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california bob
New Member


Date Joined Jan 2008
Total Posts : 3
   Posted 1/29/2008 4:16 PM (GMT -7)   
Found out a week ago that i had adenocarcinoma early stage gleason around 6 prostate at 35 grams. talked to
uroligist / surgeon who did the biopsy and he was undecided as to radiation therapy or surgery but leaning towards surgery which would have to be open as he was aprehensive about lapriscopic due to a previous orchiectomy
which was followed up by radiation therapy as a precaution in 1994. he said that the previous radiation might have caused scaring etc. which might make it difficult towards the end of a lapriscopic procedure.also thinking about
"seeds" but as i am 60 i might have 20 or so years left and would feel more "certain" about surviving with RP.
does anyone have any thoughts as i am uncertain as to which procedure to choose. the seeds are alot less invasive
but the RP is more definite???? just don't know!!! anyone with any thoughts on the matter is appreciated!!
my name is bob and i hope to hear from someone out there !! thanx

Paul1959
Veteran Member


Date Joined Nov 2007
Total Posts : 598
   Posted 1/29/2008 4:30 PM (GMT -7)   
Bob,
Welcome. you've found the best site for this stuff. As you are discovering, there is no right cure. Read, read, read, talk to others as you are doing on here, and then go with what your gut tells you. There are guys here who cover the whole spectrum. I'm just 3 weeks out of surgery. But ALL treatments have side affects associated with them. Decide what is most important to you - and go with it. you will be supported no matter what.
Paul
47 at Diagnosis.
Father died of Pca 4/07 at 86.
1/06 PSA 3.15
1/07 PSA 4.6      (Biopsy 3/07 just suspicious)
10/07 PSA 5.06   (Biopsy 11/07  1 of 12 with 8% involvment) (1mm)
Da Vinci surgery Jan 5, '08 at Mt. Sinai Hosp. NYC  www.roboticoncology.com
Saved both nerve bundles.
Path Report:  Stage 2cNxMx
-Gleason (3+3)6
-totally contained to prostate,
-10% involvement in L & R Mid lobes
 
 


biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1463
   Posted 1/29/2008 4:42 PM (GMT -7)   
Hey Bob,

You found the right place for support and information. Unfortunately no one but you can make the treatment decision. There are several treatments options represented by our folks here on the forum as you have probably found. And we all have our own reasons for our choice. The important thing is to study those options and when you decide, don't ever look back. All have there upsides and downsides and one person's outcome with a given procedure doesn't mean that yours will be the same. We all are different.

The really nice thing about this forum is that we are free to tell our biases and reasons for our treatment without meaning to offend or put down anyone else's decision. I chose surgery simply because I wanted the cancer out of me as soon as possible. Others chose various forms of radiation treatment and have no problem waiting for the results to appear over several months. That would have made me crazy - but that's just me. Also the side effects of surgery happen immediately. I was lucky in that I was continent the day after the catheter came out. However now at 13 months post-op I still have severe ED. I treat it with Viagra and injections of Trimix. The radiation guys don't have these immediate problems so in that respect, radiation is better.

If it all sounds confusing, its because it is. But please stay with us. We can all get well together...

Jim


Age 73. Diagnosed 11/03/06. PSA 7.05. Stage T2C Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Catheter out on 12/13/06.  Dry on 12/14/06.
Pathological stage: T2C N0 MX. Gleason 3+4.
PSAs from  1/3/07 - 1/17/08 0.00. 
Next PSA test on 7/17/08
 
"Patience is essential, attitude is everything."
 


Tim G
Veteran Member


Date Joined Jul 2006
Total Posts : 2246
   Posted 1/29/2008 5:12 PM (GMT -7)   
Welcome, Bob--I'd suggest that you read thru some of the posts and information on this forum to get an idea of some reasons folks give for the different treatment options.

Ultimately the method of treatment you choose is based on how you weigh the information and the options regarding your own situation. The perplexing thing is that no matter what you choose, each man's experience with the outcome and side effects is a little different.

My wife and I read books and articles on prostate cancer, got a second opinion, talked in person to men who had been treated for prostate cancer, and prayed.

Ultimately we decided on surgical removal. We choose this option for the following reasons: (1) Pathological staging that determines the exact extent of the tumor(s) and the prostate margins. (2) The PSA goes immediately to zero. (3) More options are available if the cancer returns, including salvage radiation if needed (4) Not as likely to experience painful urination and diarrhea (5) Impotence and incontinence tend to get better over time.

That said, others may have strong reasons for choosing another treatment option. There are so many factors involved. I had surgery a year and a half ago and except for erectile dysfunction requiring penile injections I am ok (Read--no incontinence or recurrence)

I'm a different person after diagnosis (A.D.) than I was before cancer (B.C.). Having cancer may go away, but having had cancer never does.
When I feel a joint pain in my pelvis, I don't think arthritis, I think--"It's back!"

My wife and I have a better relationship than ever, having traveled the cancer path together, heart-to-heart and hand-in-hand, these past two years. I wear the world more lightly than I once did. Life is richer and better for having had prostate cancer.

There are some terrific men and women on this forum whose stories are heartbreaking, enriching, challenging, inspirational and hopeful. Hope you find what you are looking for here. We're here to help! Take care and hang in there...Tim


Age 59 PSA 2.6 PSA velocity quadrupled in 1 yr 
1 of 12 biopsy cores positive (5% involvement) Open RP 6/21/06  Gleason 5
Cancer confined to prostate  Post-op PSA's non-detectable


california bob
New Member


Date Joined Jan 2008
Total Posts : 3
   Posted 1/29/2008 5:14 PM (GMT -7)   
thanx for all your responses as i do appreciate the input . are there any statistics on RP vs. bracheatherapy
do more people survive longer with RP or radiation . seems like less problems with radiation but hate to choose that treatment option and then regret it if cancer spreads in 5 years and i go to game level 2 (heaven i hope) but i would like to stay on planet earth as i feel i have more to do and i am not ready to go yet!! so WHAT TO DO????? it just seems as if you remove the problem as opposed to treating it you stand a better chance of survival on a long term basis. ???????? any thoughts!!!! thanx BOB

pcdave
Regular Member


Date Joined Oct 2006
Total Posts : 444
   Posted 1/29/2008 5:51 PM (GMT -7)   
Dear Bob
 
You have come to the right place to start your journey and decide on what PCa treatment will be best for you after extensive research.  Some believe that surgery gives an edge in survivial (especially for younger men), but some studies have indicated, depending on your stage of cancer, that all treatments may all produce similar results.  So much depends on whether or not the cancer has escaped beyond the prostate (to the margins) and to what degree. 
 
Surgery tells you immediately if your PSA goes to "0" and also allows the prostate to be biopsied to confirm your exact stage of cancer (sometimes it is worse than projected by the pre-treatment tests).  While the surgeon will undoubtedly look for and remove cancer from the margins, it may be impossible to remove it all, especially if it is microscopic in nature.  The post-surgery biopsy should indicate if the cancer had spread beyond the margins.  Surgery can, however, produce negative incontinence and impotence side effects that other treatments may avoid to a larger degree.  Even with surgery, there is no guarantee that the cancer will not return.  It can recur with any type of treatment, especially if the cancer has progressed beyond the earlier stages.  With radiation you have to wait up to 24 months or more for the PSA to reach its nadir (low point). Radiation treatment usually radiates some portion of the margins around the prostate to hopefully catch any cancer which may have escaped beyond the prostate. If cancer is found in the margins after surgery, then you often also have to be treated with radiation.  I consulted with a PCa medical oncologist at a top cancer center and he concluded with me that I had an equal chance of a cure with any of the treatments.  If you can consult with a PCa medical oncologist it may be helpful in your decision making process.  One of the most important aspects of making a treatment decision is to get a top doctor to treat you, even if you have to travel from your home area.
 
None of the foregoing swayed me to have surgery, notwithstanding that I consulted with a top robotic surgeon.  There is a link below (see signature footnote) to my journey with prostate cancer.  I chose proton radiation--you should educate yourself about the advantages/disadvantages of  proton radiation and all other treatments. Other than surgery, some of the members here have been treated with proton radiation, IMRT/IMGT x-ray radiation and also brachytherapy.  The majority of members here have been treated with surgery, but don't let that unduly sway you in making your choice. There is also a subject index at the top of Page 1, which includes a list of suggested books to read. Also, you may want to visit the website http://www.yananow.net (You are not alone) which tells the experiences of men who have treated with all of the present PCa treatment options.  They often give contact information so that you can network with them via e-mail or phone which is very helpful.  I was able to contact a patient who was treated with proton radiaiton which helped to convince me that it was the right choice for me. Whatever you decide on, best of luck. 
 
Dave


-69 years young!
-29 core biopsy 9/27/06 at age 68
-PSA 7.1, Stage T1c, Gleason 7 (3+4) [less than 20% in one area], Gleason 6 [less than 5% in two other areas], Negative DRE, bone scan and Endorectal MRI. 
-Completed 39 Proton radiation treatments 2/22/07-4/18/07.   
-PSA History: 7.1 pre-treatment; post treatment: 2.1 (3 mo.), 2.4 (6 mo.), 1.7 (9 mo). Radiation oncologist said the 3-mo. drop of 70% exceeded expectations and the slight 6-mo. movement upwards was not a cause for concern now.
-The following is a link to My Journey With Prostate Cancer -- Proton RadiationTherapy.  
 
 

Post Edited (pcdave) : 1/29/2008 6:17:11 PM (GMT-7)


Paul1959
Veteran Member


Date Joined Nov 2007
Total Posts : 598
   Posted 1/29/2008 6:18 PM (GMT -7)   
Bob,
would you put a signature in your posts (go to control panel and do the edits) with details like your age and pathology info. I was 47 at diagnosis and part of my decision was the fact that I am hoping to get 40 more years out of this carcass. Surgery gave me the biggest peace of mind that it would be gone forever. If I were older, I probably would have chosen radiation. I felt that if cancer found a home there once, it would probably find it again over the course of forty years. This is separate from a recurrance of the same cancer. I had a genetic propensity for it since my dad died of it. so, for me, I wanted it out. 


47 at Diagnosis.
Father died of Pca 4/07 at 86.
1/06 PSA 3.15
1/07 PSA 4.6      (Biopsy 3/07 just suspicious)
10/07 PSA 5.06   (Biopsy 11/07  1 of 12 with 8% involvment) (1mm)
Da Vinci surgery Jan 5, '08 at Mt. Sinai Hosp. NYC  www.roboticoncology.com
Saved both nerve bundles.
Path Report:  Stage 2cNxMx
-Gleason (3+3)6
-totally contained to prostate,
-10% involvement in L & R Mid lobes
 
 


jetguy
Veteran Member


Date Joined Sep 2006
Total Posts : 741
   Posted 1/29/2008 6:47 PM (GMT -7)   

Dear Bob,

You will find that most on this site have had surgery of one type, or another.  A few of us have done other things.  I did Image Guided IMRT and am happy with the results.

Please re-read the above posts.  They are well written and tell the truth.  In fact, many of us are voting for biker90 for President!

Regards,

Bill


August of 2006, PSA up to 4.2 from 2.7 one year ago. 
October free and total PSA 12% free and 5.0 total.
A month, or so later, 4.7.
Late in the year decide on Image Guided IMRT.
Begin 43 treatments on January 23, 2007 and finish on March 23.
Four month post treatment PSA is 1.9.
Seven month PSA is 0.8.


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 1/29/2008 9:34 PM (GMT -7)   
Welcome Bob!
 
After reading your post I'm guessing you had radiation / orchiectomy for testicular cancer? If so, congratulations on what sounds like a great outcome!
 
My DH, Paul was treated (surgery / radiation) in 95 for a stage II TCa. Paul also had an exploritory biopsy in 97 on the other side and many moons ago, a hernia repair. The potential for scar tissue was taken into consideration when he chose a robotic assisted prostatectomy. It was made clear that there was a small chance of converting to an open procedure if scar tissue became a pitfall. He was very furtunate that the surgery went smoothly. There was a tiny struggle to seperate a little of the nerve on one side. As it was put, "most of the nerve on that side was spared". I doubt that was related to scar tissue. Other than that, Paul has done quite well. No drips, no leaks, and managable ED.
 
Admittedly, ED was more of an issue than average for his age (48 at the time) but, we knew in advance this could be the case. He took a solid year of daily, low doses of Levitra or Viagra and used a pump early on to keep his tissues healthy. Today, closing in on 3 years later, Paul has very good function using oral meds and even some good days without! Oh, I forgot..he did use shots for about 4 months in the later part of the first year.
 
I hope this offers some insight into what could be expected. A good surgeon, good luck and taking advantage of tools available to men during the recovery period gives a man a reasonable chance at a successful outcome. Good Luck to you.
 
Swim
 


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8122
   Posted 1/29/2008 11:42 PM (GMT -7)   
Hi Bob,
You are a very unique case at this site because you had the Orchiectomy. Considering that the main thing that prostate cancer thrives on is testosterone, you should have a low amount in your system unless you take testosterone shots. I thinks it raises an interesting point in deciding on your treatment. One question I would ask is, is it possible that you have hormone refractory disease? If so, I would not bother with the surgery and choose radiation. Since we haven't had a case like yours here that I know of, I am just adding a possible good question to your list. the closest we have had here are some testosterone defficient cases.

But welcome to this wonderful site, filled with great people and posters. We are your friends in your battle. Good Luck and God Bless you!

Tony
Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology was poor: Gleason 4+3=7, 4 positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
 
My PSA did drop out after surgery to undetectable.  It has not returned and I will continue HT until January '08.
 
My Life is supported very well by family and friends like you all.
 
Visit my journey at:
 
STAY POSITIVE!


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 1/30/2008 5:53 AM (GMT -7)   
Tony,

Paul had an orchiectomy and radiation 10 years before PCa was diagnosed. The evidence is there, however no way to prove that scatter radiation was the cause of his Gleason 6. The only suggestion was that the prostate samples resembled those found in radiation cases. His history eliminated further radiation as a treatment choice. He glows a little already I guess ;>)

swim
 


Big one
Regular Member


Date Joined Jan 2008
Total Posts : 21
   Posted 1/30/2008 6:52 AM (GMT -7)   

Hi Goliath,

Welcome. Just diagnosed as well. I just read this article this morning and it answered a lot for me. Maybe it can be useful for you. If not it will probably provide a few laughs. Keep reading .

Lili

www.yananow.net/Mentors/GlenL.htm

 


Mo & Lili in Ohio
Age 57
Prostate size 116 grams !!
Diagnosed 1/25/08 , DRE negatif, PSA 5.7
Gleason 3+3
3 out of 12 samples 10%, 20%, 40%.
Bone scan and cat scan to come


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8122
   Posted 1/30/2008 7:55 AM (GMT -7)   
Geez, Swim,
That I did not know. Like my wife says, probably because I did not listen. Your posts here then gives this gent some good insight. I believe then that Paul had testosterone replacement therapy?

Tony
Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology was poor: Gleason 4+3=7, 4 positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
 
My PSA did drop out after surgery to undetectable.  It has not returned and I will continue HT until January '08.
 
My Life is supported very well by family and friends like you all.
 
Visit my journey at:
 
STAY POSITIVE!


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 1/30/2008 10:01 AM (GMT -7)   
Tony,

Yes, Paul is currently on T therapy. Starting testosterone patches is what awoke a sleeping dragon. His PSA jumped real quick leading to an early diagnosis.

Swim
 


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 1/30/2008 1:35 PM (GMT -7)   

  tongue Hi  ~  Bob & Loved Ones,

 

Welcome   to…   ~ HealingWell ~

 

and

 

A   Special   Warm Welcome  to  You !

 

Click  on  link  below for important information that will help you ~ help us!!

 

Welcome New Members ~ to HealingWell

 

v       This is a journey best traveled with friends. 

 Welcome ~ New Friend from all the members here... on HealingWell.com

 

v      IdahoSurvivor ~  Moderator for Prostate Cancer Forum

http://farm2.static.flickr.com/1160/1313099593_9f819e3ff8.jpg

 

v      bluebird ~  Moderator for Prostate Cancer Forum

http://i206.photobucket.com/albums/bb179/mamabluebird1955/mamabluebirdWelcome.jpg


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 1/30/2008 1:48 PM (GMT -7)   

  tongue Hey ~ Bob & Loved Ones,

 

Gentle Hugs and Warm Thoughts

 

I know we can “all” make “Your Journey” smoother ~ just by being here for you!  

Thank you for reaching out!!! 

 

You’ve just made your own journey a lot smoother.  There are a lot of Helping Hands here… and just by reaching out like you did ~ you will have a much easier time.  We’ve been where you are now…. Knowing you aren’t alone… makes a big difference in psyche and spirit.

 

We will always be here for you… This is truly a great forum!!! ~ You have joined! You are now part our forum family ~ a group of wonderful individuals who are so willing to share their journey with you!  Please take time to follow the link in your Welcome Message above… it will help to ease some of the unknowns…

 

It helps “all of us” ~ to help you ~ if we know where you are on your path.

So ~ Please stay with us and take our hand when you need it! 

Keep posting.... OKAY!!   

  

KNOWLEDGE IS POWER... and POWER conquers fear

  

YOU MAKE THE DECISIONS… YOU HAVE OPTIONS…

~ and ~

Your decision will be the right decision for you!!!

 

 

Buddy & I invite you to visit our personal thread “Our Journey”… listed in our signature below.

Hoping our experience can help you over at least one stepping-stone on your journey. 

http://i206.photobucket.com/albums/bb179/mamabluebird1955/Stepping-StonestoHealingWell.jpg

 

Our thoughts and prayers will be with you as you continue to move forward in your search for answers… Stay Close!

In Friendship ~ Lee & Buddy


mama bluebird - Lee & Buddy… from North Carolina

 

v          We invite you to visit our personal thread:  Click Here:  “Our Journey” ~ Sharing is Caring 

April 3, 2006  53 on surgery day

RRP / Radical Retropubic Prostatectomy

PSA 4.6   Gleason  3+3=6    T2a   Confined to Prostate

3rd PSA 08-07-2007 Less than 0.1 Non-Detectable :)


smilingoldcoot
Regular Member


Date Joined Jan 2008
Total Posts : 338
   Posted 1/30/2008 4:35 PM (GMT -7)   
Hi Bob
 
I am recently diagnosed also so I can't impart much information except you have come to a great place with great folks.  You will be in  my prayers tonight.
 
Keep smiling yeah
Richard & Debbie
The Shores of Toledo Bend Lake Louisiana
PSA 11/08 was 4.9 PSA 12/08 was 7.7
Biospy 1/10/08 positive for high grade Cancer but no Nodes noted
Gleason score 9, Stage T1C
Bone scan negative with additional exrays ribs and pelvic
Referred to M.D. Anderson, Houston, TX
Turn Stumbling Blocks into Steping Stones


california bob
New Member


Date Joined Jan 2008
Total Posts : 3
   Posted 1/31/2008 9:45 AM (GMT -7)   
i don't know if it is because i previously had testicular cancer (1994) and had a successful outcome,but i am
not worried or depressed about the eventual outcome of my prostate cancer as it seems to be that we identified it early (i hope) but i am aprehensive over the RP surgery and the potential for heart attack or stroke etc. i would hate to die on the operating table when i could have lived another ten or so years just
doing nothing or 15 years or more with radiation!!! anyone know the percentage of patients who terminate
due to the operation??? I guess i can deal with the after surgery concerns and discomfort but the surgery
and anesthesia are big concerns for me !!! thanx Bob H.

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4461
   Posted 1/31/2008 10:02 AM (GMT -7)   
My gas guy said during preadmit that deaths during the surgery from gas or other causes were no different from any other general surgery cases.  Something less than 1% I think he said.   So PCa, heart valve or bone setting would all the the same risk, as far as gas goes....according to him.

wd40
Regular Member


Date Joined Jan 2008
Total Posts : 218
   Posted 1/31/2008 10:38 AM (GMT -7)   
If you drive a car, I bet you are at higher risk than surgery. Don't know that but I bet it is true.
12/06/07 DaVinci and open prostate surgery after difficulties in breathing stopped the davinci.
Walked a lot
90% control the day the catherter removed.
pad only for a sneeze before the week was out
No pads most of the second week.


Tim G
Veteran Member


Date Joined Jul 2006
Total Posts : 2246
   Posted 1/31/2008 2:56 PM (GMT -7)   
california bob said...
i don't know if it is because i previously had testicular cancer (1994) and had a successful outcome,but i am
not worried or depressed about the eventual outcome of my prostate cancer as it seems to be that we identified it early (i hope) but i am aprehensive over the RP surgery and the potential for heart attack or stroke etc. i would hate to die on the operating table when i could have lived another ten or so years just
doing nothing or 15 years or more with radiation!!! anyone know the percentage of patients who terminate
due to the operation??? I guess i can deal with the after surgery concerns and discomfort but the surgery
and anesthesia are big concerns for me !!! thanx Bob H.
Bob--If you are otherwise in good health, surgery presents few problems at your age. My surgery was relatively easy.  I had never had major surgery before, so I was a little apprehensive as well.  Take care and hang in there...Tim


Age 59 PSA 2.6 PSA velocity quadrupled in 1 yr 
1 of 12 biopsy cores positive (5%) Open surgery June 2006 
Cancer confined to prostate Gleason 5  Post-op PSA's non-detectable


tullamore
New Member


Date Joined Feb 2008
Total Posts : 4
   Posted 2/4/2008 5:50 PM (GMT -7)   

Hi Bob,

You should do some reseach on ablatherm HIFU. It may be a good alternative even after your previous radiation therapy. There's a lot of information on it in Europe, specifically Germany. Here's a website that might help www.cmedtravel.com. Good luck.

tullamore


Bootheel
Regular Member


Date Joined Oct 2007
Total Posts : 300
   Posted 2/5/2008 9:47 AM (GMT -7)   

Dear Bob,

From reading your post, you have plenty of time to make a good sound decision.  I spent several months researching all of my options and the side effects of each one. The forum is a wealth of information.  I learned a lot of things that the Drs. may or may not tell you from the guys here. They have shared their stories in order to help others. So hit the books.  There is a wealth of info out there.  Good luck on your journey

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