Scared and confused

What treatments would you consider
1
Radiation and seed - 5.9%
1
Natural approach - 5.9%
13
surgery - 76.5%
2
other - 11.8%

 
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NE1haveanswers?
New Member


Date Joined Mar 2009
Total Posts : 3
   Posted 3/29/2009 12:40 PM (GMT -7)   
As I sit here I have no idea what to do. In July 2008, I was told I had prostate cancer. Doctor gave me comfort telling me it was early and very treatable so at first it did not sound too bad.
 
That all changed when he suggested surgery and told me the "possible" complications.
 
I am 46 and have a 30 year old wife. I enjoyed a very active sex life and find life wearing diapers to be unacceptable.
 
I am passed the "why me" stage and have done tremendos research into the subject.
 
So far, we have (I) opted for watchful waiting. Doctor was asking me to do the treatment by the end of March 2009. It's the end of March and I have not given the go ahead.
 
I have become convinced that I am responsible for the cancer based on my diet and that a new diet may be the answer.
 
Since everyone I go to has a profit motive, I have had to do a lot of reading.
 
 
My reading has told me that men with low grade cancer (Mine is A2 with a gleason 3+3) have a 2% chance per year of the cancer spreading to outside the prostate. My current doctor told me of a recent patient who waited 3 years before finally deciding on the treatment.
 
I have a personal friend who was on his deathbed with prostate cancer and did a body clense and is cancer free 15 years later.
 
My neighbor did radiation seeds 5 years ago and is now seeing symptions again.
 
 
Currently, I am on pumpkin seeds, Co Q 10, Flaxseed oil, Pomegranate supplements, Sawgrass, selinium, and zinc. I no longer eat red meat or dairy products, and have ramped up my exercise.
 
My reasearch tells me all of these have some hope in prevention, slowing growth and curing this cancer.
 
My PSA has been up and down in the last 3 years from 5.0 to 6.0 and is at 5.5 now.
 
What is the rush to cut me up ?
 
By waiting, I can give this natural approach a chance or the several treatments showing promise in stage 2 or 3 trials.
 
Is there anyone out there who has tried a natural approach ?
 
I am a fairly young man and the thought of these side effects makes it easier to gamble on death.
 
Honestly, I have lost my faith in modern medicine.
 
 
Robert. eyes
 
 
 
 
 
 
 
 

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 3/29/2009 2:02 PM (GMT -7)   
Like to remain normal manhood as long as possible? I know of a person whom did the Dr.Leibowitz protocol of 13 months of ADT3 hormone therapies, after that quit and stay on proscar or avodart for maintenance. He had higher numbers than you it appears at diagnosis. It is 13 yrs. since his original diagnosis, he just recently resumed second round of ADT3 for another 13 months. After the first 13 months he regained manhood and total normalcy within months and enjoyed about 11-12 years in normalcy.

He could still get any treatment for PCa anyway, surgery would be more difficult (trully). But he is not electing to those at this time and the second round of ADT3 is showing effective in control of psa, as it is dropping still.
This is no more insane than having your prostate (revised verbage as Biker pointed out should be used)-taken out right now, while you might have indolent PCa. When it looks like a necessary treatment, then it is perhaps the way to go, you decide.  You need to post and know all your parameters. You might also be able to do some other treatments and remain close to normalcy. You are likely a candidate for watchful waiting, maybe.

You might want to read about this method, he has many patients over many years doing this. You can buy time...which 10-13 yrs. from now they may have the magic therapies we are demanding.

My brother was diagnosed with indolent PCa about 5 yrs. ago now, did nothing but monitor and psa never changed, he surely does not regret waiting thus far. It is also a real option, but not to be taken for granted, either.
But of course you can get treated by anybody almost even with indolent PCa, they are not your advocate for waiting, as time is on your side, money is on their side and he whom collects first wins in the this game of choose a doctor....of course why would I say this?....after 8 opinions I saw plenty of sales tactics.

Best to you in whatever you decide...and I hope it is you that decides...don't be pushed into anything.There is one person who has posted on this board that has done this and thus far has decent results....whether he wishes to elaborate on his journey with this, at this juncture is his option, he is somewhere between 15-18 months thus far on this, I believe. I have talked with him on another board.


 

Post Edited (zufus) : 3/30/2009 4:40:08 AM (GMT-6)


CPA
Veteran Member


Date Joined Feb 2008
Total Posts : 655
   Posted 3/29/2009 2:22 PM (GMT -7)   

Greetings, Robert.  I can only give you my experience - and I'll admit right up front that I am prejudiced toward active treatment rather than natural types of healing.  It seems to me that once you have the disease, it is not a question of "changing" diet or habits to get rid of the cancer, but undergoing some type of medical treatment whether it is surgery, radiation, seeds or something else.

You are a relatively young man - the first thing I'd suggest is to get a second opinion from a qualified medical professional just to confirm the diagnosis.  My doctors considered me young and I was almost 10 years older than you.  My desire was to get rid of the cancer and the treatment with the highest probability of getting rid of the cancer was surgery so that is what we chose.

For what it's worth, the age of your wife has nothing to do with what treatment you choose.  We recently had a thread about guys with much younger wives.  You might want to go back a couple of months and look that thread up.  Frankly, job one is to get rid of the cancer.  My wife happens to be a few months older than I am.  We had been married almost 35 years (yes we got married as mere children), but that didn't mean that our physical intimate relationship was any less important.  In fact over the years it has gotten better and better.  I'll be the first to say that after the surgery it is different - not worse - but different.  I take a pill a couple of times a week and there is more stimulation required but who is complaining about that.  We both miss the ejaculation but as my wife says clean up is a breeze.  Orgasm is different without ejaculation but most times it is very intense - sometimes more intense than before.

As to incontinence, yes there are issues.  Some of us battle it for months and years.  Some of us are fortunate and don't have issues at all.  Whichever category you end up in, there are ways to deal with it.  The most important thing is to get rid of the cancer. 

You have found a good place in this website.  There are many, many people here who have been where you are and are willing to help.  We can give you our experiences and are happy to do so, but the treatment choice is up to you, your family, and your medical professionals.  Keep us posted on what you decide to do.  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


NE1haveanswers?
New Member


Date Joined Mar 2009
Total Posts : 3
   Posted 3/29/2009 2:30 PM (GMT -7)   
I have made a mistake in reading my biopsy.

What I thought was PSA readings was actually a PH reading. I don't know why the PSA is not showing, but I will ask tommorrow of the doctor.

What I do know is this...

2 biospies were done, one in 7-08 and the last one in 11-08.

The first one measured 34 cm of the prostate. Left Mid -Moderately differentiated andocarcinoma. Gleason 3+3 measuring 3 mm (15%of tissue) and involving 1 of 2 fragments.

Left Mid lat - Small focus atyical glands. xrays neg.No Perineural invasionor extraprostatic extension. 1 of 14 cores malignant. Dr.s follow up notes say
low risk because my PSA was < 10, % ws less than 30% and Gleason was 6 or <, but does not give exact info. I stopped listening after the word cancer was said.


2nd test said Left LATERAL mID PROSTAE aNDEOCARCINOMA (gRADE 3+3) INOLVING 5% OF THE NEEDLE CORE . nO EVIDENCE OF pERINEURAL INVASION. LEFT APEX PROSTATE ANDENOCARCINOMA (GRADE 3+3) INVOLVING 10% OF THE NEEDLE CORE -NO EVIDENCE OF PERINEURAL INVASION. SO THAT IS THE UPDATE INFO.
Age 46 gleason 3+3 PSA 5.5 cancer discovered 7-08
 
Current treatment watchful waiting and natural approach with supplements and diet of no red meat or diary.
 
 


CaPCa
Regular Member


Date Joined Aug 2007
Total Posts : 118
   Posted 3/29/2009 2:55 PM (GMT -7)   

I was 44 when diagnosed and treated. I had (and still have) a very healthy lifestyle and diet, with almost no red meat. I did all of the "prostate friendly" foods and supplements. Unfortunately, my family history of prostate cancer won out. Here are some points to consider:

1) Relatively young men in their 40's do particularly well with surgery. I sought out one of the best surgeons in the field. Ignoring the obvious consequence of having no prostate (no ejaculate), I can honestly say neither my wife nor I have any indication that I have had prostate surgery. In fact, in some ways, sex is actually BETTER after surgery, in no small part that I appreciate it even more.

2) I had read that something like 20-25% of men under "watchful waiting" eventually have their cancer advance outside of the prostate, even though they are being watched. Also, you will be subjected to further biopsies indefinitely.

I am biased toward treatment, certainly, but please be careful not to overemphasize the risks of complications and underemphasize the risks of postponing treatment. Best wishes

CaPCa


Age:45 (44 when diagnosed)
Father diagnosed and cured at age 52.
08/21/07: Diagnosed with T1c cancer
1 of 12 biopsy cores positive; 10% tissue
Gleason score: 3+3=6
PSA level prior to biopsy: 4.3 (velocity < 0.4ng/ml)
10/19/07: da Vinci prostatectomy by Dr. Vipul Patel
              Difficult surgery due to prostate inflammation.
              Both nerve bundles spared.
              Spongy erections began within 24hrs of surgery!
10/24/07: Catheter out; down to 1 Serenity pad/day next day.
              Final pathology: neg margins, no capsular penetration,
              Gleason 3+3=6, 5% tumor involvement, multi-focal.
11/04/07  First usable erection with Cialis
11/22/07  Thanksgiving - Bye-bye, pads
01/17/08  First post-surgery PSA result: < 0.008 ng/ml
03/17/08  Erection quality mostly back to pre-surgery levels with Cialis;
              have not tried without meds yet.
04/23/08  Second post-surgery PSA result: < 0.008 ng/ml
07/30/08  Third PSA: 0.01 ng/ml
11/04/08  One year PSA: 0.01
              Still taking 10mg Cialis every other day - enjoying the results
              too much to stop yet.
02/07/09  Taking 5mg Cialis every other day - having too much fun to try
              to stop for now.
03/23/09  PSA: 0.02
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25353
   Posted 3/29/2009 3:14 PM (GMT -7)   
Hello and welcome here, Robert, sorry you need to be here, but its a good group of men and women here. You are in the tough spot of trying to decide what to do or not to do. From your stats, you appear to have a low grade case of PC going on, at this point in time. Where the gamble comes into it, is not knowing now, or never knowing for sure, if it decides to go aggressive on you and escapes the prostate. With your stats, you are also a good candidate for seeds or conventional radiation treatments, but even with that said, then you might not be in a good position to have salvage surgery in the future if the radiation didn't cure it all. The watchful waiting has its place, for sure, and you have been doing that so far, only you know how much you are willing to gamble on waiting in the future. It's important to remember, you have prostate cancer now, its not going to go away on its own, and every day, it is growing inside you, no matter how microscopically. At your much younger age, and I am biased toward this treatment, I would suggest surgery. The side affects vary so much from surgery, from mild to severe, but there are lots of reasons for that too. If you get your prostate removed, then they will be able to know for sure how much cancer is in it and the other removed tissue. Your mild case in reality might be upgrade to something more serious after the tissue is examined closely, remember, a biopsy is just an estimate of what is going on inside. The natural things you are doing, aren't going to hurt you, I would never discourage anyone from improving their lives through proper diet and exercise. But nothing you are taking or doing is going to stop the cancer or make it go away, to believe so, I think, in my opinion, is just a form of denial. It does sound like you have plenty of time to get other opinions from other doctors about the full spectrum of treatment options that should be available to you. I wish you all the best, and hope that we can help you here, as there is a lot of first hand experience here in all the treatment methods.

David in SC
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 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, 6 month on 5/9
 
 


divo
Veteran Member


Date Joined Jul 2008
Total Posts : 637
   Posted 3/29/2009 5:41 PM (GMT -7)   
Maybe you should wait six months and look at the PSA again.....Diane
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
AUS improving..only 2 pads a day and one at night
Complete hip replacement surgery Dr. Waters Gainesville, FL 1/9/09
Hip replacement total success..pain gone!!
PSA .7 2/10/09


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4168
   Posted 3/29/2009 6:17 PM (GMT -7)   
Robert,
Your stats indicate that you are a good candidate for watchful waiting, but you must accept the possibility that you will need treatment in the future if your psa rises or if another biopsy increases your gleason or % core involvement. You can delay any treatment side affects for a number of years, but you have to accept the small risk that the cancer could spread and may no longer be curable. This is the personal trade off you alone will have to make. I would get a PSA test at least every 6 months and a biopsy once per year.
YANA web site has a lot of info on watchful waiting and UCSF has a large trial going on watchful waiting. Both of these would be good sources of information.
Diet can slow the growth of PC but cannot cure once it takes hold.
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


mjluke
Regular Member


Date Joined Jan 2009
Total Posts : 189
   Posted 3/29/2009 6:38 PM (GMT -7)   
Selmer:
You are obviously very well read and knowledgeable as your postings indicate.
I am curious however about your comments re Flaxseed oil- many consume it for cholesterol issues-- the inference is that it can   contribute to prostate cancer. How could anyone possibly know that? Are you aware of any studies or any reputable medical authority such as AMA that agrees with these doctors you refer to. And what exactly is Dr.Ornish selling? Sometimes contoversial statements are made simply to draw attention to or advertise a product.
  
 
 
63 years old-tumor discovered on digital exam- biopsy December 2008-
4 of 12 samples positive-all on right side
Gleason 3+3=6
PSA-3
Otherwise excellent health.
 
  "There may come a day when the courage of men will fail, but it will not be this day."


NE1haveanswers?
New Member


Date Joined Mar 2009
Total Posts : 3
   Posted 3/29/2009 7:12 PM (GMT -7)   
To Selmer and the others,

You have all been so helpful and I appreciate it very much.

I have to admit, a part of me may want to believe it when I read of natural cures, but it does make sense that the body is reacting to what we put into it whether it's good or bad.

I have read of a study where a doctor gave co-Q 10 to his patients and PSAs declined dramatically or that flax seed oil mixed into yogurt combines to kill cancer. I am also on Pomegrante juice, which is in an FDA trial right now.

I am aware and prepared to deal with the fact that very soon I will have to pick from the menu of traditional medicine and live with the consequences, but I think my grade is low enough now so that some more time can be devoted to finding the best method. I am trying to get in a phase 2 trial of gene therapy with the hopes it turns out to kill cancer cells, but if I had to decide today, it would probably be seed and beam as it gets me the best cure rate and the least down time.

I still can't rule out surgery, but it's confusing with so many having good results and so many having bad results. Some would say it's silly, but life without sexual intercouse is not much of a life. It's not just the sex part, but I personally feel like I am only half a man and it's really hard to get past that.

It does not help that I may have to go to work and worry about wearing adult diapers too.

With no real clear choices, waiting seems much more appealing. Having said that, the risk of it spreading is very scary as well.

I am probably going to find out there is no magic pill nor any major medical advancement will come in time for me, but that is the hope I am now under.

In the meantime I will continue to gather info on surgery and beam and hope for the best.
Age 46 gleason 3+3 cancer discovered 7-08
 
Current treatment watchful waiting and natural approach with supplements and diet of no red meat or diary.
 
I have made a mistake in reading my biopsy.

What I thought was PSA readings was actually a PH reading. I don't know why the PSA is not showing, but I will ask tommorrow of the doctor.

What I do know is this...

2 biospies were done, one in 7-08 and the last one in 11-08.

The first one measured 34 cm of the prostate. Left Mid -Moderately differentiated andocarcinoma. Gleason 3+3 measuring 3 mm (15%of tissue) and involving 1 of 2 fragments.

Left Mid lat - Small focus atyical glands. xrays neg.No Perineural invasionor extraprostatic extension. 1 of 14 cores malignant. Dr.s follow up notes say
low risk because my PSA was < 10, % ws less than 30% and Gleason was 6 or <, but does not give exact info. I stopped listening after the word cancer was said.


2nd test said Left LATERAL mID PROSTAE aNDEOCARCINOMA (gRADE 3+3) INOLVING 5% OF THE NEEDLE CORE . nO EVIDENCE OF pERINEURAL INVASION. LEFT APEX PROSTATE ANDENOCARCINOMA (GRADE 3+3) INVOLVING 10% OF THE NEEDLE CORE -NO EVIDENCE OF PERINEURAL INVASION. SO THAT IS THE UPDATE INFO.


 
 


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 3/29/2009 7:36 PM (GMT -7)   
Hi Robert,
I was 44 when I was diagnosed. Because it was looking advanced I had to rely on modern medicine. It hasn't been so bad. I am doing well and living well. Whatever you decide, you are most welcome to stay here and share it. Welcome to HealingWell and sorry you have had to find us. But it's a good group and there is a great deal of support here.

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!

Post Edited (TC-LasVegas) : 3/29/2009 9:06:27 PM (GMT-6)


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 3/29/2009 8:04 PM (GMT -7)   
Hi Robert! Welcome to HealingWell! My husband and I are the exact same age as you and your wife and I completely understand your concerns with being so young and diagnosed. I too, feel diet and exercise play an important role in curing PC, as well as many other diseases. However, I will admit my bias. Cancer is cancer. It's dangerous, ugly and doesn't follow a flow chart.
My father's PCP waited and waited and never referred him to a urologist with an elevated PSA and family history and unfortunately my father's PC was not contained. He went through RP, Radiation and is on HT. I wish more than anything that we could have caught his PC earlier. There are absolutely no guarantees either way, so know that you roll the dice with whatever decision you make. My father would have agreed with you regarding not having much of a life if he couldn't have sex, however, I hope the fact that he was around to see his grandson born helps to make up for some of it. Not the same, but life does go on. If my husband and I were in your shoes, I would tell him to make a donation in the event we want to have more kids and do the treatment that gives him the longest chance of survival. If the situation were reversed, I know my husband would value my life more than our sex life and I am sure your wife feels the same. On that note, take your time, you have it. Make the decision that is best for you and your loved ones. It is very positive that only one of your cores were positive. Have faith. Wishing you the best in this decision process. It was the hardest part of the journey for us. Again, just my opinion, I'm not a professional, your post just hits close to home. Keep us posted and welcome to the HW family.
Father's Age 62 (now 63)
Original Gleason 3+4=7, Post-Op Gleason- 4+3=7,
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin, One positive node. T3a N1 M0.
Bone Scan/CT Negative (Sept. 10, 2007)
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07, Lupron beg. Dec 03, 2007 2 yrs
Radiation March 03-April 22, 2008- 8 weeks 5x a week
July 2, 08 PSA <.02
Oct. 10, 08 PSA <.02
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum


biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1464
   Posted 3/29/2009 8:41 PM (GMT -7)   
Hey Robert,

Well, you have received the whole range of treatment options here. That's what we all faced. I'm a bit older than most guys here and here time and again that most older men should have radiation or watchful waiting. I chose surgery because I wanted the cancer out of me and had watched my dad die of advanced prostate cancer. Not a pretty sight.

I was dry the day after the catheter was taken out and have a very active and satisfactory sex life with the help of medication. Plus what is best of all, my PSAs have been undetectable for 2 1/2 years. Prostate cancer is not high on my list of things to worry about. As you can see in my signature, I got lung cancer last year. I'd hate to have had to fight two cancers at the same time.

Good luck in whatever you decide to do.

Jim
Age 74. Diagnosed 11/03/06. PSA 7.05. Stage T2C Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Catheter out on 12/13/06. Dry on 12/14/06.
Pathological stage: T2C N0 MX. Gleason 3+4.
50 mg Viagra + .04 cc Trimix = Excellent Results
PSAs from 1/3/07 - 7/17/08 0.00.
PSA on 1/28/09 - 0.02
Lung cancer dxed on 5/16/08. Surgery on 6/25/08 T1N1M0 - Stage IIA Finished 4 cycles of chemo on 11/7/08.
CT scans on 12/2/08 & 2/25/09 - in remission!!!
Next scan in May 09.
Biker90's Journey
http://www.caringbridge.org/visit/jimrobinson
"Patience is essential, attitude is everything."

Post Edited (biker90) : 3/30/2009 10:37:28 AM (GMT-6)


hawkfan75
Regular Member


Date Joined Jan 2007
Total Posts : 165
   Posted 3/29/2009 9:31 PM (GMT -7)   

Robert

One of the hardest things for me was the fact that there is no ONE choice of treatments for this beast.  I also had low grade cancer, according to the biopsy.  There were the thoughts of watchful waiting or seeds, since my cancer was supposed to be small.  I do have an older half-brother who has prostate cancer, so that also figured in my decision.  Some of the new things I've read about that they are testing could eliminiate all the discussion we're having.  However, dealing with now, the one thing for certain is that "you've got cancer."  You may be able to skirt any treatments using some of the diet and supplement assists.  Or, it could be a ticking time bomb.  No one knows for sure.  Watchful waiting is fine, but think about your comments about life without sex or living with diapers.  Side effects are there - severity can't be determined prior to treatment, but not what you're thinking.

I chose to treat my cancer aggressively, and am very glad I did so.  Not knowing it was more severe than anyone thought could have meant a much shorter life had I made the choice not to do something.  My decision was to do whatever I could to give myself a better chance for a very long and satisfying life.  Would I trade years more years for the sex life I had in my 40's?  You bet, and my wife has the same opinion.  Not to be rude, but you can't have sex with a dead man!

Good luck with your decisions


Age 57 at diagnosis (2006),  PSA 4.7 (up from 3.2 one year previous)
Biopsy November 8, 2006 1 of 10 cores positive 5% LEFT Side Gleason 3+3
Robotic surgery January 19, 2007
Post Surgery Pathology Stage T3a, Gleason 3+4, positive margins and capsular penetration RIGHT Side
Post Surgery PSA:  March 5, 2007:  0.01    5 month PSA  0.08
Adjuvant therapy began June 26, 2007 with Zoladex injection
Radiation began August 23, 2007, ended October 8
First post radiation PSA, December 18, 2007:  0;  March 2008 - still 0;  July 2008 - 0; Sept. 2008 - 0;  Dec 2008 - 0;  March 2009 - 0;  Final Zoladex injection!
 
 


mjluke
Regular Member


Date Joined Jan 2009
Total Posts : 189
   Posted 3/30/2009 9:29 AM (GMT -7)   

Selmer: Thanks for your detailed response. You describe Dr. Ornish as one of the best known doctors in America and refer to his recent studies on diet and prostate cancer involving 93 men-------hardly a "scientific" study in my opinion.

My scant research indicates that Dr. Ornish has aligned himself with Pseudoscientists like Deepak Chopra and Rustum Roy. Chopra is well-known from the talk shows and books. Rustum Roy is best known for his support of homeopathy ( quackery ).

Of course diet and lifestyle are important to ones health, but in my opinion these guys are slick con-men in it for the money and adulation, selling books and a lifestyle all under the guise of alternative medicine. They are educated and well-spoken-- snake oil salesmen nevertheless.

 

 


 
63 years old-tumor discovered on digital exam- biopsy December 2008-
4 of 12 samples positive-all on right side
Gleason 3+3=6
PSA-3
Otherwise excellent health.
 
  "There may come a day when the courage of men will fail, but it will not be this day."


sandstorm
Regular Member


Date Joined Dec 2008
Total Posts : 194
   Posted 3/30/2009 11:28 AM (GMT -7)   
mountain top high

Welcome to the board and sorry you have to be here. Good luck in your choice of treatment but just be sure it is the one that saves your life. A 30 year old wife needs and depends on you.
Age at DX 57
5-18-07 PSA 7.7
5-06-08 PSA 4.6  8% free psa, but stable
10-23-08 PSA 5.65 4% free psa
11-04-08 biopsy
11-11-08 2 of 12 cores positive
Gleason 3+3  6  stage t1c / post-op 3+4  7  stage t2c
CT and Bone scan negative
Da Vinci RRP 01-09-09
Catheter removed 1-15-09
Pathology Report says it's gone!
First Post-op PSA 2-17-09   0.00


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4015
   Posted 3/30/2009 12:13 PM (GMT -7)   

Hello Robert:

Like all of the others, I am really sorry you have to be here.  Having said that, and will all of the normal disclaimers, e.g. I am not a medical professional and all of this is IMHO, here are some thoughts:

1.  It's not surprising that your survey showed overwhelming support for surgery.  Most guys on this forum have selected this protocol and believe strongly in it.  Therefore, I'm sure there is somewhat of a built in bias toward that choice...just as I undoubtedly have a bit of a bias toward brachytherapy.  Also, many of the guys who have chosen surgery have the need to "get it out"...the cancer, that is.  I didn't have that psychological need.  I'm not sure why I didn't, but that perspective will affect your choice of treatment.  But, in any case, your stats look like you are a good candidate for most of the treatment options.

2.  Based on your stats, you probably have time to make a decision.  You mentioned "doctor" in the singular.  I would recommend that you see a variety of EXPERIENCED doctors in different disciplines, e.g. a surgeon, a radiation oncologist and a prostate oncologist.  Then you have the benefit of different perspectives as you make your decision.

3.  I think the body clense stuff is urban legend and personally don't believe it.

4.  Improving you diet certainly won't hurt and, indeed it may help...so why not?

5.  If you are seriously considering watchful waiting aka active surveillance aka expectant management, I would contact an expert in the field.  One of these is Dr. Ballentine Carter at Johns Hopkins.  Per his usual criteria he probably would not take you into his expectant management study because of your young age (your other stats are fine).  But, why don't you call him and at least do a telephone consult with him on this?  Clearly your current doc does not think WW is a good idea so you should discuss it with someone who has experience with patients who make this choice.

OK...what would I do in your shoes?  I would NOT make a hasty decision...I would believe (as you do) that I have some time and I personally would be concerned about the side effects of most treatment options.  I would do the things I suggested above plus look into HIFU and proton beam therapy.  Plus I would contact "realziggy" on this forum and find out how I could look into the clinical trial protocol he used.  In other words, I would WW while I looked at ALL of the options.

Good luck 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 3/6/09.

montee
Regular Member


Date Joined Mar 2007
Total Posts : 315
   Posted 3/30/2009 2:14 PM (GMT -7)   
my two cents and worth every penny.

I would not rely heavily on a pre-op biopsy. In my own case I had it sent to 2 labs. One said gleason 7, 1 lobe only, no pin, second said gleason 6, 1 lobe only, no pin.

Post surgery was gleason 7, both lobes, 40% gland involved, multifocal PIN.

2 well known surgeons one in Atlanta, one at Dana Farber, Boston, said it had escaped prostate, would have positive margins, seminal vesicles would be involved. Post op showed neither was true. No one knows for sure until it is out.

Also don't rely on just how high psa is, I found out later, that I had cancer at 2.8, but because it was below the magical number of 4, was told by uro that everything was ok. Go by psa velosity, no matter how low it is.

2 points as far as side effects, incontinence and ED, with your age, should not be a big factor AS LONG AS YOU HAVE A SKILLED AND EXPERIENCE SURGEON. The one who did mine had done over 3000, don't underestimate using a experienced surgeon. 2 weeks after catheter was out, I was completely continent, and with aid of cialis, sex is no problem. I only take it when needed. I would still have rather be a live steer than a dead bull!

As far as watchful waiting, that is a personal choice and in my case was not an option, but with my pre-op HT and RT was suggested as way to go, I chose RP. If there is a rattlesnake in the house, I want it out of my house, not try to starve him in hopes that he will leave me alone. I may have to have the RT and HT down the road, but for know I do not regret my choice.

Just my biased opinion
diagnosed sept 2006 @ 54 years old, live in Georgia, gleason 3+4=7, (r) lobe only

psa 4.7 (psa rose 1 point per year for 3 years, urologist said still under 4 and no concern. If I can find out about PSA velocity, why didn't he know!)

Told not to have surgery at Dana Farber as cancer had already penetrated prostate, in seminal vesicles, would have positive margins. Would only treat with radiation and HT

RP Emory Atlanta December 2006. Path-negative margin, negative lymph nodes, negative SV, both Lobes involved, 40% gland involved
multifocal perineural invasion, Gleason 3+4=7

Fully continent 2 weeks post catheter removal

1st psa April 2007-<0.04, 6 mos-<0.04, 9 mos <0.04, 1yr <0.04, 21 mos <0.04, 2 yr 0.04 (rising?) 

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