Biopsy Results today

Hi Strawhead, sorry to hear.

If I remember correctly your OH has had biopsy before MRI which means you are still pretty much in the dark.

You say that u are meeting the surgeon on the 7th to obviously discuss prostate removal or RT.

That will be Ok so long as the MRI results are available, without identifying any potential spread it would not really be possible to plan a treatment path.

Ok, it's obviously not good about the high Gleeson but all is not lost because it depends on the scans results. If it's prostate confined then all treatment options are still open.

More waiting I know..

Best wishes

Steve

There is nothing to be afraid at this stage. My dad was also a Gleason 9 (4+5) but he is doing fine so far after his surgery.

Hi Steve

There will be no MRI result as we only have an appt to meet surgeon on 7th we have no.appt before then fir an MRI..Thanks for your reply. 

Thanks for your reply. Did your dad have a lot of side effects after his surgery ? 

Strawhead

I’m sorry to hear about your Hubby’s Gleason score which is at 4 + 5 High risk, not quite so much as 5 + 4 however.

It is scary, I know having been there.  It’s scary because it confirms a cancer, but it’s also scary because as yet you don’t know how bad it is or what the treatment will be.  Things will become clearer once you’re over the initial shock and get more information.  Then you’ll know what has to be done.

I wonder if you were also told if the biopsy showed how much of the gland is involved.  You may have missed this, or may not have been told.  This gives some indication of how far advanced the tumour is.

I am wondering what the appointment on the 7^th Aug is about.  Your hubby will have to have the CT scan and the MRI and should also be having a bone scan, was this not mentioned?

I also think it unlikely that the appointment will be with a surgeon.  It will probably be with a urologist.  If it is with a surgeon then it may be a mistake, usually patients only see a surgeon if it has been decided that surgery is appropriate.  If radiotherapy is to be the treatment, your hubby will probably see an oncologist.  Quite often, as in my case, the surgeon is not even in the same hospital as the urology department that have been carrying out investigations.  It’s very specialised surgery and not many hospitals do it.

It is only when all the results of these scans have come back that any treatment can be chosen, because the scan results determine what the treatment options are.  I’m sorry if you were expecting to know about treatment on the 7^th, some options may have been mentioned previously.  Nothing definite can be decided without scans.  I doubt if all the scans can be booked and reported on in such a short time, so please don’t be disappointed.

You are right in thinking the Gleason score indicates how “aggressive” the cancer is, i.e. how fast it grows.  However this does NOT mean that it has yet “advanced”.  Prostate cancer is still relatively slow growing.  Gleason score 9 is high risk, but it doesn’t indicate in itself what stage the cancer is at.  The scans will do that.

There is a Macmillan booklet which explains the scans and how the results are used which you can download by clicking below.

 https://community.macmillan.org.uk/cfs-file/__key/communityserver-discussions-components-files/142/2161.Having_2D00_tests_2D00_for_2D00_prostate_2D00_cancer.pdf

Let us know how you get on

Hi

Thank you for your reply. yes consultant today definetly said that we would see a surgeon on Aug 7th He did say my husband needs other scans too. Yes you are right its not just the word cancer thats scary its how the treatment will work. It will be a challenge but positivity is everything. 

Strawhead

Thanks for clarifying that. 

There’s nothing negative about it, I just find it a little strange to be seeing a surgeon as yet.  It might just be to explore the option.  I guess it will do no harm.

If there’s a problem with the scans then surgery will NOT be an option.

If the scans are all OK then surgery is only one option, radiotherapy  (RT), external or internal (brachytherapy) may also be options to choose between.

I was given a choice of either external beam radiation (EBR) or surgery.  I was told I couldn’t have brachytherapy.  I chose surgery.  The consultant seemed relieved somehow.  It’s only very recently that I discovered that if I’d chosen EBR, he would have probably tried to persuade me out of it because the MDT had said it wasn’t really a good option.  A lot of men prefer RT.

This is because I had previously had chronic prostatitis and apart from the cancer my prostate was a mess!

It may be that they’ve already decided on surgery in your husbands case, (scans OK), if so there may be some reason for excluding other options.  If there isn’t any reasons then all options should be open.  Your husband should be given a choice.

If surgery is the only choice given, I’d ask why.  Men should have the opportunity to weigh up which treatment option suits them best, it can be a matter of personal choice and you have to know the benefits and costs of the different options, because they have different consequences, despite being equally effective in dealing with the cancer.

It’s not a decision your husband (and you) should rush into. 

There is lots of information available on the different treatment options I can lead you to if needed and when the time comes.

Hi, I was diagnosed with Prostate cancer 2 years ago this month, Psa was 634, Stage 4, Gleason 4+5=9, T4 N1 M1 Bone.

The cancer is in my Prostate, Ribs 3,4&5, Pelvis, Spine, Shoulder and my Lymph nodes. 

I have had 6 sessions of Chemo plus Radiotherapy on my Pelvis and Spine.

The medication I was on until Nov 2018 was stopped as I was not responding to it so it was changed to Xtandi Enzalutamide.

My PSA was going back up to 60 after it gone down to 2,

So in Dec 2018, my PSA has started going down again to 23.5 Jan 2019 10.7, Feb 12.4, March 17.2, Apr 51.1.

So then I was taken off  Xtandi Enzalutamide because I was not responding.

The good news today is my PSA is 0.32 yes 0.32 probably lower than most the Doctor out there.

So my story is my Oncologist told me I am not anyone else just think about my illness it is different than everyone else and be positive. Live every day to the best you can. 

Don't be shy to ask the Dr as many questions as you can, Find out what is available to you.

All the best to you both.    

Strawhead

As Uroborus has already  mentioned, it would be good to know the biopsy details, ie. Number of cores taken and number of cores showing  positive for cancer.

Regards your 7th August appt. If you are seeing a surgeon make sure that you don't agree to any treatment before having the scan results.

If it has spread outside the prostate surgery probably won't be an option but it is only the scan(s) that will tell u.

Don't forget that is just my opinion.

Steve

Hi Strawhead.

I'm also a Gleason 9 and responding well to hormone therapy, which improves my prognosis considerably.

And that's the good news that I wanted to share with you: I was told that aggressive prostate cancers DO generally respond well to hormone therapy, which in itself is good news in that hormone therapy generally arrests the the further spread of the cancer, buying time for additional treatments such as surgery, chemotherapy and radiotherapy.

Very best wishes,

Jonathan x