Hi Bec,, hope you don't mind me saying but i think gleason score is wrong, mine was only 8 and mine has gone to lymph nodes, spine, ribs, pelvis and a lung, if it's still contained in prostate highest score should be about 6 the higher no is a sign its spread more. Not so much its aggressiveness, psa is a rough check there has been recordings of very high psa and no cancer and low with cancer all over, my psa was 1581, it was found in Feb 2016 and ii didn't have any signs of anything wrong,, your father could have options for what treatment to have, hope i haven't worried you with my details, I'm living a normal life. Getting older, best wishes... Billy 

Hi Billygoat thanks for replying. Yes I'm confused with the Gleason score of 9 especially as out of the 16 samples taken they could only find cancerous cells in one.

If the cancer has spread to the surrounding area would this be shown on his first MRI scan? The treatment he has been offered is removal of the Prostrate or Radiotherapy and Hormone treatment. I guess we won't know exactly what can be done until he has had the bone tests etc.

It's good to know your doing well.

Thanks Billygoat. Good luck to you too

Hi Bec2137.

I am not a doctor and I have no medical qualifications. However I was diagnosed with prostate cancer back in 2010 and had my prostate removed in December that year. So far, I've not needed any further treatment.  My highest PSA was 5.6 and my Gleason score was 3+4, which after surgery was revised downwards to 3+3.  

It seems to me that although father's cancer appears to be highly mutated (4+5) and therefore potentially aggressive, it has been found very very early. From the MRI, there appears to be every reason to think that the prostate capsule is intact and any cancer is contained inside.  I think this means that there is every prospect for a complete cure, unless the remaining scans find something totally unexpected.

Undergoing tests is always worrying, but they'll be over soon and you'll have a better idea of what he's facing.  However, there is room for cautious optimism. 

Please could you keep us updated as event unfold. Your feedback helps us improve our answers for those who come later. 

Hi Telemando thanks for your reply. Yes it's a very concerning time and I'm worried sick. We are hoping that it hasn't spread out of the Prostrate but the further tests will obviously assist.

I'm thinking that if it had they would have been able to see on his MRI?! He was told that it looked intact but who knows...I never thought he would be in this situation like everyone else on here.

I will update as and when we know more. Thanks again.

Hi Bec2137

My understanding is that the MRI is pretty reliable for showing whether the prostate is still intact. But when it comes to medicine there can always be exceptions. 

I think the best way to cope with the situation is to just cross each bridge as you get to it, and try not to worry about possibilities that may never occur. 

Yes very true one step at a time. Thank you.

Hi Telemando quick update...my dad has had all the scans now and was told yesterday that there does not appear to be any spread, the capsule is still intact and the tumour is very small. He is now awaiting an appointment to talk in detail about the next step.

My dad has decided he wants the prostate taken away but has heard very differing accounts in regards to the best procedure to request (robotic or open surgery). From your knowledge does it make much of a difference which procedure he opts for? I understand it differs with every person and recovery times are slightly better with the robotic option.

Good news but still a long road ahead. I hope all is well with you.

Hi Bec2137.

The general consensus is that the most consistent and best results come when the surgery is carried out by team that doing around 5 RPs (radical prostatectomies) a week, and has done at least 100 of them in the preceding year.  That is generally the case in any NHS hospital that actually has a robot.  

After that, the robot is less intrusive than open surgery, but if you have one surgeon who is highly skilled using the robot, and another equally highly skilled doing open surgery, then outcomes are pretty similar. 

I think the situation now in the NHS is most patients are offered robotic surgery in their nearest centre of excellence.  That's what happened to me.  I was referred from a smaller local hospital to a very large city hospital.  

It's against this forum's T&C to name hospitals and consultants in an open post, but if you send me a request we can use private messaging. I'd be happy to speak directly to your father if he would like. 

It might also be worth finding if there's a local prostate group near where he lives.  You can find them all listed from the Tackle Prostate Cancer Home Page.