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Another newbie

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Prostate Cancer
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Mavica
Regular Member
Joined : Jun 2008
Posts : 407
Posted 10/7/2008 9:25 AM (GMT -8)

I'll add my welcome, also. 

My approach to this was to place complete confidence in the specialist/Urologist/surgeon my primary care physician recommended - and he told me if he had to deal with prostate cancer he'd go to the same Urologist and take his advice. 

After my biopsy disclosed the presence of the cancer the Urologist recommended the da Vinci method of surgery to remove it, because of my age, my otherwide good health and the results of the biopsy, and after a few questions I made the decision on the spot to move in that direction (removal via da Vinci). 

The Urologist recommended surgery at 6-weeks after the biopsy but I developed a sepsis infection after the biopsy and wanted to be healthy for the surgery - so I pushed back the surgical date to about 2.5 months after diagnosis. 

My preference was/is to take care of medical problems as quickly as possible and move-on with my life.  I didn't go for a second opinion nor did I undergo MRI, CT or other testing - I have confidence in the Urologist and in my hospital.  My Urologist performs about 15 of the da Vinci procedures monthly and I searched the www and found this excellent forum and I read the information here and at scores of other websites that discuss the various forms of treatment - and I was convinced further I'd made the right decision for my personal situation.

My primary care physician reviewed the biopsy report, discussed it with the Urologist, and concurred with the course of treatment recommended.  I don't believe the Urologist steered me to removal (and removal via da Vinci) because it was his preferred procedure, but because, in his educated and experienced judgement, it was the best course of action for me.

As for post-treatment complications:  they exist in one form or another for each of the treatment options, from what I understand.  I can live with the temporary (hopefully!) incontenence issues, and the potential ED issue (which early indications are I may not have to face long-term) is a non-issue for me - because a longer and overall healthier life is what's most important to me.

Odd as it may seem, my primary care physician greeted me after the biopsy with the comment "It's a good day, not a bad one."  He explained his remarks by saying the cancer was there in my body and through yearly testing it was diagnosed / discovered early, early enough that it hadn't spread and early enough to deal with effectively so that my life would not be further threatened.  I've adopted his "It's a good day" philosophy, don't dwell on the now-removed cancer, and I'm steadily getting my life back in order and I'm back at work.

You've come to the right spot on the www to learn more about the choices ahead, and what the likely results of that choice will be.

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pcdave
Regular Member
Joined : Oct 2006
Posts : 444
Posted 10/8/2008 9:17 PM (GMT -8)
Dear Golf & Cycling!

You were very fortunate to find this forum--it is one of the best resources to help you decide on your treatment of choice. The members here are "over the top" and much is to be learned from their practical experiences which cannot necessary be found elsewhere. Please do not rush to treatment unless you have fully explored all of the treatment options (and there are too many)! From your biopsy, you do not indicate the percentage of cancer found in the cancerous samples. I believe that information is important in your treatment decision along with the Gleason scores. At this point, I am assuming that you are in an early stage of PCa, in which case most of the treatment options have a good probability of eradicating your cancer. It is nonsense for your urologist to use the word "cure" to suggest or imply that surgery is your only road to a cure. As you probably know by now, even surgical patients can be subject to recurring cancer sometime after their prostate is removed. There are several members here who have had to deal with this unfortunate situation.

I suggest that you read my thread on proton radiation treatment which I opted for:

https://www.healingwell.com/community/default.aspx?f=35&m=1002871


My thread talks about all of the treatment options and why I rejected all except proton. It doesn't mean that proton will necessarily be the best for you, but I strongly suggest that you consider it. Unfortunately, most urologists will lead you to have your prostate removed (as did mine) by making your think that it is the best road to eliminating your cancer. The bias on the part of urologists is overwhelming. You are in the your mid-50's and many men in that age group have opted for proton radiation especially if they are in an earlier stage of PCa and even many in later stages of PCa have opted for such treatment with great success. The men who have their prostate removed have to deal with many unpleasant side effects (incontinence and impotence) which you can read about at length here because the majority of members have opted for surgery. I was told by a top prostate cancer oncologist that I had an equal chance of success with any form of treatment. Therefore, I reasoned why would I want to have surgery and go through with the risks of unpleasant side effects. It is true that many younger men seem to fare well with robotic surgery, but it is still not a slam dunk. Please consider reading Bob Marckini's book on proton treatment referred to in my thread. He was treated with proton radiation several years ago while still in his 50's with no serious side effects over the years. It is less likely with proton radiation that you would have to deal with incontinence; impotence can result in time but is often easily overcome with ED pills.

I get furious when I read about men subjected to painful or very uncomfortable prostate biopsies. I had 30-core samples taken with no unpleasant results. It is the responsbility of the urologist to give the patient sufficient medication so that he does not feel anything. Yes, there is some controversy as to whether having a biopsy can spread the cancer. The bottom line is what other choice is there. If the biopsy is done properly, the risk should not be significant.

Best of luck to you in your treatment decision and success in your treatment.

Dave

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Golf and Cycling
New Member
Joined : Oct 2008
Posts : 9
Posted 10/9/2008 7:04 AM (GMT -8)

pcdave,

Thank you for your input. As I mentioned in an earlier post, my wife and I are scheduled to meet next week with another local doctor who's specialty is radiation treatment. His office staff told me to set aside 1 and 1/2 hours for the appointment, so I suspect he will be thorough. I am looking forward to hearing the other side of the treatment coin from an MD as my urologist left no doubt about his recommendation. In fairness to my urologist, however, his preference for surgery has been echoed by an oncologist with whom I consulted, as well as by a well respected specialist at UCSF, although the last of these doctors did say that both forms of treatment are viable and that I am a good candidate for either.

The percentage of my two positive specimens that were cancerous was the same for each - 20%. Now if I can remember how to modify my signature, I will add that information there.

Thank you.

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Golf and Cycling
New Member
Joined : Oct 2008
Posts : 9
Posted 10/9/2008 7:13 AM (GMT -8)
I have updated my signature with more details from my pathology report. See below. ... I have edited this post to include the new details in this text because when I checked the post, my new signature information didn't show.

  • 52 yrs old
  • PSA 4.6
  • 2 of 16 needle biopsy samples positive
  • Positive sample left lat apex (3+3=6), 20% positive
  • Positive sample left medial apex (3+4=7), 20% positive with Gleason pattern 4 comprising 20% of the cancer
  • 11-6-08 LPRS scheduled at local hospital
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    Banker
    Regular Member
    Joined : Sep 2008
    Posts : 30
    Posted 10/10/2008 3:14 AM (GMT -8)
    Golf, you have just encountered the best and the worst part of this disease experience: too much information and too many opinions. However, every one of these posts is worth reading and pondering TWICE.

    You and i are part of the same club. I also just got diagonosed 2 weeks ago. My doctor sent me in for two additional tets. Yesterday, I had bone scan. And next week I will have transrectal MRI. The bone scan was a breeze. But the MRI sounds a bit more complicated. Then, he wants me to have a conversation with a radiological oncologist. He has coninued to give me information. My urologist's recmmendations are similar to what some posts here have suggested: breathe and consider ALL of your options. It would be so much easier if there was an instant answer...but it doesn't work that way.

    I do understand the need to speed up and make a decision and get it fixed along with the emotional roller coaster and the gross-out point of the needle biopsy. I also completely understand insurance limitations.

    I am not going to give you anymore advice...you've gotten plenty here, and either your head is spinning, or you have begun to ignore it. i just encourage you to do what feels right AFTER getting a lot of information (I guess i am giving a suggestion). You've stumbled on a great info/support site with folks who have a lot of experience (and opinions), and others who are in the same boat as you (new to the journey).

    Three things to consider doing (darn...broke my rule of no advice again): go talk to your doctor and share with him the various things you have heard here. Is he really pushing you to do this immediately? 2)Follow up with UCSF contact and just sit and talk to another specialist. 3) Consider the real expense of the insurance. Unless the co-pay is something ridiculous and astronomical, consider paying it again. True, I don't know your finances, but I do know you don't get a lot of chances to get this right. I wish you the best in making a terribly hard decision.
    profile picture
    kw
    Veteran Member
    Joined : Nov 2006
    Posts : 883
    Posted 10/10/2008 7:53 PM (GMT -8)
    Sorry to welcome you to the club. Take your time and make the decision that is right for You. Even if things don't go as planned you can still have options.
    Good Luck,
    KW
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