New scared member

Hello again Daniel - DP857864 

I am pleased you have found us from "New to the Community" - we are a decent bunch if i say it myself!!

Prostate Cancer with ductal adenocarcinoma is an aggressive type of Prostate Cancer and the cancer is in the Prostate ducts rather than the gland cells. This means it can spread to other parts of the body quicker than "normal" prostate cancer.

It's the side / after effects of the treatment you should worry about - 98% of men with Prostate Cancer die WITH it not of OF it!!

I would have thought in your case Surgery or Hormone/Radiotherapy would be suitable and I would be trying to get the view of Oncology as soon as you can before you decide on treatment.

Feel free to ask anything - you will get honest answers from people who have "been there - done that".

Canada is one of the places I have always wanted to visit and never yet got there - there's still a chance though!!

Best wishes - Brian.

Hello Daniel,

1. I'm sorry you have joined our club. However you will find it's member's are supportive and have useful information to share. You will need to make a decision on the treatment route to take after listening to the medics. Remember there are tools in the box to tackle your issues. I have had to use various ones but still leading a good life with a few side effects. All best wishes.

Hi, I was diagnosed with Gleason 3 + 4 last October, and I have had Ldr brachytherapy, you may wish to read my profile. 

Millibob said:

It's the side / after effects of the treatment you should worry about - 98% of men with Prostate Cancer die WITH it not of OF it!!

Hi Brian and thanks again for your reply. I'm very curious about the quote above, extracted from your response. It sounds incredibly encouraging, but I want to keep my expectations in check, particularly because you also summarized ductal adenocarcinoma as " it can spread to other parts of the body quicker than "normal" prostate cancer", which is something that I'm only slowly starting to understand at a very basic level.

So considering these two statements, one encouraging, the other not at all, I'm absolutely not sure where I stand. 

I know I need to get scanned, twice, for spread (from my understanding, bone scan and capsule mri?) but what I'm wondering is whether a prostatectomy *completely* stops potential spread if it hasn't started spreading yet. And other worries include whether the bone scan itself, which is radiation, can cause further growth and/or spread (I'm going to ask my urologist if I can get a spine and pelvis mri in order to avoid the radiation of a scan, if and only if its results are as reliable).

Mind is spinning, and doctor so far seems like he'd prefer it I just blindly followed his instructions without asking any questions.

Thanks you all 

Thanks, I read your profile but several of the acronyms I'm not familiar with... Is this the approach where radioactive pellets are inserted inside the prostate? I suppose this is intended to irradiate the prostate more and other organs less? Is this considered an approach with less side-effects than prostatectomy? 

Thanks Cuthbert. Will I find info about your treatment path if I go down into your profile? Just very curious as you said few side-effects. 

Hello Daniel,

I find that all medical treatments have a downside. However I decided not doing anything and allowing the Cancer to advance was not for me. I still have things to do with my life but need the time to do these. Therefore I made an informed choice to accept the offer of treatment. Unfortunately for me the prostectomy didn't quite stop it. Just collect as much information from the medics and make your best decision for you. All the medics surgeon oncologist have pulled no punches and highlighted the side effects. All best wishes

hi DP857864 in answer to your question

DP857864 said:

I'm wondering is whether a prostatectomy *completely* stops potential spread

my understanding is that once any spread has occurred it is pointless doing a RP, as micro mets might already be lurking outside.  Only time will tell if there is to be a spread or not.  Sorry this doesn’t help.

Brian’s quote of 98% is an overall statistic.  Obviously anyone T3b or T4 has a lower percentage chance, but new treatments are proving very good at keeping us going.

Hello Daniel (Dpoirier857864) 

So I think in your case IF there is no evidence of spread and the cancer is shown to have not broken out of the capsule on the MRI scan surgery to remove is a sound option.

IF after the surgery the histology shows they haven't got everything they can still mop up anything left with Radiotherapy and Hormone Therapy.

If you don't fancy major surgery Hormone Therapy and Radiotherapy combined should do the job or if there is any spread - combine this with Chemotherapy.

Every treatment comes with side effects / permanent effects and until you start treatment you just don't know what you will get. Like you I am 69 - I started the HT/RT route almost 4 years ago and have had every side effect going and some not listed. Would I do it all again? - Yes for a curative pathway. (You can read my journey by clicking on my name or avatar).

It's hard when you have a choice of treatments - why not make a list of the pros and cons of each treatment as to how they would affect you and your partner - come back to us with any questions.

Best wishes - Brian.

Hi Daniel

I have mixed Ductal Acinar Adenocarcinoma, which immediately made it Gleason 8. Do you have pure Ductal adenocarcinoma or is it Mixed DAC? Ductal does not typically show up in PSA in the same way as Acinar. You may find my profile an interesting read. If you add the details from your pathology report the team on this platform can provide better advice, there are fantastic people on this forum who are very knowledgeable and caring. My oncologist has focused on the Gleason score rather than the type of cancer. 

i would be very happy to answer questions around Mixed DAC as there are not many of us around. Pure DAC is even more rare representing about 0.7% I believe.

i understand it is scary at first, and Dr Google does not help. I can tell you as a fellow PC patient, after 4 years of treatment I feel perfect. I have a few side effects but still travel extensively, exercise daily and living a normal life. 

All of the best with your journey.