Stepfather newly diagnosed...yet given conflicting options

niloyoung · New User Joined: 09 Aug 2006 Posts: 2

My stepfather was recently diagnosed with Prostate Cancer about 2 weeks ago. Of course we were all initially devastated, since when you hear cancer the first thing you think is imminent doom. He had no symptoms of the disease, yet had a PSA of 4.8 when the doctor recommended a biopsy. On rectal examination the doctor couldn't feel anything however the biopsy came back positive for cancer with a Gleason score of 9, which is aggressive. They also said his staging was a T1c, since it wasn't palpable. One doctor recommeneded the prostatectomy yet urged him to get a second opinion. We live near Johns Hopkins so we went to their department and was told that not only was surgery the wrong answer, but that given his Gleason score he may expect to only live one year. Hearing this was shocking, since we never heard this from the other doctor. JH recommended radiation therapy and are following up with bone scans.

I just believe that something here is very wrong since these treatment options suggested were vastly different. I want my father to do what's best for him however is it worth getting another opinion or proceeding with JH's recommendations? Also is there anyone else out there with a similar prognosis who has had treatment?

trout · New User Joined: 09 Aug 2006 Posts: 1 Location: canada

I am so sorry to hear about your stepfather. I am sure you feel like you have been hit by a truck. Being supportive means playing an active role in finding and maintaining hope. My advice to you is to read everything you can get your hands on (the internet is an excellent and current resource), speak to anyone who has gone through diagnosis and treatment and encourage your stepfather to seek professional opinions from more than one doctor. There are a lot of decisions he will be making regarding his own treatment The standard protocol is flexible and there are many variables.
My story:
When my husband was diagnosed, his PSA was 3270 (yes, 32 hundred) and his Gleason score was 8. He was given six months to live by the GP that broke the news to us. That was four years ago August 15 and he is still with me (except not right now, he is in the mountains fishing). He has taken advantage of two new treatment options that weren't available when he was first diagnosed. There is still hope. Good luck!

niloyoung · New User Joined: 09 Aug 2006 Posts: 2

trout,

Thank you for your kind words and encouragement! I found out this evening that JH recommended radiation and hormone treatment for him (which is what my Uncle is did for his treatment and has so far been successful). I think the toughest thing for all of us has been how fast everything has moved, but we are definitely reading and researching and trying to ensure that my stepfather understands everything going on.

johnw100

Generally, a Gleason score of 9 and relatively low PSA, is agressive, but it could be early days.

ie: The cancer could still be confined to the prostae in which case surgery could still be a viable option.

An endorectal MRI would help determine if it is still confined, after which the options of surgery or radiation could be considered.

In this situation, hormonal therapy is often used in addition to the above.

Have spoken to men who have had good results with both surgery and radiation, and others who have tolerated hormonal therapy very well.

Lifestyle changes, diet, exercise are very important, regardless of what treatments are chosen.

John

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