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Prostate cancer worries

Enki
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Hi,

I am 63 and was recently diagnosed with prostate cancer T2b after my PSA level was found to be at 6.6. Subsequent biopsy tests - for which 43 samples were apparently taken - gave a Gleason score of 7 (4+3). The cancer seems to be localised but I am having a bone scan next week to find out.

I am now struggling with the therapy options: robotic surgery (Da Vinci), radiotherapy (including Brachytherapy, Proton beam,,), hormone therapy, and even the new nanoknife IRE treatment. It is not an easy decision to take as all these treatments seem to have side effects and varying chances of success.

Any personal experiences in this respect will help me make that important decision. 

I am also thinking of sending my biopsy slides to another pathology lab for a second opinion to rule out any human errors, especially as my consultant told me that the MRI scan showed a "dark" area on the left side when in fact the cancer as found on the right. The consultant could not explain this discrepancy, saying simply that the dark area might have been an inflammation. I am not reassured. Could anyone suggest the name of a reputable private pathology lab, ideally specialized in cancer biopsies, in Berkshire or London. Your help will be hugely appreciated.

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    Hi Enki. Welcome to the forum.

    I was diagnosed with prostate cancer in 2010 at age 56. Gleason 3+4, PSA 5.6, Stage 2b. This was discovered on first biopsy, with 4 out of 12 needles positive. On MRI the prostate looked unremarkable, but MRI technology has moved on since then. I wasn't given a bone scan, but I had been monitored by the hospital for the previous two years, during which time my PSA had wavered between 4.0 to 4.9. 

    I was advised to have Da Vinci surgery. Unfortunately, only the nerves on one side of the prostate could be saved.  My PSA dropped to <0.1 and has remained at this level; I regained continence in two months, and stopped wearing pads after 6 months. I still do the pelvic floor exercises when I remember.  The only downside is that despite the one sided nerve sparing I can no longer have erections - but something really strange has happened - my orgasms are far longer and far more intense than before surgery!  I really don't know whether this happens to everybody, but I'm not complaining. 

    My order of priority for treatment was: not dying; being continent; not losing sexual function. I got the first two and half of the third so I'm not complaining. Well before surgery, I decided that I had to commit fully to this treatment, with no second thoughts before the op, and more importantly, no self-recriminations and no what-ifs after the op.  I have stuck to that resolve and I believe it helped me to cope with the after effects. 

    As usual, my removed prostate was examined after surgery, and despite the biopsy only finding cancer on one side, the removed organ had cancer on both sides. Luckily the cancer was all contained, no spread, and clear margins. Also, the Gleason score was reduced from 3+4 to 3+3, which was nice to know. 

    As far as I know, only surgery will allow the organ to be examined afterwards so that the true extent of the cancer can be ascertained. This is actually valuable information, since scans can only go so far in establishing the true extent of the problem.  

    I'm happy to talk further, either openly on this forum, or through a private message. 

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