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Posted 9/1/2008 11:26 PM (GMT -8)
  

   Gleason score of 7, 5 out of 8 pieces in biopsy poisitive, all 5 were 5% to 10% with one  50%

Urologist is a robotic sugeon and recomends that strongly. Should I have it removed ?  which is best ? Radiation or surgery ? Any anwers appreciated !

thanks

Posted 9/2/2008 2:34 AM (GMT -8)

Ellsworth -

Learn as much as you can about PCa so that you can make the best decision for your particular situation.  This site has the most informed support group on the net, so ask a lot of questions and stay in touch.  Also, find the best doctor at a top notch hospital.

- John

Posted 9/2/2008 6:15 AM (GMT -8)

    Sorry to welcome you to the club.  You have to do your research and do what is best for YOU.  We are here to give encouragement and share our stories.

    Wish you well,  KW

Posted 9/2/2008 6:20 AM (GMT -8)
Ellsworth,

You are the only one who can make such an important decision and do not underestimate the consequences. So by all means learn all you can.

I chose surgery because I did not want to wake each morning with cancer inside if it could be removed. I wanted it all out if possible and wanted it done as quickly as possible.

Best,
Posted 9/2/2008 7:03 AM (GMT -8)
First of all take a deep breath and relax. You have some time before you need to make a decision. Learn all you can about the treatment options available and their side effects. Knowledge is empowerment learn all you can for after there are no do overs. That said do take into account that for the most surgeons will recommend surgery and radiologists will persuade you to go their route. I'm surprised you only had an 8 core biopsy when 12 is the standard. Also let me tell you biopsies will confirm you have PCa the normal ones really don't pinpoint the amount or location too well. Comparing my 12 core to my 45 core biopsy proved that to me. But as I said take your time in picking a treatment and after you do, take a week off and reflect on it. Also do see a radiologist, you can't have too many opinions to take into account.
Posted 9/2/2008 7:18 AM (GMT -8)

Hi Ellsworth,

You did not say what your  PSA is and a gleason 7 is right in the middle. If the PSA is high you may want to consider bone scan, CT scan and chest xray to determine spread if any. As stated earlier get as much information about your case as possible before making the decision for a particular treatment.

I chose radiation due to indication of spread to lymph nodes. Seemed to be my best option and the treatment has been relatively easy on me. My research also indicated that radiation was as effective for control as surgery especially for localized PCa. Lots of information on this on the web.

Best of luck to you,

Don

Posted 9/2/2008 9:12 AM (GMT -8)
Ellsworth,

I can only agree with all that's been said and offer that you need to talk to several oncologists before you proceed. It is a very personal choice and you need to be as informed as possible about your own condition and circumstance. This forum tends to lean towards the surgical side, and that's fine. I am in a pre-cancer state myself so I can't offer what my choice is. I can say that my father had very aggressive cancer (Gleason score 5 + 5 = 10) and very high involvement (up to 90%) and he had fantastic results with brachytherapy (sometimes called radioactive seed therapy).

One of the big questions to ask the oncologist is the recovery time and the on-going side effects of any choice. How likely is incontinence or ED or other side effects of any therapy for your case? I'm sure that there are particular details that make it impossible for a "pat" answer to these questions.

There are several very good threads on this site for questions to ask and gathering information. Take advantage of these or just drop me or anyone here a direct line and I'm sure there will be a fast answer for you.

Take care, be calm and make an informed decision.

Jim
Posted 9/3/2008 3:22 AM (GMT -8)
Ellsworth,

First things first: Have you had a 2nd reading of your biopsy slides ?

 

Posted 9/3/2008 5:12 PM (GMT -8)
Ellsworth, I can tell you my husbands journey....Radiation and seed implant + lupron was done five years, before, and then the cancer returned....in the prostate. If he had had it removed it would not have been there in the prostate...With the return he had the salvage surgery with massive side effects...(and it did not get all of the cancer)....If he had had the surgery first, radiation could then have been done.....but the other way around is very difficult....You really need to look at all of the options like everyone says...and don't dismiss the side effects.....each decision has its own side effects.... Good luck and make sure you get several opinions....from both surgeons and radiologists....also, don't tell them you are having second opinions....they may agree with each other. That was our discovery.. Di
Posted 9/6/2008 8:19 AM (GMT -8)
You might want to check out Canada where they are doing a new procedure, currently under investigation in U.S., called "HIFI". It apparently uses a very strong, carefully focused radio frequency radiation, similar to that used in a sonogram. From what I've read, the results have been very good.

I had a radical, followed by post surgical focused external beam radiation, in 2001. I've had 0.0 PSA for seven and 1/2 years, until last month when it came up 0.03, which is so low that I am having it repeated.


There were side effects, and I dealt with all of them effectively, but all of them together beat an early death. So, make your decision...but do something!
Posted 9/6/2008 8:45 AM (GMT -8)
Welcome Ellsworth!    W elcome     to   ~ HealingWell ~   and   A    Special Warm Welcome   to   You !   Knowledge gives us POWER.   POWER takes away the fear.   ~      ~      ~      ~      ~      ~      ~      ~      ~      ~      ~      ~      ~     Click   on   link   below for important information that will help you ~ help us!!                                                                    >>   Welcome New Members ~ to HealingWell   The information (link) listed above is to help you get around the forum!     This is a journey best traveled with friends.     Welcome ~ New Friend from all the members here... on HealingWell.com     Know Your Forum Moderators v       Doting Daughter  ~   Moderator for Prostate Cancer Forum   v       James C  ~   Moderator for Prostate Cancer Forum
Posted 9/6/2008 9:03 AM (GMT -8)
Hi Ellsworth,
Sorry you are here, but these great folks will be a great aid while you travel this road.

Hepotter, I believe you are referring to HIFU ~ High Intensity Focal Ultrasound.

Any selected treatment will have side effects. Some right away some later. The two treatments stated above represent a continuing push for alternatives to radiation and surgery, the current gold standard for treating PC.

Hepotter, the welcome above is for you too. I hope you stay and continue posting your progress! We need to see more HIFU posts.

Tony
Posted 9/6/2008 1:10 PM (GMT -8)
Hi Ellsworth I to would like to welcome you to the best Country Club in the world that NO one wants to join. Do take your time and get as informed as possible, you do have options and the best way to exercise those options is be informed. You will find some wonderful friends here at HW and some even better wisdom. Do not be shy and it is ok to ask the tough questions as well as post the tough topics. I will follow your post to monitor your diagnosis and decisions.
So go ahead enjoy the club grab some popcorn and join in the fun.

peace and love
Dale
Posted 9/6/2008 6:13 PM (GMT -8)
Hi Ellesworth, not much to add to what has been said other than take your time and be comfortable with YOUR decision, don't be rushed into any particular procedure, it took me 5 years to decide.
Posted 9/7/2008 1:00 PM (GMT -8)
Ellsworth:

I don't know your age, but I had a Gleason 7 (4+3) with my biopsy. I was told that with a Gleason 6 & below you have time to decide, and a whole range of options. I was told by 3 different doctors not to wait more than 60 DAYS to start doing something with my 7.

I was also told that given my age and health, the gold standard was surgery, so I did that. Once they actually diced my prostate up it turns out I was a Gleason 9 with a T3a tumor - meaning it was bulging out, but had not quite broken out. It was located where the doctor could not feel it via DRE, and I never had any symptoms at all.

So - read as much as you can, talk to as many doctors as you can, and make the decision that is right for you, but I would NOT wait 5 years to do something. (Sorry, Chris NZ)

Just my opinion,
kcragman
Posted 9/7/2008 1:19 PM (GMT -8)
PS to Ellsworth:

In the interest of full disclosure, with the surgery, you must be mentally prepared to face incontinence and ED - at least for a while. Some men recover one or both quickly, most recover continence and full or partial sexual function over time, and a few men don't recover either one.

But there are side effects to all of the treatment options.

Good luck,
kcragman
Posted 9/8/2008 7:54 AM (GMT -8)
You are at the fork in the road that all of us faced when informed we have PC. I would encourage you that you will get through this - - - as your biopsy is similar to mine, I would suggest you to go to page 9 (its location as of now) and read the exchange on "Between Radiation and Surgery." There is a lot of dialogue about this very issue. Decisions are individual and should come after researching things out. When you reach a comfort level you will move forward. I sincerely wish you the best! RB

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
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