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Mahalo
New Member


Date Joined Dec 2008
Total Posts : 3
   Posted 12/27/2008 8:35 AM (GMT -6)   
I just joined and unsure of the correct procedures, but here is my question: Dec. 2nd I was diagnosed with PC, Age 64, 5.1 PSA, Gleason 6, T1C. 83% organ confined, 13 biop cores. All other health is excellent. I have researched all alternatives and am down to Brachy or Divinici. Any guidance suggestions?
Thanks
Mahalo

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25382
   Posted 12/27/2008 8:55 AM (GMT -6)   
Welcome Mahalo, sorry you had to join us, but glad you are here. There are many, many here experienced with Divinici in particular for advice. Sure they will be glad to help you.

David
Age 56, 56 at DX
 
PSA 2007 5.8
PSA 9-2008 14.9
 
3rd Biopsy 9-2008 Positive
7 of 7 cores positive, ranging from 40 - 90%
2 tumours noted, Gleason 4+3 and 3+4
 
Open RP surgery completed on Friday, November 14, 2008 at
St. Francis Hospital, Greenville, SC, Dr. Ronald Smith - Surgeon,
Non-nerve sparing, 4 days in hospital, staples removed 11/24/8,
Catheter out on 12/15/8 on day 32.  Day 33, urine stopped flowing, new catheter put in 12/16/08 - uncertain of what went wrong.
 
Post-surgery Pathlogy Report:
Gleason 3+4=7, pT2c pN0 pMx, Prostate 42 grams, tumor 20% cancer
Contained in capsular, neg. margins apex, bladder neck, right lobe, neg. in seminal vessels and lymph nodes. Left lobe: infiltrating tumor miscroscopically appears to extend to marked left posterior margin
 
First PSA Post Surgery  Scheduled for 1/5/9
 
 


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 12/27/2008 9:15 AM (GMT -6)   
Mahalo, welcome to the club.,  I had open surgery myself, but there's lots of Divinci guys and several brady guys here who will most likely chime in shortly 
James C.         Age 61
Co-Moderator- Prostate Cancer Forum
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
16 mts: ED- Viagra, pump continues, no response- Trimix ..35ml x 2 weekly continues
Post Surgery PSA's: 3 mts-.04, 6 mts.-.04, 9 mts.-.04, 1 Year-.02.


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 12/27/2008 12:25 PM (GMT -6)   
Aloha, Mahalo!
I am guessing either in Hawai'i or from it. Either of these modalities are good options. I would ask about the side effects of each. Whatever the answer that is given, there are cases that did great and did not do so well. Most do OK, however. Before you make that first decision, spend some time and think about the what if's. What if this procedure fails, what would I do next? You have already made one great decision. You started looking for online help. I did the same thing and found this site two years ago and thank God for that. Welcome to the best site on the web for caring and compassionate support. Ask away, and keep asking. Keep a note pad ready and absorb from these others here.

Peace!

Tony
Age 46 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007 @ The City of Hope
Post-Op Pathology: Gleason 4+3=7, positive margins, Extra Prostatic Extension (EPE)
Bilateral seminal vesicle invasion (SVI); Stage pT3b, N0, Mx
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (September 17 '08): <0.1 ~ Undetectable!
 
You can visit my Journey at:
 
STAY POSITIVE!
 
 


Mahalo
New Member


Date Joined Dec 2008
Total Posts : 3
   Posted 12/27/2008 12:53 PM (GMT -6)   
thanks for the quick responses. I look forward to this site and the compassion and interaction. Unbiased sources of information can be hard to find. I feel many of the doctors are "selling" (in a responsible way) their approach. So I am looking for input from the "receivers" of the service of the "providers"
thanks again,
Mahalo

Gordy
Veteran Member


Date Joined Jun 2005
Total Posts : 528
   Posted 12/27/2008 1:59 PM (GMT -6)   
Mahalo-

"I feel many of the doctors are "selling" (in a responsible way)" and others in a greedy way (more than you might imagine).

-Les
1/2005 Dx PSA 26.5 Gleason 7 (4+3) @Age 61
1/2005 Start Casodex and Zoladex
PSA drops to <0.01
7/2005-8/2005 5 weeks of IMRT and then HDR brachy
1/2007 Rad Oncologist orders CT scan of pelvis
because of complaints of pain in both thighs
MRI confirms pain not caused by cancer BUT
1/2007 CT scan of pelvis picks up a nodule at bottom of left lung
5/2007 CT scan of lungs shows 1/2007 nodule has grown and
there are numerous nodules on both lungs.
6/2007 Thoracic surgeon removes wedge of left lung for biopsy
6/2007 Path report says 95% chance of metastatic PCa, but she's
never seen cells like this before.
8/2007 2nd opinion at M.D. Anderson in Houston.
They confirm: mutated PCa, very rare, but seen there 2 or
3 times. Recommendation: have CT scans every 6 weeks
and watch for change. At that point start chemo and will
survive for 22 - 24 months thereafter.
PSA still undetectable, but get Lupron shot to bring T down from 27
2/2008 Trip to Houston – PSA now 0.5 and nodules larger. Lupron shot.
6/2008 Trip to Houston - Finally got results from doc. A number of lung nodules have grown, but, more important to him, is the fact that the malignant lesion on my pelvis seems to have flared up and he wants me to start chemo. He said I could wait a few months, but I told him I want to start now. He to get me signed up for a clinical trial in nearby NY.
9/2008 Interim bone and CT scans show progress vs. scans done before beginning trial. I'm cautiously optimistic. Next scans 10/30/08.
10/2008Bone and CT scans continue to show improvement. Med onc attributes mostly to Taxotere/Prednisone while I believe majority of progress attributable to investigational drug, Sprycel.
12/2008 Latest scans show no change. Bah Humbug!


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 12/27/2008 4:46 PM (GMT -6)   
Welcome to the club Mahalo. I look forward to your post. There is a wealth of knowledge so by all means get your money's worth.

peace and love
Dale
My PSA at diagnosis was 16.3
age 46 (current)
My gleason score from prostate was 4+5=9 and from the lymph nodes was 4+4=8
I had 44 IMRT's
Casodex
Currently on Lupron
I go to The Cancer Treatment Center of America
Married with two kids
latest PSA 5-27-08 0.11
PSA July 24th, 2008 is 0.04
PSA Dec 16th, 2008 is .06
Testosterone keeps rising, the current number is 156, up from 57 in May
cancer in 4 of 6 cores
92%
80%
37%
28%
 


Tim G
Veteran Member


Date Joined Jul 2006
Total Posts : 2335
   Posted 12/27/2008 5:16 PM (GMT -6)   
Welcome to the fourm, Mahalo. With excellent health, you have plenty of options. I assume that your research has been extensive enough to eliminate all but the two you mentioned (brachytherapy and surgery).

My wife and I researched treatment options for several months before opting for open surgery. We looked at was proton therapy, but it was too impractical for us to seriously consider.

We live in the Pacific Northwest where brachytherapy was developed. There are several excellent facilities in our area for that treatment.

We decided on surgery for reasons that were important to us: (1) pathological staging where the extent of the tumor and margins can be accurately determined (2) The PSA goes immediately to zero (3) The availability of options like salvage radiation if the cancer recurs (4) Incontinence and impotence tend to get better with time (5) Less likely to get diarrhea and painful urination


PSA quadrupled in 1 yr (0.6 to 2.5)  
DRE neg  1 of 12 biopsies pos (< 5%) 
Open surgery June 06 at age 57
Organ confined to one small area Gleason 5   
PSA's undetectable  < 0.1  


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4243
   Posted 12/27/2008 8:36 PM (GMT -6)   
Hi Mahalo and welcome.  I have observed that most of the guys on this site have elected surgery and you will get plenty of advice from them.  My stats were not far from yours and I looked at all options, narrowed them down to da vinci and brachy, and ultimately chose bracytherapy.  My procedure was recent (3 weeks ago) and, if you are interested, you can check my thread "Tudpock's Brachaytherapy Journey" on this site to see my thought process re my choice -- plus you'll see my post-op situation which is remarkably good, i.e. my life is normal and all equipment is functioning great.
 
Having said that, I wouldn't necessarily recommend seeds for you, I just know it was right for me.  I'm sure you have examined both options carefully and know the stats and SE's backward and forwards so I won't go into those except to say that, with your cancer stats as I read them, the cure rate for both options is basically the same.  There are a few other things to consider, however, that may not necessarily be in all of the books, so I'll throw them in for whatever help they can be:
 
1.  There is a personal psychological issue that only you can answer.  That is, how important is "getting it out" to you?  You'll read a lot of posts on this site from men for whom that was a really big deal.  They wanted the cancer out of their bodies, wanted to see an immediate pathology report and that was that.  For me, that wasn't a big deal at all...the important thing was to do lots of research and make an informed decision as to the right cure and the quality of life issues, then move on.  There are no sure things with either choice...
 
2.  The other issue many men bring up is that "surgery after radiation" is not really a good option but that "radiation after surgery" is possible. That is true (though some docs do surgery after radiation but it is a very difficult procedure).  There are other options after seeds that are available but you should probably assume that surgery is not among them.  If this issue is important to you, then brachy may not be your best choice.
 
3.  The immediate side effects from surgery are well known...and you can read them in spades on this site.  Re brachy, the immediate urinary side effects are generally frequency and urgency and may last a couple of months.  However, IF you don't have much of an issue with this pre-procedure, you probably won't post-procedure.  My urologist gave me a test (can't remember what it is called) that scored me on such things as number of times I had to go urgently now, number of times I get up in the night, weak stream, etc.  My score was low (that's good), meaning that I did not have issues on those functions pre-procedure.  My radiation oncologist and my urologist both predicted that my post-procedure issues would be minor or non-existant with Flomax treatment and, so far, they have been correct.  Now, remember I'm only 3 weeks out, so I may yet have some of these issues but, so far - so good.
 
4.  ED issues occur in brachy patients at a slightly lower rate than in surgery patients -- but there are varying reports on this.  However, the ED with surgery occurs immediately after the surgery and generally gets better (with pills) over time.  The ED with brachy occurs later, i.e. 2 years++.  And, as in the case of urinary effects, if your equipment is working well before the procedure, the chances are better that it will work after the procedure.  Also, if ED does occur, the same little pills that surgery patients take work with brachy patients.  For me, sex started 2 weeks after the seeding, and junior responded well with no pill assistance needed.  I'm looking forward to 2 good years and then, if we need a little help, I'll pop the pills at that time.
 
5.  There are a small % of brachy patients who have bowel issues...but it's a larger % than surgery patients.  Experience of your radiation oncologist is key here as the issues seem to vary with seed placement and dosage.
 
I hope this helps a bit.  It's a BIG decision and I wish you the best.  Please come back and let us know what you decide.
 
Happy New Year!
 
Tudpock
Age 62
Gleason 4 +3 = 7
T1C
PSA 4.2
27cc
Brachytheraply volume study done on 11/14/08
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything functioning normally.


coxjajb
Regular Member


Date Joined Nov 2008
Total Posts : 184
   Posted 12/27/2008 9:35 PM (GMT -6)   
Welcome Mahalo. When I hear someone say they think their doctor is "selling" the treatment plan that Dr. offers, I advise you to see a uro that is part of a large group of doctors with specialists in all of the popular treatmet options. Then ask what treatment plan is best for you. Ask why a specific plan is considered best for you. Best wishes in your decision and a treatment plan that fits you the best.
Age 50
Pre - Op PSA, 4.3
Gleason 3+4=7
Stage T1C
da Vinci Prostatectomy 8/1/08
No issues with incontinence since day 1 after catheter removal
ED, need a little help from Levitra
First post op PSA 11/11/08, 0.00


divo
Veteran Member


Date Joined Jul 2008
Total Posts : 637
   Posted 12/27/2008 10:18 PM (GMT -6)   
Pete had brachy and external radiation and also lupron before and after the brachy in 2002...Everything was just fine for four years. he was continent and our intimate life was getting better and better. However, the PSA began to rise...faster and faster. doubling in 3 months. That is when you really look at your first choice.....He did have salvage surgery then ...which has had devastating side effects for him. ..... Look at Number 2 on Tudpack's list. That is what I am talking about. With surgery first, you get it out, and then if it does come back, you can radiate.....I would highly suggest anyone that has had radiation or brachy or both....not to have salvage surgery....even with the finest doctors. The scar tissue makes it really difficult . Good luck on your choice and whatever you choose, don't look back. Be satisfied with your decision...This is your journey, your life, you are the hero....Di
Husband Pete
dx Jan 2001 gleason 4 + 3 PSA 16.5
Seed implant and conformal radiation and Lupron from Jan 2001 to Jan2002
2005 Dec PSA began to rise from .5 to 8 within 6 months
Salvage surgery at MSK 9/06 Dr. Eastham
Fistula operation 2/07 MSK Dr. Wong
Many cystoscopies and ER visits with strictures
Catheter for one year....Catheter taken out Sept 07..
Total Incontinence since then....
PSA .52 3/08
AUS Operation at MSK Sept 8 2008 Dr. Sandhu
Activated Oct 28th Dr. Sandhu..MSK
Some difficulty with AUS arising Nov 10 2008
Meeting with Dr. Sandhu to discuss AUS problems and new PSA test Dec 11, 2008
PSA .6 12/08
Waiting to see if AUS gets better results
Complete hip replacement surgery coming up Jan 9, 2009


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 12/28/2008 9:11 PM (GMT -6)   
It is an overwhelming task to figure out what is best for you personally, alot ways to treat PCa and for some folks perhaps half or more of them would be cures, depending upon your stats and diagnostic information. Other people might fall into a category that has more risks of maybe the choice they make, maybe needs to be the precise protocol for their disease level and methodology for it (if you know what I mean).
The biggest factors on PCa for curative value of protocols are what are the known parameters. This is why a pathology report needs to be reviewed by the handful of experts you can enlist, what exactly are you found with.....and even this information is a "best reasonable evaluation" as the sampling given is from very small biopies from the gland and can either miss or not gather enough tissue in any given zone to analyze to get numbers to make judgements on. (I am putting this in laymans words, which works for me).
Try your data numbers in nomograms and look over Partin Tables just for something to consider, they are not totally reliable or in stone either, but it might give you clue as to "curative surgery" what percentage or what are my odds...75% or what? In my case the numbers told me-you are not worthy for surgery I would have failed before I left the table, so that just limited my choices whole lot (took a while to know this stuff).
Does your pathology show perinureal invasion???? (sounds omnious but really basically means does it show that it may be connected to a blood path to travel...and it is not uncommon). But if you had alot of these found it may be worth thinking about.
Others have mentioned that future salvage protocols are possible, but doing possible surgery 2ndly as salvage is not probably wise choice, alot of docs would not want the job too. So, you have to look at everything, might as well look at every single of them and cross them off your list as you decide.

Here is a parallel to PCa- you are in the jungle man, you don't know what is out there, you don't know how to function in a new environment, you may have to use your survivor skills(street smarts etc.) and get tough and fight your way out, pickup a machette (build one even) and get busy, you can find your way out, of course asking for help from J.C. is always a good choice- I mean that too- (amen)

Gordy
Veteran Member


Date Joined Jun 2005
Total Posts : 528
   Posted 12/28/2008 9:15 PM (GMT -6)   
Here we go again.
1/2005 Dx PSA 26.5 Gleason 7 (4+3) @Age 61
1/2005 Start Casodex and Zoladex
PSA drops to <0.01
7/2005-8/2005 5 weeks of IMRT and then HDR brachy
1/2007 Rad Oncologist orders CT scan of pelvis
because of complaints of pain in both thighs
MRI confirms pain not caused by cancer BUT
1/2007 CT scan of pelvis picks up a nodule at bottom of left lung
5/2007 CT scan of lungs shows 1/2007 nodule has grown and
there are numerous nodules on both lungs.
6/2007 Thoracic surgeon removes wedge of left lung for biopsy
6/2007 Path report says 95% chance of metastatic PCa, but she's
never seen cells like this before.
8/2007 2nd opinion at M.D. Anderson in Houston.
They confirm: mutated PCa, very rare, but seen there 2 or
3 times. Recommendation: have CT scans every 6 weeks
and watch for change. At that point start chemo and will
survive for 22 - 24 months thereafter.
PSA still undetectable, but get Lupron shot to bring T down from 27
2/2008 Trip to Houston – PSA now 0.5 and nodules larger. Lupron shot.
6/2008 Trip to Houston - Finally got results from doc. A number of lung nodules have grown, but, more important to him, is the fact that the malignant lesion on my pelvis seems to have flared up and he wants me to start chemo. He said I could wait a few months, but I told him I want to start now. He to get me signed up for a clinical trial in nearby NY.
9/2008 Interim bone and CT scans show progress vs. scans done before beginning trial. I'm cautiously optimistic. Next scans 10/30/08.
10/2008Bone and CT scans continue to show improvement. Med onc attributes mostly to Taxotere/Prednisone while I believe majority of progress attributable to investigational drug, Sprycel.
12/2008 Latest scans show no change. Bah Humbug!


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 12/28/2008 10:04 PM (GMT -6)   
Hi Bob,
I did have my pathology reviewed but a top gun. (Epstein). He did not change anything on the initial results rom the City of Hope after my surgery, and he also concurred with the clinical biopsy, but I am glad he was on my team. The one probem with putting too much into a pathology pre-surgery is that it isn't an exact science for a number of reasons. Using it to confirm cancer is an important step, however. But even saturation biopsies, and 3d mapping will not guarentee an absolutely conclusive accurate detectciont of cancer, biological stage and G score. Most biopsies do not detect more than what they penetrated as you are saying. One thing for sure, if a biopsy is positive then you have cancer. Getting a second opinion from a heavy hitter when possible is good advice. Getting treatment at a major center and if necessary a stellar prostate cancer oncologist is a huge plus. Knowing full well what you want to do after educating yourself is the right thing to do. And if you are a spiritual person, using what you do and know will definately help you.

While this isn't for everybody, it is important that you rely on your faith too. Prostate cancer is a very serious ailment. And I believe that I have done as well on an uphill battle as I have is that I have great doctors, excellent education, great support from ALL here, and foremost my faith. For that reason, I am grateful I found good doctors, took the time to learn about my disease, found great folks on line, and I truly feel I have been blessed in all of this.


Tony


Age 46 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007 @ The City of Hope
Post-Op Pathology: Gleason 4+3=7, positive margins, Extra Prostatic Extension (EPE)
Bilateral seminal vesicle invasion (SVI); Stage pT3b, N0, Mx
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (September 17 '08): <0.1 ~ Undetectable!
 
You can visit my Journey at:
 
STAY POSITIVE!
 
 

Post Edited (TC-LasVegas) : 12/28/2008 8:53:49 PM (GMT-7)


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 12/28/2008 10:56 PM (GMT -6)   
Gordy said...
Here we go again.

Some cannot help themselves...........they have an audience seeking knowledge about a serious disease so slipping in a plug for their particular deity seems appropriate to them. Now if anyone is interested, I have this golden elixir, handed directly to me by the sun-god, Ra................
Bill
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07
4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August 08 <0.001 undetectable (disregarded due to lab "misreporting")
Post-op pathology rechecked by new lab:
Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September 08 <0.01 (new lab)

Post Edited (BillyMac) : 12/28/2008 9:02:42 PM (GMT-7)


jetguy
Veteran Member


Date Joined Sep 2006
Total Posts : 741
   Posted 12/28/2008 11:06 PM (GMT -6)   
Bill, if you can PROVE the efficacy of your elixir, I'll buy it. First in line.

Regards,

Bill
 
BTW Bill, I'm on your side.  ALL should PROVE the efficacy of what they
insist is true.


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.
 
Wow, almost two years behind.  I had a typical radiation bounce that
scared me, but it seems to be ok.  PSA is about 1.0 which is ok for
a rad guy at this stage of the game.
 
Got my FAA medical certificate back four months after starting my
treatment.  It's still a First Class, just jumping through a few hoops.

Post Edited (jetguy) : 12/28/2008 9:13:16 PM (GMT-7)


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 12/28/2008 11:10 PM (GMT -6)   
LOL, Les and Bill,
I love you guys! My apologies. Bill, You should sell it on the web. There are probably lots of takers.

I hope you guys are always doing well. I know one thing for sure, Bill you probably have way better weather than most of us in the states. It was 29 this morning here in Vegas. I could use a visit from the sun god....

Tony
Age 46 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007 @ The City of Hope
Post-Op Pathology: Gleason 4+3=7, positive margins, Extra Prostatic Extension (EPE)
Bilateral seminal vesicle invasion (SVI); Stage pT3b, N0, Mx
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (September 17 '08): <0.1 ~ Undetectable!
 
You can visit my Journey at:
 
STAY POSITIVE!
 
 


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 12/28/2008 11:11 PM (GMT -6)   
Bill (jetguy),
Can't you just accept Ra's elixir on faith
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07
4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August 08 <0.001 undetectable (disregarded due to lab "misreporting")
Post-op pathology rechecked by new lab:
Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September 08 <0.01 (new lab)


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 12/28/2008 11:17 PM (GMT -6)   
Seriously though, what if Mahalo who has come here to this great site seeking knowledge and guidance regarding treatment was a Buddhist or Hindu or whatever. Do you really think an answer which includes directing him to "J.C." appropriate?
Bill
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07
4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August 08 <0.001 undetectable (disregarded due to lab "misreporting")
Post-op pathology rechecked by new lab:
Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September 08 <0.01 (new lab)


jetguy
Veteran Member


Date Joined Sep 2006
Total Posts : 741
   Posted 12/28/2008 11:17 PM (GMT -6)   
Hey Bill, you know the answer to that, but we're hijacking a serious post, so I gotta' quit.

Best to you and Les and Tony and all the other great peeps here,

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.
 
Wow, almost two years behind.  I had a typical radiation bounce that
scared me, but it seems to be ok.  PSA is about 1.0 which is ok for
a rad guy at this stage of the game.
 
Got my FAA medical certificate back four months after starting my
treatment.  It's still a First Class, just jumping through a few hoops.


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 12/28/2008 11:26 PM (GMT -6)   
You're right....we don't want to travel that road again. My best to all members(especially Bill Les and Tony) at this great time of year. In answer to Mahalo's question. I, as is obvious from my signature went with Da Vinci. Despite my to date excellent outcome, I am now questioning my decision. If I was to face making that decision again I believe I would opt for open surgery conducted by a very experienced surgeon. (probably the one that did the da Vinci on me)
bill
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07
4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August 08 <0.001 undetectable (disregarded due to lab "misreporting")
Post-op pathology rechecked by new lab:
Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September 08 <0.01 (new lab)

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