't hesitate to get a second opinion, if for no other reason than to hear options and build confidence in your decisions. To follow up on what was referring to, the PSMA test is the current gold standard in locating metastatic prostate cancer. This article I wrote goes into further detail: https://prostatecancer.net/clinical/psma-imaging-scan. Your doctors should be able to provide additional information. Please feel free to keep us posted on what you learn. This community is here for you. Best, Richard (ProstateCancer.net Team) I’m 80, had radical prostatectomy 14 months ago. 10 of 12 lymph nodes affected. PSMA last August showed spread in inter pelvic area. Started quarterly Lupron injections in September and Erleada. PSA & Testosterone .02 since December. I’ve tolerated Lupron well, but Erleada dosage has been reduced after skin reaction from interaction with another medication.I try not to think about my “prognosis” (my sense is that the answer is “that depends”) but rather keeping active, eating well, regular sleep, etc. 
Here is information on the Lu177 PSMA 617 that was mentioned ...
Novartis 177Lu-PSMA-617 significantly improves overall survival and radiographic progression-free survival for men with metastatic castration-resistant prostate cancer in Phase III VISION study
As others have mentioned here ask lots of questions and definitely get other opinions (2nd or 3rd). No matter how you look at a prostate cancer diagnosis just know things will be different going forward. The key I found was to roll with the punches, adapt to the changes and try to maintain a positive outlook. For some reason we all have a tendency to envision the worst outcomes first vs looking at workable solutions
I also had few to no symptoms and discovered I had an aggressive cancer in 2013 There are a lot of options and treatments out there and between you and your MD's you will arrive at an answer. With cancer MD's typically ask what you want to do vs telling you what is best.
The right decision is the one you make at the time with the information you have at hand. No one has the 100% correct answer. I was diagnosed 9 years ago and following surgery and radiation and Lupron - mine is under now control.
As Richard Faust pointed out the PSMA scans are the gold standard in finding clusters of cancer that potentially can be treated with radiation or proton therapy. The fact that you are in Philly is good news as it gives you access to some major medical centers. Best advice is take this one day at a time. Prostate cancer tends to be a slow growing so do your research.
So glad you found this site - a lot of us here have faced this and understand the mind game this plays with you. Please just reach out . If you want feel fee to visit www.theprostatecancercoach.com - The site contains a video journal of my 40 radiation treatments + Lupron when i was facing follow up radiation for a returning prostate cancer. Keep moving , eat well and rest when you need it. ... Dennis(ProstateCancer.net TEAM)
