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Prostate Cancer
Rouge53 posted:
My husband is 59 yrs old and was just diagnosed with prostate cancer. His PSA in 2011 was around 1.4 and a year later, 2012 it jumped to 4.6. A biopsy confirmed the presence of cancer in 1 of the 12 samples that were tested. Is there a way to determine if cancer may be present in another section of the prostate? In addition, he is at 6 on the Gleason scale. How does that compare to the 'stage' ratings? For instance, is a 6 comparable to stage 3 prostate cancer? What are the chances for a full recovery and non-recurrence if a radical prostectomy is performed.
billh99 responded:
This is the stages of PC

You did not give enough details to be sure, but he probably is at stage 1.

Is there a way to determine if cancer may be present in another section of the prostate?

The only practical way to find cancer in the prostate is via biopsy. And it only samples a small area.

What are the chances for a full recovery and non-recurrence if a radical prostectomy is performed.

Fairly high.

Here is a calculator that you can put his specifics in.

And here is a good resource for information on PC.

There are other treatments other than surgery.

But in this thread I mention why I chose surgery.
Basir U Tareen, MD responded:
Everything about your husband's disease suggests low risk disease, except for one thing -- the relatively fast rise in PSA from 1.4 to 4.6. I think one important question which we may not be able to answer is, "was that rise in PSA from cancer."

One core of small volume (low risk) Gleason 6 prostate cancer typically doesn't manifest with a fast PSA rise.

One problem with prostate cancer staging is that you never really know the true stage of prostate cancer until the prostate is removed.

Assuming it really is a low volume Gleason 6 cancer, his chance of cure is very high with any treatment -- radiation, surgery, and many would say no treatment. Translation -- for the typical low volume Gleason 6 prostate cancer active surveillance (sometimes called watchful waiting) is a reasonable option as data would suggest that the chance of death from this disease over the next 15 years is very low.

I think a detailed discussion with your urologist about active surveillance, radical prostatectomy and radiation is a wise next step. You are always more than welcome to get 2nd opinions.

My only advice is that if you do choose active surveillance (which to be honest is what I would choose if it were me) you must be followed very closely with repeat PSAs (every 3 months) a repeat biopsy, and regular visits to the urologist.

However, as I tell all my patients if you don't think you can be compliant with the followup involved in active surveillance or don't like the anxiety of not treating right away, than you should choose a different option.

Best of luck
billh99 responded:
BTW, for the best outcome with surgery studies have shown that the following have helped the outcome.

1. Lose weight if needed.

2. Get in shape. Specifically walking and other lower body exercises help.

3. Eat a healthy diet.

4. Start doing the kegel exercises before the surgery.

And 1-3 would are helpful for any treatment even active surveillance.

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For more information, visit the Duke Health Prostate Cancer Center