Surgery or Radiation Side Effects Question

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Confusion
New Member


Date Joined Jan 2009
Total Posts : 13
   Posted 1/10/2009 11:48 AM (GMT -6)   
I have to decide between surgery or radiation and am not sure which one has the most side effects. I have read all the information in the brochures and websites, but everyone has a different story. I think the more stories I hear the better understanding I will have...at least that is my way of thinking.

I also understand the with radiation you can have it re-done if the cancer comes back.

Age 60
Diagnosis summary: Adenocarcinoma. gleason 6 (3+3) involving the left base, mid and apex.

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 1/10/2009 12:09 PM (GMT -6)   
Well radiation and drug survivor now- 7yrs., alot depends on whom does it skills, technology is probably very important in radiations...they are not all the same...they have alot more differences than is well known. All protocol/treatments can have horror stories and success stories. You and others actually have many more choices than you listed, you just don't know about them yet perhaps, some maybe be less main stream...does not necessarily mean they are junk. Examples: HIFU, HDK, ADT3 only-13 months Leibowitz protocol, Neutron/Photon IMRT radiation external (rarer program which I also did), Hi-Dose Casodex or other drug protocols (Now remember we don't know all the parameters of 'Confusions' stats at this moment maybe is not a candidate for some of these concepts). Surgery many methods LRRP looks very appealing, but there are others in that mix.

You might not even have to decide at this juncture???? You need to know more as to assess what is you total disease assessment, beyond what you already posted. You could be a good candidate for monitoring (W.W.-watchful waiting). My brother has similar numbers you mentioned, 1 positive core with 5% or less PCa, Gleason 6 (3+3) and low psa 1.0 when detected, DRE seemed suspicious. Anyway it has been between 4-5 yrs. since his diagnosis and no treatment and stabil psa, no increase, even slight decrease seen. Don't know if his choice is perfect or not, he is the judge. I can tell you he loves every minute of not doing a major treatment.

Alot of people will tell you that you have to have it out by sunset (lol), I say bull to that.

Get studying on this stuff asap including watchful waiting- the empowered patients method...knowledge. There is bias and agenda on PCa, noticed I did not tell you to get radiation up front.

zufus- www.yananow.net/Mentors/RobP.htm (an usual journey to say the least, I am not the typical PCa case when diagnosed, perhaps pray I were)
 
Others herein know alot about surgery and tidbits on that, weight it all out, it is in the end your journey to walk the walk.
 
 

Post Edited (zufus) : 1/10/2009 10:14:27 AM (GMT-7)


kcragman
Regular Member


Date Joined May 2008
Total Posts : 240
   Posted 1/10/2009 12:19 PM (GMT -6)   
Confusion:

Everybody is different. There are success stories and horror stories on this board about all treatments. Your physical health and your specific cancer conditions are very important considerations.

I chose surgery because I had 3 doctors tell me that it was the "gold standard" for someone my age (52) and that they expected me to live another 25 years and I should have it out of there. Also, if you have surgery and it "fails" or the cancer comes back, you can fall back on radiation. You cannot always have surgery if you have radiation first.

I am not completely happy with my situation. I still leak a little bit, and I do not have a useable erection yet (but making progress) BUT - when the post-op patho report came out, and it was explained to me that I was darn near a dead man walking - I was extremely glad that I made the choice I did. I am completely convinced that I would not be enjoying the level of cancer-free success I've had so far if I had chosen another path.

BUT - my situation is different than yours. You have to research as much as possible, talk to as many doctors as possible, and get mentally comfortable with a treatment path - and then do whatever Purgatory says.

Just kidding. But you get the picture.
Good luck, there are LOTS of good people here.
kcragman
Age: 53; 52 at DX
March 2006: PSA 2.5
Dec 2007: PSA taken for insurance application. I did not see the results until late
              Jan '08 - after I was rejected. Their lab said PSA 4.5.
Feb 2008: PSA 3.7.
March 2008: Biopsy. Gleason 7 (4+3) 12 cores taken. 5 on the left side were
              cancerous and the 6th was suspect.  
May 5, 2008: Da Vinci robotic laparoscopy at GW Hospital, Washington DC.

Post op: Gleason 9 (4+5). 15% of prostate involved. Stage: pT3a. Negative margins. Lymph node and nerve samples taken, and appeared to be cancer free.

July 2008: PSA at 7 weeks was undetectable.
August 2008: PSA at 14 weeks (3 months) was undetectable.
Nov 2008: PSA at 6 months was undetectable.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25382
   Posted 1/10/2009 12:24 PM (GMT -6)   
Hello Confusion,
Welcome here, glad you found our little community. You are being faced with the same choice that many of us had to deal with. I feel strongly about this, but it is just my opinion, the common thinking is that with your stats, you do surgery first, either open (like mine) or robotic (like many here). Then if your cancer, God forbid, should ever come back, then you could do radiation as a salvage treatment, to destroy what came back. Most, and I am not claiming all, urological surgeon do not like and some (my own dr/surgeon) will refuse to a salvage surgery after radiation fails. It makes for a lot of complications and difficulties, and the men that do it in that order, usually have very terrible side affects. If you PC is fully contained at this point, then either method should do the job in theory, but you do have to have a back up plan in case your primary treatment plan fails. I am sure you will have plenty of time to study all your choices, and get lots of opinions from here and the medical community. In most people's cases, you don't have to make a decision in 24 hours, despite getting pressure from doctors. Think it through, its your body, your cancer, your life.

We will be happy to help you through the entire process ahead, great people here.

David in SC
Age 56, 56 at DX
PSA 7/7 5.8, 7/8 12.3, 9/8 14.9, 10/8 16.4
3rd Biopsy 9-2008 Positive 7 of 7 cores positive, ranging from 40 - 90%, G 4+3 & 3+4
Open RP surgery  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, Catheter out 12/29/08.  After 7 hours, complete stoppage again, emergency room put in Catheter #3 early evening of day 45, still 12/29/08. 1/5/9 - Cath #3 out, dr. did cycloscope, saw potential blockage, put in Catheter #4, 1/9/9 - pre-op, 1/13/9 - corrective operation scheduled at St. Francis
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.
First PSA Post Surgery  Scheduled now for 2/9/9
 
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25382
   Posted 1/10/2009 12:36 PM (GMT -6)   
kcragman,
hope you were kidding. struck me as an odd thing to say. my opinion is no better, no more qualified then any other in here. I have no magic insight, I am a just another man dealing with Prostate Cancer, and I am surviving the best I can. What I just suggested to "confusion" was right out of the text book, standard answer from most urologist/surgeons. I am still hoping I made the right choice and order for me.

David in SC
Age 56, 56 at DX
PSA 7/7 5.8, 7/8 12.3, 9/8 14.9, 10/8 16.4
3rd Biopsy 9-2008 Positive 7 of 7 cores positive, ranging from 40 - 90%, G 4+3 & 3+4
Open RP surgery  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, Catheter out 12/29/08.  After 7 hours, complete stoppage again, emergency room put in Catheter #3 early evening of day 45, still 12/29/08. 1/5/9 - Cath #3 out, dr. did cycloscope, saw potential blockage, put in Catheter #4, 1/9/9 - pre-op, 1/13/9 - corrective operation scheduled at St. Francis
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.
First PSA Post Surgery  Scheduled now for 2/9/9
 
 


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 1/10/2009 12:47 PM (GMT -6)   
Welcome to the club confusion. I know there are many other clubs you would rather join however the fact is you are here so get your monies worth. Decision or so individual so my two cents are to get yourself educated as best you can. One way is to ask questions from the folks here at the forum, other is to read books, check websites, etc. Once you have established your protocol give it all you got and don't look back. This is a battle you can win and luckily there are a few ways to attack. If I can be of any help please let know.

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%
 


don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 1/10/2009 12:56 PM (GMT -6)   

Hi Confusion,

I have recently completed IGRT/IMRT using the Varian Smartbeam machine. My case is considered advanced due to potential lymph node envolvement. I had a combined full pelvic and prostate focused radiation treatment (see signature for detail) around the 20th treatment I developed diarrhea and urinary burning and frequency. Imodium relieved the first and Flomax relieved the second two. As soon as the last full pelvic (#25) was completed the diarrhea resolved within 48 hours. I did continue on the Flomax until the end and for three weeks after. I have had only one episode of diarrhea and regurgitation about six weeks after completion. Only one incidence. I have had no more occurrences and have resumed my workout schedule. All in all I would rate the side effects as benign.

Each of us is different in terms of our physical ability to tolerate and heal from injury so my experience may be very different from yours.

One note on your comment regarding redoing radiation. I have been told that it cannot be repeated. However, I have seen some recent research that indicates the use of seeds (brachytherapy) placed in prostate tissue as a salvage for failed radiation where it can be established that the PCa is organ confined. I have also read some interesting information regarding salvage surgery performed in Germany. Also in Dr Walsh's book he mentions that with the use of IMRT and better targeting methods today that surgery may not be ruled out as salvage. Radiation causes fibrosis in the gland and surrounding areas which makes it difficult to detach the remaining organ without potential damage to the bladder or rectum. Dr Walsh does state that the choice of surgeon will be key to success and that side effects will be increased.

Another modality for salvage is cryotherapy. Side effects are there but advancements in technique are helping to limit them. 

Well, I am getting a bit long winded so I will close. I wish you luck and good results from whatever treatment you choose.

Take care,

Don


Diagnosed 04/10/08
Age 58
PSA 21.5 (first and only test resulted from follow up visit to emergency room for kidney stone. first time for kidney stone too)
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear
Chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Lupron injection on May 15 and every four months for next two years
PSA test on July 14, 08 after 8 weeks hormone .82
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 to be full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
Second Lupron shot 09/11/08
Next PSA test by oncologist 03/09
 
 


Ziggy9
Veteran Member


Date Joined Jul 2008
Total Posts : 981
   Posted 1/10/2009 1:13 PM (GMT -6)   
I tell everyone new here to take your time and learn the treatment options available, their side effects and the impact of all this on your lifestyle and family. There is no need to rush and remember there are no do overs. Knowledge is empowerment. Urologists will near always recommend surgery, that's what they do. While radiologists will near always recommend radiation. Please take that into account. Do get other opinions from other doctors. There's much to take into account. For example I first was leaning towards robotic surgery, then brachytherapy radiation. Finally I rejected both and went with a new clinical research study I'm very happy with and it had minimal effect on me and my life. But first and foremost DON"T RUSH TO CHOOSE A TREATMENT!!!!

When everything you soon will learn becomes overwhelming I suggest you take a week off away from all of it. Later when you decide take a few days off to reflect before making the final decision. Then once you do don't look back.
Diagnosed 11/08/07
Age: 58
3 of 12 @5%
Psa: 2.3
3+3=6
Size: 34g
T-2-A
 
2/22/08
3D Mapping Saturation Biopsy
1 of 45 @2%
Psa:2.1
3+3=6
28g after taking Avodart
Catheter for 1 day
Good Candidate for TFT
(Targeted Focal Therapy)
Cryosurgery(Ice Balls)
Clinical Research Study
 
4/22/08
TFT performed at University of Colorado
Medical Center at Denver Fitzsimons Campus
Catheter for 4 days
Slight soreness for 2 weeks but afterward
life returns as normal
 
7/30/08
Psa: .32
 
11/10/08
Psa.62
Not unexpected bounce after
the 80% drop the quarter earlier.
Along with urine flow readings, and
acceptable amount left in bladder measured
by sonic. Results  warrant skipping third
quarter tests, and to return 
April, 2009 for
final biopsy scheduled to
complete clinical research study 
 
 
 


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 1/10/2009 1:58 PM (GMT -6)   
www.paactusa.org  (for advanced cases of PCa patients-assistance)

Just to start.

Post Edited (zufus) : 1/10/2009 12:05:08 PM (GMT-7)


Confusion
New Member


Date Joined Jan 2009
Total Posts : 13
   Posted 1/10/2009 3:23 PM (GMT -6)   
Well I appreciate everyone's candor and help. I will do research on the other treatment types. I don't plan on rushing into treatment. I was not aware of the other treatment types that 'zufus' suggested and will look into them.

Everyone's help will give me better direction and thoughts. his was unexpected but not making me rush.

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 1/10/2009 5:00 PM (GMT -6)   
Confusion-Welcome to the jungle cause that is what PCa turns out to be, I agree don't rush, my brother has been with PCa for 4+yrs. while he is monitoring and no change in psa's or anything else so far. Hopefully you are not talked into any proceedure, without knowledge prior.

I never say rush to anybody, in most cases its been growing in your body for 10-20 yrs. before you got diagnosed, they say. Majority of patients are diagnosed with early and less aggressive PCa, exceptions may exist with younger patients to some degree.

But if you are concerned the rush might be to know what is known and or definable in the PCa jungle, lots of exceptions, lots of grey unknowns on every aspect: psa, biopsy, pathology, staging, scans, assessments-nomograms-Partin tables-then comes protocols and treatments, the truth is nothing is 100% in this jungle, ever. Knowledge is your best advocate in making the choice you have to live with, and only you.

Best to all of us

Post Edited (zufus) : 1/10/2009 3:04:22 PM (GMT-7)


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4231
   Posted 1/11/2009 1:30 PM (GMT -6)   

Hello Confusion...sorry you are here, but this is a place with lots of good advice and compassion.  Shown below is a reply I gave to another "newbie" a couple of weeks back.  Hope this helps.

Also, one of the members, Rolerbe, I believe, posted this link which I think you will find very helpful.

http://content.nejm.org/cgi/content/full/359/24/2605?query=TOC

Tudpock (the following was posted approx. Dec. 30...post procedure quality of life continues to be normal today)

Hello 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 Brachytherapy 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.
 
 
Tudpock



Age 62
Gleason 4 +3 = 7
T1C
PSA 4.2
2 of 16 cores cancerous
27cc
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 12/30/08.

Post Edited (Tudpock18) : 1/11/2009 3:50:15 PM (GMT-7)


kcragman
Regular Member


Date Joined May 2008
Total Posts : 240
   Posted 1/12/2009 1:12 PM (GMT -6)   
Purgatory -

I said "Just kidding." I could have put anybody's name in there. Frankly, yours was the first to pop into my mind. I thought it was freaky/hilarious that a post from you coincidentally popped up 5 minutes after mine. You were obviously writing your post while I was sending mine.

I apologize for any concern this may have caused on your part. I was absolutely not making any statement/comment/judgement/insinuation about your posts.

Be well,
kcragman
Age: 53; 52 at DX
March 2006: PSA 2.5
Dec 2007: PSA taken for insurance application. I did not see the results until late
              Jan '08 - after I was rejected. Their lab said PSA 4.5.
Feb 2008: PSA 3.7.
March 2008: Biopsy. Gleason 7 (4+3) 12 cores taken. 5 on the left side were
              cancerous and the 6th was suspect.  
May 5, 2008: Da Vinci robotic laparoscopy at GW Hospital, Washington DC.

Post op: Gleason 9 (4+5). 15% of prostate involved. Stage: pT3a. Negative margins. Lymph node and nerve samples taken, and appeared to be cancer free.

July 2008: PSA at 7 weeks was undetectable.
August 2008: PSA at 14 weeks (3 months) was undetectable.
Nov 2008: PSA at 6 months was undetectable.


brb0923
Regular Member


Date Joined Jan 2009
Total Posts : 32
   Posted 1/12/2009 1:37 PM (GMT -6)   
Welcome to the club,
Yeah it's real confusing and i'm still absorbing all of this. I am active waiting, trying dietary changes and monitoring psa quaterly. Can't add anything new, but this site has tons of information. You are far from alone. Best to you

Check the links provided by zufus.
Age 59, very healthy
Psa 2007 3.2
Psa fall 2008 4.9 two weeks later 4.4
11/2008 biopsy, T1c, gleason 3+3=6 low-volume prostrate carcinoma
1 of 12 samples malignant
Left lateral mid .05mm (5%)
CT scan negative
Consultation 12/2008 decided active waiting (diet) while researching options.
Followup PSA in March 2009


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4247
   Posted 1/12/2009 2:22 PM (GMT -6)   

Confusion,

With a Gleason 6 you have a lot of options(if in fact you really have a gleason 6; I originally thought I had a gleason 6, but it was actually a gleason 7). The best adivice I got was to get a 2nd opinion from a prostate oncologist. You can find a list of oncologists on Prostate Research Institute's web site. My oncologist was far more knowlegable than any of the 5 Urologists I had seen and recommended 3 other tests that were never mentioned to me by any of my other doctors. He also said that my path reports, PSA history and recommendation for surgery didn't make any sense and that we had to get more data in order to come to a treatment recommendation.

I found that prostate oncologists have less of a vested interest in pushing a particular treatment and spend much more time in trying to stage your cancer using many more tests that a urologist would use. The more accurate the initial staging the more effective the treatment will be. In my case the initial stating was completely wrong and the treatment I was originally persuing would not have been effctive.

JohnT


Diagnosed 10-08 at 63 with PSA of 33
PSA was 4.4 in 1999 and has risen steadily.
Had 13 biopsies and an endorectal MRI, all negative until 10-08. Two cores out of 25 with a gleason 6
2nd opinion with an oncologist said cancer found was insignificant, but suspected larger tumor somewhere.
Doppler ultrasound with target biopsy indicate a large tumor in the transition zone, gleason 7.
Bone and CT scans negative.
PSA3= 43; (high normal is 35)
Scheduled for Combidex MRI in Feb. (Lymph node imaging MRI done in Holland).
Location of tumor makes positive surgical margin unlikely.
Looking at IMRT with hormone therapy as soon as staging is complete with Combidex MRI.
Changed diet, eliminated all meat and dairy. Taking the normal supplements recommended for PC.
 
JohnT
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
John T


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25382
   Posted 1/12/2009 3:42 PM (GMT -6)   
kcragman, no foul, no offense taken.
Age 56, 56 at DX
PSA 7/7 5.8, 7/8 12.3, 9/8 14.9, 10/8 16.4
3rd Biopsy 9-2008 Positive 7 of 7 cores positive, ranging from 40 - 90%, G 4+3 & 3+4
Open RP surgery  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, Catheter out 12/29/08.  After 7 hours, complete stoppage again, emergency room put in Catheter #3 early evening of day 45, still 12/29/08. 1/5/9 - Cath #3 out, dr. did cycloscope, saw potential blockage, put in Catheter #4, 1/9/9 - pre-op, 1/13/9 - corrective operation scheduled at St. Francis
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.
First PSA Post Surgery  Scheduled now for 2/9/9
 
 


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 1/12/2009 4:31 PM (GMT -6)   
John T, I believe has the number one thing patients and their docs need to know, the overall assessment of the patient, disease level, confinement percentages Partin tables(etc.), the patients health (might determine some methods he should not do) and blood markers...yada...yada, expert pathology is the key...uro-doc's send that out and read the report (then they might know what you have: PIN, HG PIN, Gleason scores, volume/percentages PCa found in each biopsy, perinureal invasion, benign tissue, or 18 variant possible PCa's only a maybe an expert pathologist could figure out, without the pathologists they could not assess very much at all, there are other things that can be defined by pathology too. (ploidities DNA stranding of PCA cells actually 3 types). Uro-doc can add psa history, utlra sound tests, DRE, gland size, etc. Then you have data to plug into the nomograms and Partin Tables etc. So that you can have an idea of statistical organ confinement, and nomograms for treatment efficacy to look over. Its kind of like let's do the math, once you have a subset of numbers from the real world (close as they can compile) you should know the odds for a successful treatment atleast to some degree. My uro-doc had nothing to say, I understood better little later.





The type of prostate cancer most of us probably herein have should be Acinar, the andemocarcenoma (spelling) is synonymous with 'prostate cancer' the type is: Acinar or others.

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