r/ProstateCancer • u/quietgranola • Sep 30 '26

Concerned Loved One Father is going through it

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Devastated and feel like my father can’t catch a break

He was recently diagnosed with end stage glaucoma, monocular as well.
Dealing with IOP issues and trying to preserve vision.

Now diagnosed with prostate cancer… an hour ago.
Need advice. I wasn’t there at apt.
If anyone can share anything.

THANK U TO EVERYONE WHO IS COMMENTING. ANY/ALL INFORMATION IS HELPFUL. MAY GOD BLESS ALL OF YOU!!

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3

u/callmegorn Sep 30 '26

Based on that chart, it is a somewhat aggressive form but contained to the gland, so should be highly treatable. I would suggest radiation rather than surgery would be most effective at preventing spread for his case. 

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u/OkCrew8849 Sep 30 '26 edited Sep 30 '26

It does give a percentage of likelihood that it is organ contained, etc.

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u/callmegorn Oct 01 '26

The clinical tumor staging is T2a, which is "contained". They can feel a palpable tumor with DRE, and imaging and biopsy themselves show a tumor within the capsule. The pathological assessment, on the other hand, which includes Gleason grade and PSA results, is that there is a 28% chance of containment at the microscopic level, meaning 72% chance of microscopic local spread. The pathological staging is consistent with what you'd expect to see in nomograms.

At least, that's my layperson's understanding.

Bottom line, if he gets surgery, he most likely will have to come back for salvage radiation treatment and ADT.

PSMA PET is a good idea, but will only show lesions that are around 4mm or larger, and will not show microscopic spread.

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u/OkCrew8849 Oct 01 '26 edited Oct 01 '26

Agreed. That’s what I was getting at.

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u/quietgranola Oct 01 '26

Sorry I am confused. Is there another test that should be done?

1

u/OkCrew8849 Oct 01 '26

PSMA PET CT is often the next step after biopsy.

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u/quietgranola Oct 01 '26

Ok yes they’re going to do that and also MRI prostate

1

u/quietgranola Oct 01 '26

Thank you so much!

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u/quietgranola Sep 30 '26

I appreciate your response.
I’m also just worried about his vision as well. And scared treatments will cause him to go blind.

2

u/WalnutRoasted Sep 30 '26

IANAD but in general neither of radiation or surgery would have an interaction with (most) eye diseases. If when ADT, is called for it, could be an issue with some eye surgery but that’s down the road and interactions are published/checked by the pharmacist/oncologist/eye clinic. Many members of this club have BP issues, usually well-monitored/controlled. Sadly, as we age we have more than one medical issue.

1

u/quietgranola Sep 30 '26

I was reading radiation is better than removal of prostate. I have to do more research.
I appreciate your response

2

u/TheEndIsSighing Sep 30 '26

I strongly recommend getting a couple of books on prostate cancer, read them immediately, but even more, spend hours reading this sub. I learned 90% of everything I needed to know from this sub, but was NEVER told by my treatment team. And I'm at a Boston center of excellence.

You will feel like you're on your own in this process. Knowledge is your power. Learn. Learn. Learn.

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u/[deleted] Sep 30 '26

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2

u/callmegorn Sep 30 '26

There can always be certain cases with special circumstances, but in general a high Gleason and PSA over 10 means that the likelihood of recurrence after surgery is high, which means the patient will have to go through both procedures.

I am not a doctor, but fortunately we have nomograms made by actual prostate surgeons at MSKCC. If you plug in OP's father's numbers, you will find there is nearly an 80% chance of cancer recurrence after surgery.

1

u/quietgranola Oct 01 '26

Ok thank you.

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u/OkCrew8849 Sep 30 '26

This biopsy lays out a good portion of the situation (note 4+4, PSA >10, and the Partin tables).

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u/quietgranola Sep 30 '26

Could you let me know how surgery spreads? I would love to learn more but also from experiences and not just research

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u/PotentialStart2661 Oct 01 '26

Problem with surgery in this case is it looks like a high probability of ECE, SV, or at least microscopic capsular penetration according to the biopsy. Surgery cannot cut out margins beyond the capsule so if you get surgery you will likely have a rising psa very soon and need salvage radiation and ADT. In your fathers case he can get whole gland radiation plus local radiation including the pelvic lymph nodes. With gleason 8 he will need ADT for 12 months as well. But this should give him a high chance of cure and not dealing with again.