Hello there - newly diagnosed!

Hello Neil (Neil101) 

A warm welcome to the group although I am sorry to find you joining us.

Everything has been sorted pretty quickly for you. The presence of cribriform pattern shows the cancer can be an aggressive cancer and the main lesion is quite large. Two things come to mind

* Have you not been offered a bone scan?

* Whilst you have a meeting with a surgeon, your case should go to an MDT meeting to decide the best treatment plan for you. You don't have to accept the treatment offered by the MDT meeting and I would at least want to speak with an oncologist to check if other treatments are suitable before the surgeon gets busy with his knife.

All treatments come with side effects and you should discuss these with any partner too.

Do ask questions, there's a wealth of lived experience on the group and you will get answers.

Best wishes - Brian.

Hi Millibob 

Many thanks for your quick reply.  NO, I haven't been offered an Oncologist or a bone scan as yet.  After reading some of the posts here, it is on my list to contact my key worker tomorrow and find out what the options are!!

Welcome sadly Neil101 ,

You are a very young lad to be found with this couple’s disease. If you are married or have a partner this will effect them as much as you.

Be patient, the cancer is slow growing.

Be brave and positive, that’s as good as medicine.

Take care and ask questions, there’s nothing to silly.

Neil101 said:

I expect that my treatment plan will be surgery first, then see what final pathology identifies

Hi Neil101 be careful with this assumption. You’re only 52 and you need to think carefully about side effects. Your quote above seems to be leaning towards surgery then see about possible radiotherapy if the pathology doesn’t look favourable.

The problem there is that surgery will take out the gland and the urinary sphincter valve, leaving you entirely dependent on your pelvic floor. Surgery may even take your nerve bundles on the outside of the gland - causing possible erectile dysfunction. It is a deep operation despite being robotic with five keyholes (some bigger than others).  Then radiotherapy has its own set of side effects (although most are temporary during and for sometime after treatment, especially if hormone therapy is in the mix).

I would advise you to discuss the above with your surgeon and an oncologist.  AW

Thanks Alpine Wanderer 

There are a list of questions I have for the surgeon including all possible side effects.  I have not yet seen an oncologist.

Hi again Neil101 you should also check percentage success rates. When I was discussing surgery, my surgeon was honest and told me it carried a 30% cancer recurrence rate.

You have cribriform morphology, it may only be starting and not extensive like mine was. This was the leading reason why I chose to hit mine hard with radiotherapy (of the whole pelvic area, as it happens, but this should not apply to you as a T2).  However, as Millibob said, it is an aggressive trait (micro mets can break away and travel in blood and lymph systems). I’m not trying to scare you - I’m just saying that this cancer needs a similar aggressive approach to ensure there are no escapees.  Radiotherapy will kill cancer and, whether the cells are laid out in a cribriform pattern or not, if they are in the radiotherapy beam target area, they will be dead.  AW

I have actually emailed my clinical nurse specialist if a PET scan would be useful before deciding on the best course of action. 

Good.  You’re obviously getting the hang of things.  AW

Hi Neil101

Sorry to see you joining us, but you are in a great place for support advice and general chit chat from a greta bunch people.

I have stage 4 metastatic PC found last September 25 with a PSA of 953 so was pushed along fairly quickly! CT/Bone scan and Biopsy

Surgery not an option as in my lymph glands in pelvis and abdomen. I am on "Triplet Therapy" - a hormone implant by injection every twelve weeks (Zoladex) and daily Darolutamide tablets (another hormone treatment). I have - yesterday - just finished six rounds of chemo (Docetaxel).  My PSA this week - <0.025 and classed as undetectable!

My next appointment with my consultant is to talk about radiotherapy later in the year.  I am following the "Hit it Hard" approach...

Check profiles for more details (click on the green name or round symbol next to it)

It is certainly good to have an oncologist to speak to.

All the very best 

KrisPy

also don't forget Prostate Cancer UK site! Great support stuff on there, and their info often has lists of key questions to ask at consultations - useful prompts indeed.