Mike M lives in Texas, USA. He was 63 when he was diagnosed in November, 2017. His initial PSA was 11.29 ng/ml, his Gleason Score was 7b, and he was staged Unknown. His choice of treatment was Undecided. Here is his story.
I am recently diagnosed with Gleason 7B (4+3), so I am still feeling my way through all of this. I will post updates as my situation and my treatment progress. I am a Medical Technologist MT(ASCP) and have been in the Medical Field for over 35 years, so the lingo does not intimidate me and I am pretty familiar with the pathology of the diagnosis. I never thought I would have a cancer, I'm breaking new ground in my family history. Two years ago (August 2015) my PSA was 3.5 and my DRE was normal. One year ago (August 2016) my PSA had increased to 7.8 and my doctor's opinion at that time was that the value of the PSA as a test was somewhat questionable and lead to many expensive and painful biopsies that were unnecessary. DRE at that visit was normal, so we opted for a wait and see approach. At my last annual exam in August 2017 my PSA had increased to 11.29 and my doctor's impression of the DRE was that the prostate felt somewhat spongy. Off to the Urologist who repeated the DRE and said the DRE was not suspicious at all to him, but in light of the doubling of the PSA he felt that a biopsy was the only prudent way to determine whether there was a cancer involved. He did 10 biopsies, not as unpleasant as I had imagined, but not a lot of fun either. At that time, he said that the size of the Prostate was about what he would expect for someone in my age group and that he saw no focal areas of concern. He assured me that he felt confident that all would turn out well. However, 2 biopsies returned as Prostatic Adenocarcinoma, Gleason Grade 4+3=7 (Prognostic Grade Group 3), one involving 88% of the tissue and the other 50%. I have an appointment with the Urologist to discuss treatment options on Wednesday November 8, 2017. I am leaning right now towards Robotic Laparoscopic Surgery but Gleason 7 might, from what I've read, require open surgery so that they can test a few sentinel lymph nodes for metastasis. [That is not correct -- all of that can be done using the robotic surgical techniques]. I will know more after I speak with the Urologist on Wednesday. I am most worried about the prospects of urinary incontinence, and of course the possibility of a metastasis. All methods have their upsides and their downsides. Surgery, if nerve sparing, seems to offer the best chance for full remission, assuming that the capsule of the prostate has not been breached and no cells have moved into the blood stream. At least with the prostate out of the equation, my PSA will become a better diagnostic indicator of metastasis. Other tests may be recommended, I will update this as soon as I speak with the Urologist and as my treatments progress. Many posts recommend a second opinion, even a second opinion with a different kind of doctor (i.e.: surgeon vs radiation vs Chemo). My Urologist is a surgeon and I assume he will lean towards some aspect of surgery. My Urologist is a little suspect right now since he described my DRE as not suspicious at all after my primary care doctor had reported slightly spongy. Maybe I'm being nit-picky, I have never felt of a Prostate so it is probably a real art.
Mike's e-mail address is: 9hranch AT gmail.com (replace "AT" with "@")