What is the best treatment available.
Hi My Dad is 57 years old, recently he started to feel numbness on the fingers when he wake up every morning and its like cannot fold the fingers in the beginning, weakness and tiredness. He had a medical check up and the PSA was 20 and said 60% of Prostate is affected and the doctor said it was aggressive and at grade 9 out of 10. Since its aggressive and the samples taken made cut on his prostate the chances of spreading is very severe. A doctor said immediate robotic surgery is required as it is aggressive and at the same time a doctor from another hospital said it can be treated with chemotherapy and hormone treatment. Consideration both have side effects and he is not too old, which is the better way to treat the prostate cancer with PSA 20 and 60% affected and at grade 9 out of 10. Immediate help requesting. Thank you.
It would be inappropriate for lay people to offer any form of medical recommendation. That being said here are a few items for you to consider / research:
1. Do you have confidence in the medical professionals you are already seeing? Are they well qualified, and experienced?
2. Have you considered getting a third opinion from a multidisciplinary team of prostate cancer experts? Use Google to locate some options in this regard.
3. You mention robotic prostatectomy and chemo/hormone but do not mention radiation. Did either doctor discuss radiation options?
4. I found with my cancer (PCa) that the medical professionals could provide me with data, and the pros and cons for each option, but at the end of the day it was up to me to choose the way forward. Factors such as any other health conditions need to be considered.
5. Did either doctor comment on the numbness in the extremities, and its potential correlation with PCa?
6. Has your Dad had an MRI?
7. Has he had a nuclear bone scan?
8. If you Google something along the lines of "What’s the best approach for Gleason 9-10 prostate cancer?" you will find several articles which may provide you with additonal material to discuss with your medical team(s).
My heart goes out to you and your Dad.
We appreciate you and your support of others in the community. Fantastic input. -Samuel, Team Member
We are now into the end of January 2022 and just reaching out to follow up.
I also had a Gleason 9 back in 2013. Since the cancer appeared to be contained I opted for surgery - the surgeon and follow up pathology did not show it has spread following my surgery. Hope your dad is doing well ... Dennis(ProstateCancer.net TEAM)we were told a prostatectomy would be the best way to go if my husbands cancer was more aggressive. My husband has a Gleason score of 4+3. And he’s 64. Age definitely a factor. If my husband was younger, he would do the surgery. Because his cancer is more localized and his age, he’s opted for radiation and hormone therapy.
Hope this helps!!I am NOT looking to sway your husband's decision in any way, shape, or form - the treatment decision is obviously a very personal one.
Age is a factor for sure, but so is health and relative physical fitness.
Last year, at age 72, I was clinically diagnosed PSA 9.7, GS 4+3.
Apart from PCa my health was reasonably good. I'm 5'10", and the morning of surgery I was 145lbs. I was, and remain, fairly active.
I had single-port daVinci RALP, BPLND, and bladder neck suspension on 9/15/21, I was home the afternoon of the surgery. Recovery was uncomplicated, just some Tylenol the first couple of days. The catheter was removed 5 days later; I had zero incontinence from that evening forward.
In my case the cancer had spread beyond the gland, requiring the removal of seminal vesicles, part of the bladder neck, and the left nerve bundle. The pathology showed clear margins, T3b, N0, M0. Subsequent uPSA has been undetectable at <0.006.
I'm grateful for the advice and skill of my surgeon (a leader in the field of robotics), the advanced robotic technology that he deployed, input from my oncologist, the care administered by nursing staff & numerous technicians, practical advice provided by patient support groups (such as this one), ongoing research by the Prostate Cancer Foundation, and of course the support of friends and family.
