Shocked

Hi everyone 

Im just posting an update on my husbands diagnosis. 
We went to Christie’s today and was told the bone scan was clear which has been a huge relief. 
Had treatment options explained and he is having a RP as this was felt best option as he already is having urinary symptoms that they felt could be made worse by brachytherapy. 
All in all a much more positive experience than we had with the very down beat surgeon. 
it was explained to us that the stage is currently  T2 No Mo

They expect the RP to be curative at this stage as there appears to be no disease outside prostate or in the SV etc 

This was the best news we could have hoped for today. 
I would like to once again like to thank all those who replied to my initial post and helped us through the dark first days. 
I will continue to post updates as this journey continues. 

Margot, I was 46 when diagnosed.  I was pT3b, Gleason 9, extra capsular extension, positive margins, perineural invasion.  I had a prostatectomy and a year later radiotherapy and hormone therapy.  My PSA has been undetectable for years.   8 years later, I consider myself cured, although I accept it could still 'come back'.  Your husband's case is serious, but not incurable.  I'm proof of thar.

Hi All

This is my first post, my husband (58) has been diagnosed with Gleason 9 (4+5) today. I’m just shattered despite expecting a cancer diagnosis after a PIRADs 5 MPMRI showing a 16mm left mid lesion. PSA 6.6 
His histology showed not EC or SV involvement and no node involvement or evidence on bony mets

he has a bone scan scheduled and an appt with oncologist. 
The consultant was so pessimistic about the aggressive nature of the disease and non committal when I asked if he expected to see anything in bone scan? 
The specialist  nurse was more positive she said until proved otherwise he has one tumour in one half of prostate that shows aggressive nature but is still curable. 
Can anyone give me any hope of cure with this diagnosis or is mets or recurrence a forgone conclusion. 
thank you in advance 

G9 doesn't necessarily relate to spread beyond the prostate, though so far so good for your husband. There are people with G7 who have mets spread to far flung places and that's when it gets tricky to go for a "cure". If a biopsy has shown that there's no spread outside the prostate it's pretty pessimistic to speculate about invisible mets for which there's no evidence.

At the relatively young age of 58 there's a higher chance that the cancer will be aggressive than is the case for old gits like me [78] and age does have some bearing on which treatment you might choose. At his age he might be able to go for a prostatectomy, partly because it could remove all of the cancer but also because if he gets recurrence it could be treated with RT. There is a very slight chance that having RT at his age might increase the chances of him getting cancer related to that RT later in life but it's a very low increase in probability beyond the normal range.

On the other hand, RT has improved hugely in recent years so it could also be a first choice. Both treatments have side effects during and after, so it might be mistake to think that simply removing the prostate will solve all his problems. If there's any spread to the prostate bed,  RT has a fair chance of taking it out at the same time as it's blasting the key points in the prostate.

There's always brachytherapy and it might be an option.

Jules

Thanks for the update Margot.

Phew, best possible outcome Margot. [booo to the downbeat surgeon]

Jules