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James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4462
   Posted 7/31/2008 8:50 AM (GMT -6)   
   Since Hopeful203 asked for help in another thread, his post is being moved here for his own thread.  He has already had a couple responses there and maybe this will get more people involved.

I am 57 and was told two days ago that my biopsy came back with 2 of 12 cores show cancer.  Of the two cores, one was 3+4 and the other was 4+4.  In each core they were around 14%.  I've read articles, forums, talked to docs, and I'm just not sure what to do.  It seems that for me, the more information I get the more confused I become.  I simply am phobic about general anesthesia so most of my confusion is probably me trying to convince myself that there is a better way.  I was pretty much settled on IMRT but my docs haven't said anything to my about hormones.  The original urologist, who is a surgeon, recommended surgery because of my age. The only thing I've read so far that has me really concerned is what options - other than hormonal therapy - do I have should my psa go up in a few years?  It sounds like there isn't anything I can do due to the scares caused by the radiation.  Am I missing anything here?  Is there something that could be done IF the cancer came back in 10 years?  Also, is the hormonal treatments palative or can they also cure the cancer?

Between  Cyberknife, Proton, DaVinci, HIFU, Radical, IMRT, IBRT, Brachia(sp), Hormones, I feel a little overwhelmed.

Help! :/

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Post Edited (James C.) : 7/31/2008 8:02:47 AM (GMT-6)

James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4462
   Posted 7/31/2008 9:14 AM (GMT -6)   
Besides general anesthesia, there is the epidural or spinal block and maybe others. Before cutting surgery from your list due to fear of anesthesia, it would be worth it to consult the oruologist or surgical team that would be doing the anesthesia and discussing the alternatives.  I'm not advocating surgery, just offering some alternatives to getting around your phobia.

James C.
Co-Moderator- Prostate Cancer Forum

Age 61
4/19/07 PSA 7.6, referred to Urologist, recheck 6.7
7/11/07 Biopsy- 16 core samples, size of gland around 76 cc. Staging pT2c
7/17/07 Path report: 3 of 16 PCa, 5% involved, left lobe , GS 3/3:6.
9/24/07 (open) Retropubic Radical Prostatectomy performed
9/26/07 Post-op Path Report: GS 3+3=6 Staging pT2c, 110gms, margins clear
10/15/07 ED- begin 50mg Viagra and Vacurect pump nightly, Fully continent
1/14/08 Caverject started/stopped, aching. 2/24/08 .5ml Bimix started-success
7/31/08 ED- Viagra, pump continues, no response- Trimix .10ml x 2 weekly continues
Post Surgery PSA's:  3 mts-0, 6 mts.-0, 9 mts.-0.

Regular Member

Date Joined Apr 2008
Total Posts : 270
   Posted 7/31/2008 9:51 AM (GMT -6)   
Hopeful 203,
If you review my own situation (Between Radiation and Surger - RBinCountry) you will find a lot of good comments from the great support group who dials in here.

No one can tell you what to do and you will very likely be fine whichever direction you turn - as has already been said you should have many more good years. Saying that - I would tell you that my surgery was uneventful. I have had more pain and inconvenience from bad colds or the flu. The anesthesia was a breeze. I was being introduced to one of the surgery assistants and that was the last thing I knew until someone was talking to me in another room. I then thought - "well when are they going to take the darn thing out of me" - of course they already had! There were no after effects from anesthesia. Wearing a cathedar for several days was probably the most inconvenience, but even that was really no big deal.

Whatever you do - know that there are many of us who have already walked the same path, and there are great abilities all around us to solve these kinds of problems. We live in a time of blessing and opportunity. A few years ago we would all have been much worse off. Blessings to you!

Age 61
Original data - pre-operation
PSA: 5.1
T1C clinical diagnosis, Needle biopsy - 10 cores, Gleason 7 = 3+4 in 1 core (40%), 7 cores Gleason 6 = 3+3 ranging from 5% to 12%
All scans negative
Lupron administered 4/9/2008 for 4 months (with idea I would undergo external beam radiation followed by seed implants - then I changed my mind).
Robotic DiVinci surgery - Dr. Fagin (Austin) May 19th
Post operative - pathology
pT2c NX MX
Gleason 3+4
Margins - negative
Extraprostatic extension - negative
seminal vesicle invasion - uninvolved
1st Post PSA .04

Doting Daughter
Veteran Member

Date Joined Aug 2007
Total Posts : 1064
   Posted 7/31/2008 9:58 AM (GMT -6)   
Welcome!!! There is a lot of anxiety around PCa and the treatments. You are definitely not alone. One thing that we found during this process is that whatever specialist you see, they will recommend their type of treatment. Therefore, it is not surprising the urologist recommended surgery. If you see a Radiation Oncologist, they will likely feel radiation is the best treatment. Try to take into account all the "opinions" and make a decision based on what you believe is the best for you. There are no guarantees with any of them. The side effects for one person are different than another. However, as you will see from this forum, many, many people have done extremely well!! I am confident that you will be no different. Please continue to share and ask away on this journey. The help my family received through this forum was invaluable! Best wishes!
Father's Age 62 (now 63)
Original Gleason 3+4=7, Post-Op Gleason- 4+3=7,
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin, One positive node. T3a N1 M0.
Bone Scan/CT Negative (Sept. 10, 2007)
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07, Lupron beg. Dec 03, 2007 2 yrs
Radiation March 03-April 22, 2008- 8 weeks 5x a week
July 2, 08 PSA <.02
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum

Veteran Member

Date Joined Jul 2008
Total Posts : 981
   Posted 7/31/2008 11:35 AM (GMT -6)   
Hopeful the best I can recommend for now is to step back and take a deep breath. You don't have to make any decisions right away. Knowledge is empowerment. Study up for awhile. then take a few days off before you make a decision for whats best for you. There's many factors to consider. It will seem overwhelming at first.
Diagnosed 10/08/07
Age: 58
3 of 12 @5%
Psa: 2.3
Size: 34g
3D Mapping Saturation Biopsy
1 of 45 @2%
28g after taking Avodart
Catheter for 1 day
Good Candidate for TFT
(Targeted Focal Therapy)
Cryosurgery(Ice Balls)
Clinical Research Study
TFT performed at University of Colorado
Medical Center at Denver Fitzsimmons Campus
Catheter for 4 days
Slight soreness for 2 weeks but afterward
life returns as normal
Quarterly PSA tests to start and
another biopsy next April

Regular Member

Date Joined Jan 2008
Total Posts : 338
   Posted 7/31/2008 9:04 PM (GMT -6)   
Everything I can offer except support here, via email, or the phone is contained in my website.
I know the confusion because I so recently went through it.  You will decide on your treatment and then move forward.  Stay with us.
The best to you in this time of darkness. There is a light shining somewhere for you.
Retired USAF Richard & Debbie on The Shores of Toledo Bend Lake Louisiana
Biospy 1/10/08 Gleason 10, Stage T1C  8 of 12 samples positive all Less Than 5% 
Suspected lymph node involvement
Lupron & Casodek May 08 for 2 years
Completed 25 IMRT and 17 PBRT U of Florida Proton Therapy Institute 7/24/08
PSA .21, free PSA .08, Percent free PSA 38.1, testosterone 14.6
Turn Stumbling Blocks into Steping Stones and Keep Smiling
Our Journey is on WWW.GLEASON10.COM

Veteran Member

Date Joined Apr 2007
Total Posts : 823
   Posted 8/1/2008 9:17 PM (GMT -6)   

We have all walked the path you are on now. It can really be a mine field when it comes to decision time. Most Doctors will tell you it is your decision to make. Get educated and go to a hospital that offers a multidiciplinary approach to treating PC. You will get a lot of information from various Doctors. Do all the reasearch you can and ask as many questions of your fellow forum members here. But, it is your decision and your body.

Make that decision and don't look back. You can beat it.

age at dx 54 now 56
psa at dx 4.3
got the bad news 1/29/07
open surgery Duke Medical Center 5-29-07
never more than 2 pads
Tossed the pads this spring
ED still a problem
first year PSA less than zero

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