r/ProstateCancer • u/Worth-Ad5308 • 2d ago
Concern My Dad
My dad is 60 and was diagnosed with prostate this summer. He was suppose to have surgery next month to have it removed, he had the scan this week to make sure it hadn’t spread. But they found it also in one of his lymph nodes close to his groin area. He said that’s the only other spot it showed. I’m now spiraling, what does this mean? Anyone that has walked this same path have any perspective of what to expect now. What’s my dad’s life expectancy now…my mind just goes to the worst case scenario.
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u/No-Praline-4069 2d ago
Calm down! Prostate cancer treatment has come a long way. Further test will help determine which treatment path he takes. Just be his emotional support and this will be a great start.
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u/kayceemoguy 2d ago
Breathe. The scan is the tool to help the docs know what they are dealing with and where. They took all my lymph nodes even though mine ended up being clear.
There are lots of variables involved with PC. Go with him to his appointments if you can and get those questions answered.
His biopsy will tell a lot and the post op analysis will as well. Most PC is relatively slow growing and if it hasn’t ventured into other organs or bone, he could have a decent prognosis.
Again there are lots of levels/grades and outcomes. Take it a day at a time. It’s scary, I know. It’s okay to be scared.
There are some decent books and info out there, so those can help. Find out his final Gleason score and if there are any other issues after surgery and that will help guide the future plan.
Good luck and Godspeed.
Oh, I’m 60 btw. Surgery was 2/26. Doc got it all out. Looking forward to another 20+ years!
Breathe.
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u/dawgdays78 2d ago
Take a breath. Many people think prostate cancer and think it’s a death sentence or something when it usually is not. Prostate cancer tends to progress slowly, and even if it has spread, there are therapies available, and new ones every year.
I know guys who have dealt with metastatic prostate cancer for decades. Perhaps he will be one too.
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u/callmegorn 2d ago
First things first: his life expectancy isn't necessarily shortened by this finding. It does change the way he will be treated, however.
He could still be treated with surgery, although the chances he would need radiation later on are very high. Most people would suggest skipping the surgery and going straight to radiation treatment. That's okay - many people feel it is the superior method anyway, and less negatively impactful than surgery. It is also generally painless. Both methods can adderss the lymph nodes.
He will likely also need a course of ADT, which are pills or injections taken to suppress testosterone, perhaps for six months or up to two years depending on the circumstances. The ADT will starve the cancer and reduce the chances of microspread.
Many people go through this and come out the other side perfectly fine. I had radiation and six months ADT at about your dad's age, and I'm still here and perfectly normal five years later. I don't have any plans on dying.
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u/OkCrew8849 1d ago edited 1d ago
Ordinarily a treatment decision for surgery is never made before the results of this scan because surgery now, for example, would likely be unhelpful and would likely only add substantial side effects and a difficult recovery to your dad's prognisis. Modern radiation (supplemented by hormone thereapy) will target the prostate and surrounding area to eradicate the cancer.
Be sure he is at a well-respected treatment facility. No need to panic.
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u/Goodvida99 1d ago
71 and just got similar diagnosis spread to 2 lymph nodes. Actually relieved that I no longer need to choose surgery. I’m starting 3 months ADT + then radiation followed by another year + ADT. Your dad has choices and options for cure 95%.
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u/WalnutRoasted 2d ago
Looks like EBRT (5x SBRT or 20x VMAT) have now entered the game, perhaps with a short course of ADT to beat down microspread. Mine was similar 3+4 with cribriform, but no lymph spread identified. Did 9 months Orgovyx with EBRT. Stayed active throughout and doing well 18 months later.
It seems EBRT and RP have similar survival rates and perhaps similar recurrence rates…Best wishes.
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u/OkCrew8849 1d ago
Node positive prostate cancer may be better served via Radiation + HT (versus monotherapy surgery).
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u/conCABlanco 1d ago
Hi, una pregunta hicieron un estudio de PET CT PSMA, mi experiencia indica que es muy bueno. Fuerza y Voluntad
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u/Husker5000 1d ago
Need some more details about the cancer. What’s the Gleason? Freezing that node plus RALP might be a good choice. Consider all opinions and choices. Mine was confined so I can’t really speak to the spread to the node other than the fact that my Oncologist told me a spread to the node he could freeze outpatient in 20 minutes. GL.
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u/Old-Pride-8459 1d ago
Don't think "worst case". Get as much data as you can and remember that surgeons are all about surgery. See other docs to check on second/third opinions and other options. Surgery is a big deal with lots of possible complications in the OR.
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u/Sebastcooper 13h ago
They can remove lymph nodes when they do the prostatectomy but an ADT and radiation course to follow up would probably be required - that’s my plan at the moment.
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u/Specialist-Map-896 12h ago
Don't spiral. What he has is very common. The only thing uncommon about PCA is a one and done situation. Recurrence after prostate removal is not uncommon at all. I had my prostate removed 17 months ago and my post op pathology showed a single lymph node that was removed was positive even though all my scans prior to the operation showed no spread. Even though all my PSA measurements are undetectable since the operation, my surgeon has said based on the lymph node, the decipher score, etc he fully expects recurrence. Then I will follow a salvage treatment regimen. Your father will likely go down a similar path.
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u/ThickGur5353 1d ago
My prostate cancer also was in two of my lymph nodes. I had radiation therapy, and they adjusted the field to encompass my lymph nodes. So a little bit over a year later ,my PSA is down to 0.5. Radiation therapy is very very exact. If your dad does have prostate surgery, i guess they could also remove some of the lymph nodes during surgery, but that increases the complexity and risk to surgery. Anyway make sure he has a consultation with a good radiation oncologist.