Options becoming clearer

[Scorpio53]

Just met with my MO, who is excellent at listening and providing a fuller picture of my prostate cancer. Turns out I have one T2 tumor (Gleason 4+3) on right lobe with no spread to lymph nodes or further afield. This is the first time (after seeing my uroliogist who told me I had cancer) about the type/size of tumor. I know this is mostly my fault but would have been helpful if the urologist had been a bit clearer.

Am glad I listened to the network (thank you) to getting addtional opinions/advice. Will be seeing and RO in a few weeks. I will also be postponing surgery until I find out what type of cancer cells are in the tumor and then determining which course of treatment (surgery or radiation). To that end would be eager to hear any further advice.

Again, thank you for the advice, checklist and research sources.

[Hockeyforever]

Middle of November 2022: diagnosed with prostate cancer, confined within my prostate. Start of March 2023: surgery performed, histology determined cancer had spread outside my prostate. I recommend you don't delay deciding and commencing treatment.

[Scorpio53 in reply to Hockeyforever]

Thank you. I initially wanted to take a very aggresive approach but availability of doctors, especially anesthesiologist availability, put that on hold. When my surgery was scheduled, it got moved to an undetermined date by the doctors. More than a bit maddening, but I think it has paid off by giving me more time to consider alternative treatment and having the time to speak to an MO and RO, Will know more soon and make a decision in a few weeks.

[Hockeyforever in reply to Scorpio53]

I chose a robotic radical prostatectomy rather than radiation because radiation has side effects which appear 5 or more years later and if histology after surgery discovers cancer was not confined to the prostate then radiation can be used to treat non confined cancer after surgery. However if treatment is radiation of the prostate then after completion of radiation treatment, if cancer is detected inside the prostate, surgery is not an option. I asked a lot of questions and relied on the information provided by two independent urologists. My opinion is time is not your friend. This web link is worth reading.

prostatecanceruk.org/prosta....

[groundhogy]

Here is a good website to compare odds of cure for the major treatment paths. You have to determine your stage, low risk, intermediate, or high risk (risk of recurrence). So if you are intermediate, pull up the intermediate chart and you can see the odds of 10-20 yr survival, etc. based on the treatment you pick.

prostatecancerfree.org/comp...

It is best viewed on computer or just print it on paper. Not so viewable on phone.

To make the graphs easier to read, i drew a dot on the endpoints of the elipses, and then drew a line through the dots. This turns the elipses into lines.

Also be aware the the graphs don’t show any salvage radiation benefit. This would boost the surgery odds up a bit.

Also beware, this is a very dysfunctional industry from my view. Loads of bad info mixed in with the good info. Same with the docs. Some of them are more dangerous than the cancer.

[Scorpio53 in reply to groundhogy]

Thank you. I have spent a ot of time with the chart and other information on the website. Very useful. I did have an issue with the fact that some of my data points were in each category (or so it seemed to me). I am waiting to hear back from my MO (who will do more tests on my biopsy samples) and the RO who will provide more info on that treatment option.

I agree with your perspective vis a vis confusing information. I finally found an MO who gave me a plain English reply to my questions. That was eye opening and made me wonder why other docstors couldn't have done this earlier. Also, I am questioning why my GP didn't refer me to an MO and RO (only to a urologist).

[groundhogy]

Urologists still rule the roost in the prostate industry. They still tend to assign you to a urologist as the lead. In other cancers, its the MO that is typical lead.

This is because in the beginning there were only surgeons. ROs and MOs are more recent developments.