Advanced Prostate Cancer
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Newly diagnosed

PSA 194. Gleason 7/8 in 6 of ten samples. No bone mets.

5 Replies


Your diagnosis is of advanced disease. If you are being treated by a urologist, your first task should be to find a medical oncologist who specializes in prostate cancer. There has been a lot of new research on prostate cancer ("PCa") and it is desirable to get treatment from a real specialist who keep up with the latest research. If you live in the U.S. (and the name "jimbob" makes me think that you do), one good place to look is in the National Cancer Institute's directory of "Designated Cancer Centers". See:

Best of luck.



Hi Jimbob, welcome to the group. I can understand that you feel this is devastating, please know many of us have been through it, and have survived through treatment for years. Likely they will put you on Lupron or zolodex to reduce testosterone, current studies show improved survival with 6 upfront cycles of chemo , and there is a good chance that combo could put you into remission. You are not alone, we are all here for you, and I wish you the best



There is no question when you hear the words,”you have cancer”, your life changes. But please keep this in mind, while you have advanced cancer, there are still a lot of things on your side. No bone mets? That is great news! Hopefully they also ran a CT scan to help determine if if has spread to other parts of the body. Hopefully it has not.

Based on information you provided there are a lot of options. The big two are surgery or radiation (or like what I had, surgery then radiation). They may want to put you on hormonal therapy to help shrink the size of the cancer. If you decide on surgery please pick a surgeon that has done literally thousands of surgeries. There is not that much difference in outcomes between DaVinci or open operations, though DaVinci has a faster recovery time.

Likewise if you go with radiation, pick a radiologist that has a lot of experience and is up to date with the latest advances. Please note that you can have radiation after surgery. Because of the scar tissue that forms from radiation, it is very hard to have surgery as the secondary treatment.

There are a lot of sources for information. A good source is the Prostate Cancer Foundation. Listed below is some good information

Again, so sorry that you are here. We are all in this together. Please stay strong!

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JimBob, find you a Proton Radiation center and talk with them before you decide. The oncologist will tell you if they can treat it. Proton is a lot safer than photon radiation. Look it up on the internet to see what the difference is. I am two years out cancer free after treatment and have or had no side effects and the only invasion is placing the markers. Check it out.


Nothing to think about, but one thing. The same that AlanMeyer suggested. You need a Medical Oncologist, who is associated with a center of excellence. This means that the Oncologist should be a Specialist in Prostate Cancer. As Generalists are bombarded with all new research for all Cancers, and they do not have the time in their day to keep up with just Prostate Cancer. Centers of Excellence, I.E. are like John Hopkins, MD Anderson, Mayo, Dana Farber--In California, I personally like Compassionate Oncology, and Dr, Liebowitz--they are not a center of Excellence--but they are pretty top in their approach, with advanced disease.

I live in N.C.--I use the Levine Cancer Institute, and my Doctor is the Head of Prostate Cancer Research.

If confused use the site Alan suggested, OR CALL the Prostate Research Cancer Institute--PRCI. Call and get a personal advocate. Their 800 number is at their web site. You can call 24 hours, whoever answers, will set you up immediately with an advocate, who can direct you to different resources. And all Advocates have Prostate Cancer--so you will have much in common. They can recommend Doctors and Centers, based on where you live. Best Wishes!



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