Hello, El:

I'm truly sorry you've had to join the group -- and you're so young, too!
But there are lots of reasons to hope.  Ron has given you some of his
wisdom, and quite a few others will join in shortly to wish you well and
offer theirs, too.  

I'm a little confused by your report, in which you have "T1c (Clinical), T2b
(Pathlogical)."  Usually, the clinical staging occurs at the time of
diagnosis, while the pathological staging occurs after the gland has been
removed and analyzed.  Do you mean that one doc couldn't feel it (T1c)
while another could (T2b)?  That's what happened in my case; I had a T1c
staging from my local uro who did the biopsy and diagnosis, while the
surgeon who eventually did the prostatectomy staged it as T2b.  

My local uro sent off the core samples to a pathologist about an hour's
drive from here (west-central NY).  When I settled on my surgeon at Johns
Hopkins, he insisted that I use a pathologist from JH, which was fine with
me.  The Gleason scores did change in my favor.  So, I agree with Ron; get
a second pathologist to take a look at those samples.  

I was diagnosed in late July of 2007, and had my laparoscopic radical
prostatectomy (LRP) in mid-November.  My local uro all but advised me not
to use him; that's why I shopped around a bit.  Baltimore was a good choice
for me, as I had in-laws to recuperate with, and Johns Hopkins has a very
good team.  Others will tell you good things about other places.  If you
have not done so already, it is very much worth your while to get a surgeon
who does this procedure all the time -- more experience translates into
lower risk of side effects.  But you do have time to consider your options.
October is probably not too long to wait.  Prostate tumors are usually
pretty slow-growing.  

Whereabouts are you?  I'm asking because a lot of us can recommend places
for you to visit:  hospitals, support groups, and such.  If you're on the
West coast, you probably won't think about JH or MSK or other places over
on this side.  

There's also a lot of reading you should do -- many of us recommend our
favorite books.  Here are mine:

The Prostate Book, by Peter Scardino
The Prostate, by Patrick Walsh (get the latest edition)
Prostate Cancer for Dummies, by Paul Lange

Others will post some web sites that are really good sources for you as
well.  

Good luck with this, El, and please keep us posted on your progress.  I
imagine that it all feels a little overwhelming now, but that will pass.  

All the best,

charlie

Hi EW...Studies indicate that for people with low-risk disease (e.g.
T1c, GS=6, PSA<10), waiting a month or two generally (that's a
probability statement) will not matter.  In other words, the odds are
on your side that waiting a month will not worsen the situation.

Your steadily rising PSA, high core involvement and low GS caught my
eye.  An accurate Gleason score is important in terms of treatment
selection and outcome prediction.  Have you had your biopsy samples
read by someone who is expert in PCa pathology?  If not, it might be
something to consider.  Such second readings are usually covered by
insurance.  If you search "pathology expert" within this newsgroup,
you'll get some leads on names...Best wishes and good health, ron

Sorry to hear it. I'm going to be 6 weeks post op this Tuesday, so as
you can see by the info in my sig, my biopsy was in March and the
procedure was done in June.

After deciding on surgery, I opted for the RLRP mainly because of the
minimally invasive incisions and low chance for a need of a blood
transfusion. As of today, I feel I am doing very well at this early
stage of recovery.

I told myself, the bad new was I was only 45 and that was way too
young to be confronted with this. I told myself the good news was I
was only 45 and in a position to beat what has hit almost every male
ancestor in my family tree.

All I can recommend is read up on this, try and match the treatment
with your situation and don't look back on your decisions. While I was
extremely grateful of my local uro for having the wherewithal to
insist on biopsying me, I was not comfortable with him as my surgeon
and I picked a surgeon who I felt good with. By the time I did my perp
walk to the OR suite, I was a free man!

Now I go from PSA test to PSA test hoping to stay free....

Best of luck to you.

El Woody,

You have a goot set of numbers for surgery and your age pretty much
pre-empts everything else.  You can wait a month and your first task should
be to find the best surgery within in your area or means.  You should ask
each one whom you investigate how many surgeries they do, how many
nerve-sparing surgeries, and what their success rate is.

Since you have already determined surgery, I would recommend you immediately
run out and get Dr. Patrick Walsh's Guide to Surviving Prostate Cancer.  The
first edition was getting a little dated and I have not seen the second.
But, he does a tremendous job in describing how to select a surgeon.

To complement the therapy your doctors have laid out for you, my Dad really
believes that regularly taking Pomegranate extract tablets and drinking
Pomegranate juice played some roll in his recovery (with his conventional
radiation treatment, of course.)

His doctor too, one of the top Cancer specialists in the world famous
Christies Hospital (A.K.A. Holt Radium Institute), certainly believes in
complimenting traditional therapies with high dose antioxidants. They are
believed by many to slow the development of the bad cells (and possibly
prevent them growing for the undiagnosed). Although he is less than happy
about those who rely solely on these kind of treatments....and I'm sure we
can understand why.

But the research into the effects of antioxidants on cancer cells has been
interesting to say the least. Especially the tests done on mice with
prostate cancer cells. It was that experiment that led my dad to try them.
His doctor described his recovery, and his consistent negligible PSA scores
for two years since, as "quite remarkable". How much of that was due to his
complimenting his 'traditional' therapy with antioxidants we just don't
know......but what can you lose trying? A few measly quid?

Best of luck with whatever treatment you have though, and I wish you a
speedy, full recovery!