Welcome new friend- richienofear

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James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 2/27/2009 9:09 AM (GMT -6)   
In another thread, richienofear posted for the first time, saying:

Newly diagnosed Psa 2.3,biopsie report 3+3 left base,4+3 mid lat,surgeon suggest davinci radical,waiting to get second opinion from radialogical oncologist on Mar 18,good health,any suggestions,oh my prostate is 61.5cc,first urologist suggested 2yrs hormones and seed implants,I dont like side effects of hormones,nixed that thanks ,richienofear

Welcome to the Forum, Richie. Hate to see ya here, glad you came...Your scaling seems to indicate early stages of the disease, so you don't have to be in a big rush. Spend plenty of time reading and researching your option, then make an informed decision and don't look back. Making an informed decision is the hard part, isn't it? :-) If you've spent any time here before posting, you realize the options are varied and the opinions as well, but the experience factor is unmatched, in my opinion.

It would be helpful if you would organize your info into a Signature, so it is posted each time you post. This helps others speaking with you to see where you are at on your Journey and lets you share your progress. Just click the Control Panel button on the left side, then click the Edit Profile button, scroll to the bottom of that page and fill out the signature box.
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
16 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix .35ml 2X week continues
PSA's: .04 each 3 months

Post Edited (James C.) : 2/27/2009 8:28:27 AM (GMT-7)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 2/27/2009 9:23 AM (GMT -6)   
Welcome here, Richie. As usual, always glad to have a new friend among us, but wish you didn't have the need to be here. I agree with James above, if you could put up a signature, it would help us understand where you are at. With what you have shared, I would definitely slow down and investigate fully each of your possible treatment options. Once you make it, you have to live with it of course. Look for Tudpock here, resident guru on "seeding", he could answer your questions on that treatment. Plenty of men here with recent experience with both Robotic and open surgeries. Be happy to help 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
 
 


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4157
   Posted 2/27/2009 11:10 AM (GMT -6)   

Richie:

As the others have said...sorry to have you here with the disease.  Having said that, this is a great forum for info and support and I hope you will feel free to ask any question since there are lots of caring men and women here who have spent a lot of time researching PCa.

Re the seeds, I think you got the right advice from your urologist re the need to shrink the prostate prior to seed treatment.  You certainly should ask the radiation oncologist about this but, generally, brachytherapy is suggested for patients with prostates 50 cc and under so your would need some shrinkage prior to that treatment.  I doubt the two years, however, as it should not take that long to go from 60 to 50.  Again, ask the radiation doc.

If you want first person info on seeds, I suggest you look at "JustJulie's Brachytherapy Journey" on this site or my more recent journey, "Tudpock's Brachytherapy Journey", also on this site.  And, if you have specific questions, please don't hesitate to ask.

Finally, it sounds like your disease is early stage so please take the time to research all of the options you may have.  That will include not only seeds and surgery but also proton beam radiation, HIFU amd others.

Good luck.

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 1/31/09.


richienofear
New Member


Date Joined Feb 2009
Total Posts : 18
   Posted 2/27/2009 12:23 PM (GMT -6)   
thanks for info will keep you all updated
working at it


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 2/27/2009 12:49 PM (GMT -6)   
usual commission will work, tudpock. lol.
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
 
 


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4157
   Posted 2/27/2009 6:50 PM (GMT -6)   

David...the check is in the mail...

LOL, 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 1/31/09.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 2/27/2009 7:33 PM (GMT -6)   
A few more like that, and I might make my next car payment!
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
 
 


richienofear
New Member


Date Joined Feb 2009
Total Posts : 18
   Posted 3/7/2009 7:53 AM (GMT -6)   
does anyone have an idea of how long it would take to shrink a 61.5cc prostate down to 50cc using Lupron?
working at it


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4227
   Posted 3/7/2009 11:53 AM (GMT -6)   
If you are afraid of the effects of hormone therapy, especially Lupron, Casodex and proscar will also shrink the prostate with very few side affects in an 8 week period. Please post your stats, because Lupron is given if there is a high probability that the cancer has spread. If it is fairly certain it is contained then Casodex and proscar should do just fine.
JohnT

Modified by moderator ~ Tony Crispino

 John your signature is in space consumption overload again...Please look at your posts when done.  If you need help let me know

Post Edited By Moderator (TC-LasVegas) : 3/7/2009 12:53:28 PM (GMT-7)


richienofear
New Member


Date Joined Feb 2009
Total Posts : 18
   Posted 3/9/2009 5:57 PM (GMT -6)   
i HAVE A 3+3 IN ONE LOBE ON LEFT BASE,ONE ON THE RIGHT MID LAT AT 4+3,i HAVE AN APPOINTMENT WITH A RADILOGICAL ONCOLOGIST AND WILL ASK about PROSCAR OR CASODEX,THANKS FOR INFO.
working at it


richienofear
New Member


Date Joined Feb 2009
Total Posts : 18
   Posted 3/10/2009 5:23 PM (GMT -6)   
now that i heard the news on over treatment of prostate cancer I am wondering whether i should do active surveilance of my cancer, 2of 12 cells cancerous one a gl 7 other gl 6,any opions out there are surely appreciated,thanks
working at it


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4227
   Posted 3/10/2009 6:04 PM (GMT -6)   
Richieofear,
Watchful waiting is OK for a gleason 6 with a low PSA (under 10) and less than 5% core involvement. I don't think you should wait with a Gleason 7, and 2 cores in different places. This indicates the cancer is multifocal. What was your % core involvement?
JohnT

64 years old.

I had an initial PSA test in 1999 of 4.4. PSA increased every 6 months reaching 40 in 5-08. PSA free ranged from 16% to 10%. Over this time period I had a total of 13 biopsies and an endorectal MRIS all negative and have seen doctors at Long Beach, UCLA, UCSF and UCI. DX has always been BPH and continue to get biopsies every year.

In 10-08 I had a 25 core biopsy that showed 2 cores positive, gleason 6 at less than 5%. Surgery was recommended and I was in the process of interviewing surgeons when my wife's oncologist recommended I get a 2nd opinion from a prostate oncologist.

I saw Dr Sholtz, in Marina Del Rey, and he said that the path reports indicated no tumor, but indolant cancer clusters that didn't need any treatment. He was concerned that my PSA history indicated that I had a large amount of PC somewhere that had yet to be uncovered and put me through several more tests.

A color doppler targeted biopsy in 11-08 found a large tumor in the transition zone, gleason 6 and 7. Because of my high PSA Dr. suspected lymph node involvement, 30% chance, and sent me to Holland for a Combidex MRI, even though bone and CT scans were clear.

Combidex MRI showed clear lymph nodes and a 2,5 cm tumor in the anterior. I was his 1st patient to come up clear on the Combidex which has a 96% accuracy,

I've been on a no meat and dairy diet since 12-08 and PSA reduce to 30 while I awaited the Combidex MRI.

The location of the tumor in the anterior apex next to the urethea makes a good surgical margin very unlikely. Currently on Casodex and Proscar for 8 weeks to shrink my 60 mm prostate. Treatment will be seeds followed by 5 weeks of IMRT while continuing on Casodex and Proscar. So far no side affects from the Casodex.

JohnT


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 3/10/2009 6:32 PM (GMT -6)   
Hi again, Mr. Nofear!

I don't see your age. That is helpful in the decision process. You should consider what expectancy is for you and your family. Many fail to do so. Seeds are a great solution but they were not when I was diagnosed at 44. I too am a 4+3 guy...Unfortunately advanced...but I had 4 of 9 cores at up to 90% positive, as well. You look quite a bit better off.

Tony
Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (January 13, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


richienofear
New Member


Date Joined Feb 2009
Total Posts : 18
   Posted 3/12/2009 4:06 PM (GMT -6)   
I'm 68 years old and the 4+3=7 was 5% cancerous and the 3+3=6 was 30% cancerous,multi focal.

working at it


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4157
   Posted 3/12/2009 5:44 PM (GMT -6)   

Dear Richie:

I have cut and pasted part of a post I recently included in another thread.  Dr. Ballentine Carter of Johns Hopkins is the doc that runs this program.  These are some very good guidelines as to whether to consider watchful waiting...

Tudpock

Re the issue of "watchful waiting", "active surveillance" or, as Johns Hopkins references it, "expectant management", had I had the right stats I would have chosen that course.  I didn't and don't regret choosing treatment.  Re Tony's comment about John being too general, here are some specific guidelines from Johns Hopkins for patients they allow into there "expectant management" program:

1.  Age 60+.

2.  T1C, i.e. nothing felt on DRE.

3.  PSA density of .1 or less (this is PSA divided by size of prostate, e.g. PSA of 3 divided by prostate size of 35cc equals PSA density of .086 which is less than the .1 threshhold.

4.  Gleason 6 or less.

5.  2 or fewer cores of cancer.

6.  No core with more than 50% cancer involvment.

So, you can see that these requirement eliminate most of us.  In other words, only older men with VERY early state PCa are suggested to consider "expectant management".  However, for those that do, they undergo frequent PSA testing and biopsies and, as John mentioned, only a small percentage require treatment after 3 years.  Hence, these men don't get "overtreated".  To take this approach, however, DOES require a mindset of living with cancer, something many men cannot do, hence their urgency to "get it out".  Those men may indeed be "overtreated", but it's because of their own decision making not because they took a PSA test...

Respectfully submitted,

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 3/6/09.


richienofear
New Member


Date Joined Feb 2009
Total Posts : 18
   Posted 6/11/2009 5:01 PM (GMT -6)   
turn  Well,i had the davinci surgery on May 21
post surgery pathology report
3=4=7 gleason
both lobes
vascular invasion-not identified
right nerve saved ,left gone
perineural invasion -yes
% ofprostate involvement by tumor-1%
surgical margins- free
capsular invasion -not identified
presence of PIN-yes
seminal vesicles-free
lymph nodes -not applicable
stage-ptc2cNXMX
size-75 grams
cathether out in 10 days
3 weeks since surgery 4 pads a day
hoping that I am dry in 3 or 4 months
got me on 50mg viagra every other day
hope it helps
 
 
working at it


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 6/11/2009 6:32 PM (GMT -6)   
Well, welcome to the other side and the first steps in part 2 of your Journey. The path report sounds really good, sorry about the one nerve loss. Here's wishing you an uneventful and quick recovery of all functions...
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
21 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix .35ml 2X week continues
PSA's: .04 each 3 months


DS Can
Regular Member


Date Joined May 2009
Total Posts : 195
   Posted 6/11/2009 8:21 PM (GMT -6)   
 
Heal well richienofear,
 
You should be feeling a little better every week.
Hope is a wonderful thing.
 
DS
 
PSA 01/07 was 1.2, PSA 01/08 was 1.9, PSA 01/09 was 2.5.
BIOPSY 02/24/09, adenocarcinoma DX at age 52
 Right:GS 3+3=6, tumor 3/6 cores, 10% involvement,PNI-Yes
 Left: GS 3+3=6, tumor 1/7 cores, <5% involvement,PNI-No
LARP 04/09/09,nerve sparing. Final pathology:
 GS 3+4=7, Margins uninvolved, 2 lymph nodes negative.
Catheter removed on 04/17. First no-pad day was 05/03.
ED treatment is 25 mg Viagra nightly.
First followup PSA results on 05/28/09: <0.1,undetectable!
 
 


CPA
Veteran Member


Date Joined Feb 2008
Total Posts : 655
   Posted 6/12/2009 6:18 AM (GMT -6)   
Welcome to the other side of surgery.  Glad you are doing well and we'll trust you will get excellent progress reports and a long long lifetime of zero's.  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
PSA every 90 days - ZERO's everytime!
Great wife and family who take very good care of me


gtmriviera
Regular Member


Date Joined May 2007
Total Posts : 338
   Posted 6/12/2009 8:16 AM (GMT -6)   
After my biopsy I was told that we had caught this "very very early".  I read as much as possible about the treatment options, but I did not want to worry in the future about the PC coming back so I chose surgery.  Due to major health problems with elderly parents I put off the surgery for a couple of months longer than I would have otherwise.  After the surgery I was told that without the surgery I would have had about five years.  Slow moving and watching is fine, but it's not like risking five dollars on the lottery.  It's your life that you're betting on. Why don't I have a signature?  Because I never read anyone else's.  Sorry.

Post Edited (gtmriviera) : 6/12/2009 8:19:15 AM (GMT-6)


richienofear
New Member


Date Joined Feb 2009
Total Posts : 18
   Posted 6/12/2009 5:30 PM (GMT -6)   
thanks for the input ,I am now taking it one day at a time and as those days mount up I know I will be on my way to recovery
working at it


richienofear
New Member


Date Joined Feb 2009
Total Posts : 18
   Posted 7/3/2009 2:46 PM (GMT -6)   
tongue   turn well I'm now 6 weeks out of surgery'doing well mentally,walking 2 miles a day,doing kegels 4 times /day,I am dry at night,and using 1 or 2 pads a day depending on how active I am, I am going to try golfing on Sunday,may stop if I feel any twinge,up to this point I am very happy with my recovery,I am still taking Viagra 50 mg every other day,self manipulation( **********) has worked with only semi hardness,but still a nice feeling without the sperm,but at 68 I didn't expect very much at this time,overall I believe I have made the right decision by going da vinci method,I am due for first psa test in August,hoping for a zero,thanks again for all your help thru this ordeal,best to all of you.
richienofear
working at it


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 7/4/2009 7:51 AM (GMT -6)   
Good news, thanks for sharing it with us.  May the rest of your journey to recovery be so easy...
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
21 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix .35ml 2X week continues
PSA's: .04 each 3 months


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 7/5/2009 9:40 PM (GMT -6)   
As a word of encouragement, some data that I posted several weeks ago lumped one nerve spared together with both nerves spared and showed good ED results 12 months out. I take this to mean that that while we think that two is better than one, nature can get by on one just as well.

Dry at night and 1-2 pads a day is good progress. As things progress many guys shift to one lighter pad per day and finally notice that even that is not needed.

Your path looks good so I hope you are saving up so you are able to pay your dues to the zeros club.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan 1/09 negative, Bone scan 1/09 negative

Robotic surgery 03/03/09 Catheter Removed 03/08/09
Pathology report. Lymph nodes negative, Seminal vesicles negative
Margins positive, Capsular penetration extensive Gleason 4+3=7
6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
10 weeks: no pad at night -- slight unpredictable leakage day/1 pad.


richienofear
New Member


Date Joined Feb 2009
Total Posts : 18
   Posted 12/3/2009 7:45 AM (GMT -6)   
December 2,2009 6 months since Da Vinci
Well my psa result is .001
I am still using 1 pad/day
but not much leakage
Ed still there
using pump twice a week
50 mg viagra every other day
I feel I am doing very well at this point
playing softball twice a week
golfing once a week
tennis once a week
life is good
working at it,on my journey

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