re: Prostate cancer, gleason score 6, psa 5…..

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Wait, what? Why?

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My dad just had the giant robot spider prostatectomy. From what we understood, radiation causes changes to the prostate that make surgery very hard to successfully complete later. It's like the texture and how it attaches to stuff in the area changes and makes it hard to peel the prostate cleanly off the surroundings successfully if the cancer returns. If surgery after radiation makes sure to take the cancer, the risk of bad damage to the rectum, nerves, etc. Is relatively high. If you try to spare the surrounding structures, you run a very real risk of leaving cancer behind.

At least that's how I understood what the urologist said.

Discuss with your doc.

There is a genome test they can run on the biopsy core samples that will give a score used in the same manner as Gleason. They examine the genetic make up of the cells to see what type of cells are there (aggressive /nonaggressive). It can give the patient another data point that can help uncover additional risk not seen with the Gleason. It’s not cheap but should be covered by insurance.

My urologist and radiologist both told me the same thing : if you have radiation first, surgery is not a safe second option if cancer returns. The detailed explanation above matches what I was told, too. If you have surgery first, then radiation is an option.

Dang Butch.

Where did you have surgery?

I had my surgery at River Oaks in Flowood...

About 2 years ago, I did some blood work and got a call from a nurse a couple days later. She says, “Your PSA is 12.4.”

I’m like, “Okay. Is that not normal?” She says, “No, it’s high and you should see a doctor soon.” I tell her thanks and hang up and forget about it. I didn’t even know what a PSA was.

A couple days later, I’m at work in Houston between flights and my wife calls me. She had opened my test results and saw the PSA. (She was bringing the results to our insurance to get a $100 refund). She asked if I was concerned and I said no. She says, “Look up a PSA test on your phone and what your numbers should be and call me back.”

So I look up PSA scores. It says that a PSA over 10 means you have a 50% of prostate cancer. My heart dropped. I called my wife back and told her I was coming home. Called out sick and flew home. Next day I got an emergency appointment with a doctor and he gave me a prostate exam and found nothing. Did the blood work again and the PSA came back normal.

Don’t know how that happened, but it scared the shite out of me.

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Don’t know how that happened, but it scared the shite out of me.

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Enlarged prostate will give a higher rating PSA and so will sex the night before a blood test. Happened to me, I had a biopsy ran and all 12 samples came back negative. Turns out I have a very enlarged prostate.

At 6 I would wait. It could be years before you have to make a decision. I went two years before I elected to surgery. Relax. You will beat this.

I’ll have three opinions when I’m done. I was trying to figure out what’s the desk with HIfU vs radiation or complete removal