Prostate cancer

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After a bunch of tests and procedures in the last few years,I now know that I have gleason 6 prostate cancer. Even though it's a low grade cancer, my urologist would like to do an MRI and possibly another biopsy. He wants to target another area of the prostate. The last biopsy I had was very painful/uncomfortable. If I can avoid having another one, it would be wonderful. Does an MRI detect cancer that a biopsy doesn't find? I'm not sure what kind of treatment he will suggest...turp, prostatectomy. Will my prostate continue to grow after turp? Can gleason 6 continue to grow? I'm really getting tired of all the procedures. Should I have the prostate removed, and be done with it? I'm nearly 70 years old. I know that any kind of surgery can cause some incontinence. I'm already dealing with that to a degree, and have become accepting and comfortable needing diapers.
Thanks.

 

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Recently I had to undergo an MRI of the prostate -- from the MRI I believe they are able to tell whether Cancer is present, but they cannot tell to what extend. It is my understanding to find that out they have to do a biopsy, which is what I had to do.

In my case they biopsed the entire prostate - 12 sections were taken.

Not sure if from an MRI they can determine where the cancer is located in which case perhaps they can target one particular area of the prostate.

As far as what else an MRI can detect - my understanding is that it can also detect if the cancer has moved into any of the organs around the prostate such as the kidney, bladder and lymph nodes.

 

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I'd accept any level of temporary pain to get clarification on a cancer diagnosis. I get the apprehension, but get the biopsy. Gleason 6, from what I've read is almost not even considered "cancer" as it's unknown if it even has the ability to turn into a higher grade metastatic disease. But the jury is still out on that so I'd be wanting 100% confirmation of what I'm dealing with and then make an informed treatment decision. Sometimes Gleason 6 exists along with nearby higher grade cancer. Your doctor might be curious to see if there is more and or different cancer in another area of the prostate. Needle cytology (biopsy) can tell exactly what kind of cancer it is, and what grade it is. MRI can usually only tell that there is a mass present but can't tell exactly what it is.

All your questions need to be asked to an oncologist, not an internet message board. If I were you, i'd spend some time and write down every single question I could think of and fire them off next time you see the doctor. I find that sometimes doctors throw bits and pieces of info at you and things move along but unless you stop them and ask for specific points of clarification they just keep going.

Good luck to you though.

 

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I understand your apprehension and fears. I was diagnosed with a Gleason 6 in 2014, at age 67. My PSA was only 4.5, but the Urologist was concerned with the velocity, since I had provided previous PSA scores from 10+ years before. I opted for active surveillance for a year, along with Proscar. My 2nd biopsy the following year resulted in 10 cores of 12 being affected, rather than 2 only in 2014. I opted for Da Vinci robotic surgery and glad I did because they found some microscopic cancer in my seminal vesicles too in the path report (T-3b).My post-op PSA was 0.07, and then 0.09, but increased to 0.12 within a year. Adjuvant radiation therapy, 40 sessions, was the recommendation in 2016. I underwent the radiation and some Lupron therapy during the treatments. Since then, my 3-month PSAs have been 0.01 and I hope they remain that low. I was reading everything like crazy on the internet and there is so much information, from holistic treatments to various surgeries and radiation options and I think I drove my Urologists crazy with all my questions. I did purchase a book that will provide you with very comprehensive information. I know it is available on Amazon. The title isr. Patrick Walsh's Guide to Surviving Prostate Cancer.-3rd edition. He is a distinguished Professor of Urology from Johns Hopkins Medical Institutions. A prostate cancer diagnosis is frightening and each case is different, but realize that you are not alone and much progress in treatment has been and is being made. I found this forum helpful, as I went through my treatments. I wish you the best.

 

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After meeting with still another urologist yesterday, I have decided to have my prostate removed. I'm really tired of having tubes, needles, etc. stuck in me. So, on April 11 it will be removed. The urologist said my bladder is a mess...his words. I retain a great deal and have several diverticulum. He said the incontinence I now have will probably be worse, but I have become accepting and comfortable with diapers. I hope I'm making the right decision.

 

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Da Vinci? Just FYI, I suggest you inquire as to how many surgeries of this nature the urologist has performed.

 

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From our conversation, he performs this type of surgery a couple of times a week.

 

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This surgery is very complex and requires practice. Damp please check around your location and find the MD who has done hundreds of these procedures. There is an "art" to it.

 

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Damp, The above is good advice. My surgeon had done over 200. The more experience, the better.

 

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Thanks for the concern and advice. I'm being treated at a very reputable hospital and clinic. I am in good hands.

 

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I agree. You have done your homework well. I'll pray as time goes on. Maybe we can start calling you Dry in six months.

 

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Begin your Kegel exercises ASAP. The incontinence is pretty much inevitable and they are very beneficial. It is frustrating, but gets better. Hang in there.