Choosing Surgery

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ConcernedDC
New Member


Date Joined Nov 2008
Total Posts : 5
   Posted 2/27/2009 6:21 AM (GMT -7)   
I have decided on a treatment plan - assuming the bone scan and the CT scan are negative, I'm having open surgery on 12 March, despite the high Gleason score.  According to what I have read and been told by the docs, there is a fair probability that the cancer is already outside the prostate.  Nevertheless I think that surgery gives me the best chance for long-term survival.  The other option I was provided was to skip the surgery and have IMRT along with hormone therapy. 
The side effects of surgery really worry me, but I feel I have to take the chance that surgery will get all of the cancer out.  If not, I still have the other treatments available. 
 
BillyMac, thanks for the link you provided earlier on questions to ask the docs - it really helped.
 
Steve

Age 49
PSA: Feb 2006 - 2.1
Feb 2007 - 2.9
Oct 2008 - 3.8
Nov 2008 - 4.2
 
DRE - GP said he felt something; Urologist said he didn't feel anything.
Biopsy done 15 Dec 08.  2 of 12 cores positive, both on right side. One 5% 3+3=6, one 20% 5+5=10.
 
My Father: DX with PC in 1994 at age 62.  Had already spread outside prostate.  Radiation, hormones.  It came back in 2006 - chemotherapy treatment.  He is now under Hospice care.


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 2/27/2009 6:51 AM (GMT -7)   
Excellent Steve...getting the treatment plan decision behind you is the first step. My advise now, is to take a few days to step away from the thoughts about cancer and enjoy family time. Getting to this point has been nothing but stress and anxiety for you and your loved ones. So taking a few days or weeks to 'forgetaboutit' is in order.

I know if I were in your shoes with the same stats...I would make the very same decision for the very same reasons...the chance for a cure.

Best of luck to you and we will see you on the "other" side...
You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal-Gland 38 cc
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral (Perineural Invasion present at base) - Gleason (3+3) 6  Stage T1C
August 23 - Bone Scan - Hips, Spine and ribs marked uptake - X-Ray showed clear -Hooray
Sept 9 2nd DRE - questionable - TRUS...shadow in base - Gland now 41 cc
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (4+3) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
4 tumors in prostate - largest being 6 cm 
PSA 5 week Oct 2008 <.05
       3 month Jan 2009 .06


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25353
   Posted 2/27/2009 7:29 AM (GMT -7)   
Steve, based on your own personal stats and the family history with PC, I think you made the correct choice.
I will be happy to hear when you make it back from the "other side" of your surgery. If it is not fully contained, then you will have other options to work with. With the open surgery, your dr/surgeon(s) will have total access to you and it should work well in your favor. Hoping the best for you.

David in SC
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Right nerves saved, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05
 
 


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2455
   Posted 2/27/2009 9:29 AM (GMT -7)   
Steve,
I think you made the right choice. My PC was also aggressive and I had the same 2 choices you have. I opted for Robotic surgery since I can always use radiation if it came back after the surgery.
Age: 67
Retired in 2001 and living in Austin TX.
PSA 3.5 free PSA 11%
Dx 12/30/08
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed on Feb 9th
Surgeon: Dr. Randy Fagin, Austin TX.
Post op Pathology report:
Prostate weighed 57 grams
size:5.2 x 5.0 x 4.9 cm
10-20% involved
Bilateral
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx
Negative margins
Lymph nodes: not dissected
seminal vesicles clean


CPA
Veteran Member


Date Joined Feb 2008
Total Posts : 655
   Posted 2/27/2009 10:08 AM (GMT -7)   

Greetings, Steve.  Sorry you have to be here with us, but since you are let me assure you that you are among friends.  There will be lots of questions in the days, weeks and months to come - please feel free to use this group as a sounding board. 

As you know, however, when it comes right down to it you have to make your decisions along with your family and your medical providers.  For me, surgery was the only choice.  Now that you have made that decision, don't look back.  Yes, a lot of things change.  However, bottom line my wife and I are closer than ever having gone through all we have gone through over the last year and done it together.

Best wishes in the next couple of weeks - relax and get ready - everything will go great.  David


Age 55
Diagnosed Dec 2007 during annual routine physical
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 positive with 2 marginal
Gleason 3 + 3 = 6
RRP 4 Feb 08
Both nerves spared
Good pathology - no margins - all encapsulated - Gleason 4 + 3 = 7
Catheter out Feb 13 - wore pad for couple of days - pad free Feb 16
Great wife and family who take very good care of me


mirv
Regular Member


Date Joined Nov 2008
Total Posts : 30
   Posted 2/27/2009 3:05 PM (GMT -7)   
Hi Steve,
I think I would probably proceed the same way with your stats because I like the idea of actually getting the tissue out of there if possible. The second opinion on the biopsy cores also sounds like something that needs to be done. Before my surgery I asked my surgeon if a second opinion would be good and he said that he always did them just to be sure, but with such a wide difference in scores it sounds like you really should check it again.
Best of luck and take care,
Mark
Age 52
PSA 3.1 fPSA 26% Dx: 11-07-08
1 of 12 cores with 5% adenocarcinoma
11 of 12 cores clear Gleason grade 3+3=6
Robotic laproscopic surgery 2-4-09
Dr. Garret Matsunaga, Torrance Memorial Hosp.
Free hernia repair! 2 day stay.
Pathology: pT2c NXMX
upgraded to 3+4=7 and <2% tertiary 5
negative margins
negative extraprostatic extension
negative seminal vesicle invasion


LJF
New Member


Date Joined Feb 2009
Total Posts : 14
   Posted 3/7/2009 9:53 PM (GMT -7)   
As Les said, the hardest part is deciding on what course of action to take. If you are good with your decision and the person performing the surgery, that's all that matters right now. If you can manage it, take a bit of time off now and go enjoy life with family/friends. Go do something enjoyable. This whole process of making the rounds to get the expert opinions, which may or may not be unanimous, is highly stressful.

Prior to the surgery, a big time stressor in its own right, plan on doing something enjoyable a month after its been done. That way, you have something to look forward to and can take a little break from the big "C" you know doubt feel you have emblazoned on your forehead.

Best wishes to you!
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