New and following in others footsteps with questions

[Mike1600]

Hello All, I'm 58 and was diagnosed in October following MRI and template biopsy as 2Tc, PSA 4.2, Gleason 4+3.

Was a shock as wasn't expecting the results based on the comments of consultant after the MRI. Have had a CT scan awaiting results and down for a bone scan too. Is this routine to have a CT and a Bone scan when cancer is found.

I had been going to the doctors over the last year with bouts of fatigue but it wasn't until May of this year a blood test was suggested. Is anyone aware of fatigue being experienced as a symptom of PC.

I'm experiencing another bout of fatigue which is making work really difficult which is demanding and stressful at the best of times, this in turn is adding to my anxiety. I'm going to the doctors tomorrow as I think I need to take some time off work to get my head straight.

Have decided on a Radical Prostatechtomy but as the cancer is in both sides then the nerves can't be spared. I think the consultant said he would have to take the interfascial nerves but leave the intrafacial nerves, not sure what this means other than a loss of erections.

My consultant said he hoped for a cure, but when I read about 2Tc on some sites (thats the danger of reading sites on the internet), they talk about being high risk of reoccurrence. Does anyone active on the site have any insights into this.

Thank you in anticipation

[Fairwind]

The CT and bone scans are done routinely looking for metastasis or other problems that might complicate your treatment. With a PSA of 4.2 they are unlikely to find anything. Prostate cancer at this stage has few if any symptoms, so your fatigue is coming from someplace else....A complete blood work-up might spot something that's been overlooked...Before you commit to surgery, make and appointment with a RO, radiation oncologist, one that performs brachytherapy and have a talk with him or her..Surgery has hardly advanced at all over the last 20 years but radiation has made huge improvements in its effectiveness , safety, reduced side-effects, the equipment being used today is light-years ahead of what they had 20 years ago. So in many cases, radiation is the better choice. Much of what you will find posted on the "net is obsolete information from 20 years ago..

[Tall_Allen]

Yes, a bone scan and CT are standard for anyone diagnosed with "unfavorable intermediate risk" prostate cancer.

You can see how men with your diagnosis did with a prostatectomy by filling out this nomogram:

mskcc.org/nomograms/prostat...

(You are probably NOT stage cT2c as used in that nomogram, as imaging and biopsy are not used to define clinical stage. Only a DRE is used, which is most often negative (cT1c) or a small lump (cT2a).

It doesn't sound like you've talked to experts in other, possibly more curative therapies. You should, even if you decide later to have surgery. The therapies that have the best odds of curing you are external beam coupled with a brachytherapy boost to the prostate, SBRT monotherapy, and HDR brachytherapy monotherapy. If you don't know what they are, you haven't yet done your due diligence. You have plenty of time to meet with doctors before deciding. I think that The Royal Marsden Hospital offers many, if not all of those.

[Burnett1948]

Burnett1948.I haven't got the knowledge of the earlier repondants. But I agree that External Radiation is the way to go. I had my prostate cut out in 2005 and the Robot missed 6mm. (I wasn't told about this until 2012: I should have had Salvation radiation straight after the surgery; thats another story) I had Salvage Radiation in 2009 and am just finishing external radiation to get rid of a lymph node picked up by a PET scan. In 2005 I wasn't told my prostate was enlarged.I had a MRI then and was told it was localised. My numbers were:- PSA 7.6; Gleeson 3+4=7 and T1. Also I believe there are very few surgeons who can guarantee that you will be continent and potent after their surgery. Surgery shortens your penis anyhow. I don't know what initial External Radiation does to ones plumbing but I believe you will be incontinent and impotent too. However I believe you have a greater chance of a cure. I regret not having External Radiation because I don't have a cure. One other point: I believe that in 2005 the Surgeons out numbered the Radiation Oncologists or they were more powerful. Because their recommendations for a Radical Prostatectomy got precedent over Radiation in the prostate cancer literature I was given. I remember reading you had a better chance of a cure with surgery. I now read that Radiation is now more accurate than it use to be. Also I rushed my decision making in 2005 when I shouldn't have because Prostate cancer is slower than other cancers.

[Mike1600]

Thanks everyone for your replies. I'm going to consider in more detail what I do before I make the final choice. Really appreciate your support.

[monte1111]

Good luck Sir Lancealot. So glad you are up a lot. My wife, who sadly passed years ago, complained that my penis was too long. But having been on lupron for 20 months now I no longer get the ruler out. Glad you still have choices.

[JimVanHorn]

Hello Mr. Upalot, Good luck with your future. You can make decisions for your future and all we can do is tell you what we did and what happened. Each PCa is a different type of cancer, in different places and stages, so what I did may not be what you need. I had 42 radiations in 2007 and they did a bone scan in 2011 and found metastases on my hip bones. I had an additional 30 radiations and started Lupron injections (every 3 months) for 6 and 1/2 years. Recently I was told that I no long have cancer and my metastases were gone. My PSA is 0.00 now for 6 years. I wish you the same in your journey, and ask at least 2 doctors what you should do and no matter what, just keep truckin'.

[Hidden]

Here's hoping your CT and bone scans are clear, which would imply, but not guarantee, that it hasn't spread. You might research HIFU as something that touts minimal quality of life impacts. I can vouch for that. Good luck with whatever you choose to do. Don't be in a rush to decide.

[j-o-h-n]

Yep - good advice here... Do NOT rush into doing anything, Pca is slow growing so research and get yourself a good team of doctors. You have time (don't panic).

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 11/12/2018 7:53 PM EST

[Mike1600]

Again gentlemen I am humbled and grateful for you sharing your thoughts, insights and experiences. Monte1111 suggested one humorous reason for my username as being somewhat amorous , well the reality its short for 'upalot at night peeing' :-). I have looked at radiology treatments/surgery and I take on board what several of you have said, dont rush and do my homework. WSOPeddie I'm going to talk to my consultant on Friday about HIFU to see if I would be candidate.

Thank you all

PS I'm located in Southampton, UK