Open main menu ☰
HealingWell
Search Close Search
Health Conditions
Allergies Alzheimer's Disease Anxiety & Panic Disorders Arthritis Breast Cancer Chronic Illness Crohn's Disease Depression Diabetes
Fibromyalgia GERD & Acid Reflux Irritable Bowel Syndrome Lupus Lyme Disease Migraine Headache Multiple Sclerosis Prostate Cancer Ulcerative Colitis

View Conditions A to Z »
Support Forums
Anxiety & Panic Disorders Bipolar Disorder Breast Cancer Chronic Pain Crohn's Disease Depression Diabetes Fibromyalgia GERD & Acid Reflux
Hepatitis Irritable Bowel Syndrome Lupus Lyme Disease Multiple Sclerosis Ostomies Prostate Cancer Rheumatoid Arthritis Ulcerative Colitis

View Forums A to Z »
Log In
Join Us
Close main menu ×
  • Home
  • Health Conditions
    • All Conditions
    • Allergies
    • Alzheimer's Disease
    • Anxiety & Panic Disorders
    • Arthritis
    • Breast Cancer
    • Chronic Illness
    • Crohn's Disease
    • Depression
    • Diabetes
    • Fibromyalgia
    • GERD & Acid Reflux
    • Irritable Bowel Syndrome
    • Lupus
    • Lyme Disease
    • Migraine Headache
    • Multiple Sclerosis
    • Prostate Cancer
    • Ulcerative Colitis
  • Support Forums
    • All Forums
    • Anxiety & Panic Disorders
    • Bipolar Disorder
    • Breast Cancer
    • Chronic Pain
    • Crohn's Disease
    • Depression
    • Diabetes
    • Fibromyalgia
    • GERD & Acid Reflux
    • Hepatitis
    • Irritable Bowel Syndrome
    • Lupus
    • Lyme Disease
    • Multiple Sclerosis
    • Ostomies
    • Prostate Cancer
    • Rheumatoid Arthritis
    • Ulcerative Colitis
  • Log In
  • Join Us
Join Us
☰
Forum Home| Forum Rules| Moderators| Active Topics| Help| Log In

new to HealingWell

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
profile picture
Mahalo
New Member
Joined : Dec 2008
Posts : 3
Posted 12/27/2008 5:35 AM (GMT -8)
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
profile picture
Purgatory
Elite Member
Joined : Oct 2008
Posts : 25448
Posted 12/27/2008 5:55 AM (GMT -8)
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
profile picture
James C.
Veteran Member
Joined : Aug 2007
Posts : 4464
Posted 12/27/2008 6:15 AM (GMT -8)
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 
profile picture
Tony Crispino
Veteran Member
Joined : Dec 2006
Posts : 8160
Posted 12/27/2008 9:25 AM (GMT -8)
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
profile picture
Mahalo
New Member
Joined : Dec 2008
Posts : 3
Posted 12/27/2008 9:53 AM (GMT -8)
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
profile picture
Gordy
Veteran Member
Joined : Jun 2005
Posts : 528
Posted 12/27/2008 10:59 AM (GMT -8)
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
profile picture
livinadream
Veteran Member
Joined : Apr 2008
Posts : 1382
Posted 12/27/2008 1:46 PM (GMT -8)
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
profile picture
Tim G
Veteran Member
Joined : Jul 2006
Posts : 3057
Posted 12/27/2008 2:16 PM (GMT -8)
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
profile picture
Tudpock18
Forum Moderator
Joined : Sep 2008
Posts : 5403
Posted 12/27/2008 5:36 PM (GMT -8)
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

profile picture
coxjajb
Regular Member
Joined : Nov 2008
Posts : 184
Posted 12/27/2008 6:35 PM (GMT -8)
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.
profile picture
divo
Veteran Member
Joined : Jul 2008
Posts : 637
Posted 12/27/2008 7:18 PM (GMT -8)
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
profile picture
zufus
Veteran Member
Joined : Dec 2008
Posts : 3149
Posted 12/28/2008 6:11 PM (GMT -8)
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)
profile picture
Gordy
Veteran Member
Joined : Jun 2005
Posts : 528
Posted 12/28/2008 6:15 PM (GMT -8)
Here we go again.
profile picture
Tony Crispino
Veteran Member
Joined : Dec 2006
Posts : 8160
Posted 12/28/2008 7:04 PM (GMT -8)
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
profile picture
BillyMac
Veteran Member
Joined : Feb 2008
Posts : 1858
Posted 12/28/2008 7:56 PM (GMT -8)

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
profile picture
jetguy
Veteran Member
Joined : Sep 2006
Posts : 750
Posted 12/28/2008 8:06 PM (GMT -8)
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.

profile picture
Tony Crispino
Veteran Member
Joined : Dec 2006
Posts : 8160
Posted 12/28/2008 8:10 PM (GMT -8)
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
profile picture
BillyMac
Veteran Member
Joined : Feb 2008
Posts : 1858
Posted 12/28/2008 8:11 PM (GMT -8)
Bill (jetguy),
Can't you just accept Ra's elixir on faith
profile picture
BillyMac
Veteran Member
Joined : Feb 2008
Posts : 1858
Posted 12/28/2008 8:17 PM (GMT -8)
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
profile picture
jetguy
Veteran Member
Joined : Sep 2006
Posts : 750
Posted 12/28/2008 8:17 PM (GMT -8)
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
profile picture
BillyMac
Veteran Member
Joined : Feb 2008
Posts : 1858
Posted 12/28/2008 8:26 PM (GMT -8)
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
✚ New Topic ✚ Reply


More On Prostate Cancer

Side Effects Of Prostate Cancer Radiation Treatment

Side Effects Of Prostate Cancer Radiation Treatment

Positive For Prostate Cancer

Positive For Prostate Cancer


HealingWell

About Us  |   Advertise  |   Subscribe  |   Privacy & Disclaimer
Connect With Us
Facebook Twitter Instagram Pinterest LinkedIn
© 1997-2023 HealingWell.com LLC All Rights Reserved. Our website is for informational purposes only. HealingWell.com LLC does not provide medical advice, diagnosis, or treatment.