Another New Member, and a few questions

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wee_one
New Member


Date Joined May 2009
Total Posts : 5
   Posted 5/19/2009 11:58 PM (GMT -6)   

Hello, I’m new to this forum, a close friend who’s been through this saga turned me on (ugh!) to you folks.  I have been reading many of the conversations you have here and I am very grateful for all the help and information you are all giving to me.

 

I’m pretty much in the beginning of my saga, not on the ‘other side’ yet.  But, I’d like any comments about my journey so far, in case there might be any flaws in my thinking that you all might pick out.  Thank you for any comments you might have.

 

Here we go.  I had a PSA show up in the 4s in the fall of 2006; I was 52 at the time.  My doctor decided to send me to an Urologist for further investigation.  The DRE at the time was non-suspicious, but a biopsy was scheduled.  The biopsy date was 11/29/2006, and the total PSA at that time was 6.1.  Six cores were taken and no cancer was found, but I was told there was ‘Small focus of atypical glands’.  I was told that they were going to just watch and wait, and would continue to watch what was going on with future PSA tests.  

 

On 3/2008 another biopsy was taken, at that time the DRE was abnormal, it was stated there was ‘a ridge’ on the left base.  The PSA was 7.5, and the 6 sample biopsy revealed one sample in the left base that had adenocarcinoma (Gleason score 3 + 3 = 6) involving 3% of the specimen.  (Whoa!  I’ve got a problem here!)  I was told that they still wanted me to wait and watch.  I was put on fenasteride, a female hormone derivative or something like that, which acts to shrink the prostate.  Supposedly, the PC feeds off the same stuff that causes the prostate to enlarge in older men, and so this hormone therapy might cause the cancer to shrink.  I didn’t know anything about prostate cancer at the time to be at all nervous about the DRE finding.  I didn’t realize until seeing this forum that the ridge could be cancer in the margins.

 

I was still uninformed until this last biopsy.  It was collected 4/29/2009.  My PSA a that time was 1.7, but I was told the reading was affected by the hormone I am taking.  It was 12 samples and I not only got a hit on the left lateral base in 20% of the tissue, but also in the Right Apex in 30% of the sample.  Both were Gleason 3 + 3 = 6.  (Oh No! This is getting serious!)

 

The interesting thing is the DRE was reported non-suspicious again!  As far as I’m concerned this means better chance at nothing in the margins.  (I’m sorry, the engineer in me understands statistics, and I would love to be looking at different areas in the statistical charts for organ confinement!)  My first question is, they rated my clinical stage as T2c, but doesn’t that mean they can feel something in the DRE?  My doctor commented that whatever was there has gone away. Shouldn’t I be rated T1c?

 

My head is swimming with all the choices available for treatment.  I see them all on this forum, however, it appears that most of the people around here are talking about the RP journey, and most talk about radiation therapies are recovery oriented.  The Urologist group that I’m seeing is primarily radiation guys.  They do all types, but to their credit, my primary Urologist told me that I should consider RP.  He stated that I should consider it because of my age (54 now).  The Urologist expressed a little concern about the cancer found in the Apex.  He stated that radiation in that area has resulted in a higher incidence in colon cancer 10 years out after those treatments.  Have any of you heard this?  Perhaps that was part of his decision to recommend RP.  (Besides, I plan on living longer than 10 years!)

 

To make a long story short, I decided to go for the surgery.  I feel it’s important that I can be certain the cancer is gone right away, if there is nothing in the margins, that I’ll know right away if I need recovery, and that I would rather live with the complications (continence and ED) if I can know for certain that I am cancer free.  Do any of you have opinions on the soundness of my judgment?  The surgery is currently scheduled for June 10.  (Boy, they didn’t waste any time!)

 

To tell you all the truth, I am really concerned about the whole ED thing.  All the talk about the things that have to be done to ‘get it back’ are initially distasteful and cause the prude in me to blush.  But, when I really think about it, ‘you gotta do what you gotta do’.   I really thank you all in this forum for your open and frank discussions on this subject.  I’ve not heard anything about this part of the process from the urologists I’ve been talking to.  They all just say ‘you’ve got a very good chance to get your potency back’.  Well, there are certainly a lot of ‘degrees of success’ if you will.  (I get that from this forum).

 

Above all, again, thank you all for making this forum the wealth of information it is, and thank you especially, moderators, for keeping it going.  It’s really a comfort to share my own journey with all of you who are going through the same thing.

 


___________________________
Age 54;
Biopsy1, 11/2006, PSA 6.1, DRE non-suspicious, Small focus of atypical glands
Biopsy2, 3/2008, PSA 7.5, DRE abnormal, 3% cancer on one sample, Gleason 3+3=6,
Oral hormone finasteride prescribed
Biopsy3, 4/29/2009, PSA 1.7, DRE non-suspicious, 2 hits, right apex 30%, left base lateral 20%,
Gleason 3+3=6 on both samples
Open RP scheduled for 6/10/2009


dsmc
Regular Member


Date Joined Jul 2008
Total Posts : 149
   Posted 5/20/2009 6:04 AM (GMT -6)   
Hi wee_one,
I am sorry you had to be here but it's a pretty good place to be given our circumstances. I think your decision on surgery is the right one. From personal experience I was glad I chose surgery as my initial treatment. I you are unfortunate enough to have a recurrence you still have RT to fall back on. I fell into that category even with having very a high percentage of not recurring, sometimes it happens. I have just finished Salvage RT in January and just got the good news of an undetectable (<0.04) PSA last week. I am 54 myself and was 50 at diagnosis. As far as the ED goes it was a slow process for myself but everyone is different. I had good results at the 2 year mark. I am hoping the RT does not hinder this. I did not have any continence issues after the first month. At any rate just stay positive and get this surgery out of the way and recover well. Good luck to you and keep the board posted.

David
Age 53
Pre-op PSA 4.3
Surgery Feb. 17 2005
Post-op Path : Gleason 3+3=6
Right pelvic lymph nodes: negative for metastatic carcinoma
Left pelvic lymph nodes: negative for metastatic carcinoma
extent: right lobe 40% left lobe 10%
capsular penetration: Absent
Seminal vesicles and vasa differentia: Uninvolved
Prostate: 26 grams
Post-op PSA's <0.04 for 3 years
Feb. 08: 0.07, March 08: 0.08, June 08: 0.09 and Sept. 08: 0.1
IGRT scheduled.....November 17th....
FINISHED 01/14/09 YEA!
05/14/09
1st PSA after Salvage RT <0.04..... Another YEA!


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 5/20/2009 7:57 AM (GMT -6)   
DREs are a matter of opinion. My internist and one urologist felt something, a second urologist didn’t but he kept me at stage two just in case (enough to remind an engineer that medicine may not quite be a science.) Any Gleason under 7 is pretty good news.

Here is where I step onto very thin ice and suggest you seek anther opinion. On the one hand you have made a choice and I should respect that, but on the other this board is very strong on second and third opinions. In particular I wonder if you have been evaluated for brachytherapy given that your cancer seems quite localized. That said, I chose RP and my younger brother chose brachy and both of us are happy with our choices

Good luck and I am sorry if I have added to your uncertainty.
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
Post surgical pathology report. Lymph nodes negative, Seminal vesicles negative
Surgical margins positive, Capsular penetration extensive Gleason 4 + 3 = 7
At 6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.


carver
Regular Member


Date Joined Jan 2009
Total Posts : 27
   Posted 5/20/2009 8:04 AM (GMT -6)   
Re; Kegels. Check out kegels. Many many years prior to my RP in 1995  my GP said to stop my stream while urinating so as to maintain good urinary control as I aged. I did that and after my RP and the catheter was removed I regained full urinary control four days later. I attribute this to his good advice. Stopping one's stream is a good way to learn the kegel exercise! Best wishes, Al

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 5/20/2009 8:47 AM (GMT -6)   
Welcome to the forum and thanks for sharing your story. ED is so individualized that your experience will be different than anyone else's here, so there's no forewarning can be made by anyone as to what you will get. You will find that the prude factor falls away quickly if you do have an absence of erections for a while after your treatment. It's amazing how the conti9nued lack of a good erection can make us do things we wouldn't have even faintly considered in an earlier period. Like I say, there's two times in your life when you can pee without worrying about wetting your pants- infancy and with a catheter, and there's one time when most of us can really explore our sexuality- while regaining our erections , by using pumps, pills, and pricks (injections), along with frequent musterbation. Yes, I misspelled it because our bad word editor would change the original. We can claim 'doctors orders' to do things we might have felt or been told was shameful in another period of our life. So read on, prepare and good luck with the next stage of your Journey. smilewinkgrin
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


lastcowboy42
Regular Member


Date Joined Dec 2008
Total Posts : 22
   Posted 5/20/2009 10:12 AM (GMT -6)   
Sorry you are here Wee one but welcome to the forum, I had the choices and looked it over on the net and talked with other docters and I chose the surgery .
One reason I did the surgery is if they take our the prostate the chances of the cancer comming back are very slim compaired to the other treatments and because of my ae and knowing I had this darn cancer for around 5 years and not even knowing it.
I had my surgery on Nov 18 2009 came home from 11 days elk hunting had a day of rest then in I went , hosp... stay was 3 days cath came out 2 weeks later was on pads and depends lol for 4 months now I am dry no pads except for the occ... leak with a sneeze, heavy cough or bending and lifting something heavy .
I had to work hard on the kegels I would start now before the surgery and as for the ED well 100 mg viagra dont work for me going in today to see the doc , I use a pump now ust to keep the blood going , this a new thing but we will see.
All in all I would make the same choice I made because I know I have a very very good chance of watching my little 4 year old girl grow up .
Best ok luck to you
God bless and keep up the fight
 I am 42 years  young
Psa 11.6
gleasen 4+3=7
Catscan-Neg but for a cyst on liver
Bone scane - Neg
11 out of 17 bio tests came back pos full rt side agressive cancer lft side  core  had 2 bios  pos
had the open RP on Tuesday November 18th of 2008 at 7:45  am , finished at 1:30 and took the 3 pts of blood I gave .
 At Kaiser Sunnyside  in Oregon
Performed by Dr Matthew Forsyth
 Came home on 11-21 , cath and staples out on 12-01
now the real work begins
 


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4241
   Posted 5/20/2009 10:21 AM (GMT -6)   

Dear wee_one:

Sorry you have to join us but you will get lots of info and assistance on this site.

It sounds like you have done the right thing by seeking multiple opinions re treatment options.  It is critically important that you consult with a surgeon, radiation oncologist and prostate oncologist to make sure you have reviewed all of the options and can reach an informed opinion.  Assuming you have done that, I can't really comment on the accuracy of the statement re the occurance of colon cancer if you treat with radiation when the PCa is near the apex.  I did a quick search for this and came up empty...perhaps others on the forum will find relevant data to help you.  At the very least, you should ask your doctor to quote the statistics from which he makes this statement.  Anecdotal does not count...

Also, whatever treatment you choose, you should go in with your eyes wide open.  The statement you made, "I feel it’s important that I can be certain the cancer is gone right away, if there is nothing in the margins, that I’ll know right away if I need recovery, and that I would rather live with the complications (continence and ED) if I can know for certain that I am cancer free," is not totally correct.  This forum has plenty of patients who received post surgery reports of "clear margins", "clear lymph nodes" and/or "contained in capule" and have found out later on that they are not cancer free.  Here is a link from our good friend "Purgatory" (aka David from SC) who recently got some apparent bad news.

http://www.healingwell.com/community/default.aspx?f=35&m=1470227

I'm not sharing this with you to alarm you or put you on a downer, rather one of the real benefits of this site is the sharing of honest opinions and facts with each other.  Surgery may well be the proper treatment for your case...I just want to advise you to get all of the facts so that you are fully informed before your treatment.

Best of 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 5/1/09.

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4250
   Posted 5/20/2009 11:02 AM (GMT -6)   
Wee one,
You have reason to be confused as there are a lot of opinions and stats on PC and most of them are confusing and conflcting.
First. Radiation doesn't cause colon cancer. This may have happened in the very early days of radiation when everything was radiated and the myth still persists.
With an early stage G6 and low PSA just about any local cure will have a very high probability of success, but the side affects of all local treatments are vastly different.
The lowest side affects are from Proton radiation and seeds
The highest from surgery and IMRT.
HUIF and cryosurgery are also options and have many satisfied patients.
Stay away from anyone who tells you there is a best way to treat an early localized PC. You are a poster child for ALL local treatments.
If you are comfortable with ananlysis then do your own research and come to your own conculsion.
The Prostate Cancer Research Institute has a lot of information and papers on variouse treatments.
Books are also helpful:
Walsh or Sardino on Surgery,
Danatolli on Brachatherapy and IMRT
Stephen Strum on Prostate cancer Basics
Robert Marckini on Proton Therapy
Charles Meyrs on Diet
YANA website has stories of men having different treatment and is very helpful.
Prostate cancer is very slow growing and you have a lot of time to make a decision. Learn everything you can and question everything you hear.
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.

As of April 10 and 7 weeks on Casodex and Proscar PSA has gone from 30 to 0.62 and protate from 60mm to 32mm. Very minor side affects. Doc says all this indicates tumor is not aggessive

Awaiting schedule for seed impants

 


CPA
Veteran Member


Date Joined Feb 2008
Total Posts : 655
   Posted 5/21/2009 12:50 AM (GMT -6)   
Greetings, Wee one.  Sorry you have to be here but you are among friends who have walked down your path and are willing to walk down this one with you.  Treatment options are very personal and you must get comfortable with what is best for you.  Most on the board believe they made the right choice for them and I believe most of us did.  I chose surgery because my doc said at my relativly young age the best chance to permanently take care of the cancer was to get it out of there.  I did the research and believe that I made the right choice for me.  Others choose different options and those options are right for them.  Please keep us posted.  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


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 5/21/2009 3:11 AM (GMT -6)   
Hi Wee_one.
Welcome to HealingWell. This is a great site for everyone choosing all kinds of treatment options. As CPA said, this is a very personal decision. What makes you feel good is what you need to go with. Surgery is a good option that is well proven. If I was in your position, with positive biopsy on each lobe, I would have chosen it as well. I did have surgery ~ DaVinci Robotic, and it went very well. With your numbers, you have an excellent shot at being cancer free after the procedure.

Feel free to ask anything. My best advice is once you have made your decision, don't look back. And when you need help, call on us...

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 (May 11, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


55 and healthy in NJ
Regular Member


Date Joined Apr 2009
Total Posts : 58
   Posted 5/22/2009 3:45 AM (GMT -6)   
Wee-one,

As someone who just a few days ago crossed over to "the other side" of surgery, let me also welcome you to the brotherhood. I agree with what everyone has already said, but I didn't notice that anyone had answered your T2c vs. T1c question. I believe the answer is that the staging convention for PCa defines T2 as the presence of cancer in both lobes.

I went through a similar logic regarding choosing surgery over radiation. Please explore the forum on treatment options and choosing one course over another, it will help to put your mind at ease.

Best wishes,
Greg
Age 55
Physical exam (01/22/2009): blood pressure 130/85, good EKG; basically all-around healthy
PSA 4.9 (02/05/2009)
Urologist DRE observed slightly hardened left lobe (02/19/2009)
Chest X-ray normal (02/23/2009)
Biopsy (03/03/2009)
PCa present in all sextants, <5% to 50%
Prostate gland 37 grams
Gleason score 7 (in two sextants, scored 6 elsewhere)
Cystoscopy (05/08/2009), showed clear
MRI (05/08/2009), "No findings are present to suggest extracapsular tumor."
Robot-assisted (daVinci) laparoscopic radical prostatectomy (05/18/2009) by Michael Esposito, M.D. and Vincent Lanteri, M.D.  Both nerve bundles spared.  Awaiting final pathology report to verify that PCa was contained within the capsule.
 
 
Research:
Surgery (daVinci robotic) consult with Michael Esposito, M.D., http://www.roboticurology.com/ (03/30/2009)
Radiation oncology (Varian IMRT/IGRT RapidArc) consult with Mark Macher, M.D., http://www.njneuro.org/fp/gammateam.asp (04/08/2009)
Other resources: Dr. Peter Scardino's Prostate Book (Peter Scardino (Sloan-Kettering), 2005); Urologic Robotic Surgery (Michael Esposito, Vincent Lanteri & Jeffrey Stock, 2007)


RBinCountry
Regular Member


Date Joined Apr 2008
Total Posts : 270
   Posted 5/22/2009 10:55 AM (GMT -6)   

I will throw the hat in the ring here.  You will note my prognosis was more serious than yours - I wrestled with all the same things and am now 1 year out from DiVinci surgery.  So far I am "undetectable" on PSA.

The surgery itself was relatively easy, and the recovery for me was quick.  Incontinence continued at a manageable level for some time, and I still one year out have minor issues with that- no big deal.  ED is a reality and I have resorted to the fact I will likely never be near the same as before.  Yes, there are things you can do, but they are all inconvenient.  All of this to say I am grateful to be alive and at this moment cancer free.

Surgery on the one hand gave me the opportunity to know the extent of my cancer from the pathology, and has given me hope of being cancer free.  Radiation would have kept me wondering, and the monitoring process is not as black and white.  Supposedly long term results with surgery are better than radiation, but these statistics from what I have seen can be argued.  Even with surgery and good pathology, there are no guarantees of continuing to be cancer free.  You will note persons on this forum that had good post-pathology and later had their cancer return.  Had I gone through my original plan of brachy, External beam, and harmones, I would be through that now as well.  Would I have been as comfortable now with that decision?  I don't know!  Would I not be having ED?  I don't know?

All of this being said - I would do the same thing all over again that I have done - it simply appears it provides the slightly best argument for doing all you can do to rid yourself of cancer, and above everything else that is the number 1 goal.  On the other hand, you go into it with your eyes wide open.  I wish you the very best.


RB
Age 62
Original data - pre-operation
PSA: 5.1
T1C clinical diagnosis, Needle biopsy - 10 cores, Gleason 7 = 3+4 in 1 core (40%), 7 cores Gleason 6 = 3+3 ranging from 5% to 12%
All scans negative
Lupron administered 4/9/2008 for 4 months (with idea I would undergo external beam radiation followed by seed implants - then I changed my mind).
Robotic DiVinci surgery - Dr. Fagin (Austin) 5/19/2008
Post operative - pathology
pT2c NX MX
Gleason 3+4
Margins - negative
Extraprostatic extension - negative
seminal vesicle invasion - uninvolved

PSA <.04 7/12/2008

PSA <.01 10/30/2008

PSA <.01 4/03/2009

 


TeddyG
Regular Member


Date Joined Apr 2009
Total Posts : 133
   Posted 5/22/2009 10:12 PM (GMT -6)   
Wee,
Based on the info that you provided and the apparent fact that you are a "numbers guy", statistically you are very likely to have a good outcome. The age factor certainly weghs in favor of a surgical solution in the hope that it will be contained and completely excised. Go to the book store this weekend and in the health section, get Patrick Walsh's or another nationally recognized expert's book. Educate yourself and you will be much more confident in your decisions.
FYI, I too chose surgery for similar reasons. The hardest part of all was the stress leading to the treatment decision. Then I made it, with the help and sipport of my wife, and did it. I went back to work in 2 weeks and it has now been 6 weeks: slight leaks, getting better each day and I will deal with ED next. One step at a time....the first step was getting the PCa out of me so I could then consider the rest of my life.
Best wishes,
TeddyG
Background:
Age 55, two teens, very fit cyclist (avg 2000+ miles per year) and weight, diet, etc. consistent with good habits. Stressful job as attorney; very supporting wife who is helping me through every stage of this war.
Stats:
2006 PSA - 1.5
2007 PSA - 2.3
2008 PSA - 5.3 (18 mos.)
2009 Jan. 20 - Biopsy 12 samples
        Feb 3 Dx 2/12 samples positive, low volume  (5% and 7-10%)
Gleason 3+4, later downgraded by second opinion at Johns-Hopkins to 3+3, but "it's still PCa" as my Doc said.
Laproscopic surgery April 9,  University of KY Medical Center, Lexington, 3 days in hospital, catheter removal April 21.
Pathology: clear margins, no cancer in prostate: told that this is very rare and Doc has only seen it in 3 out of over 1400 cases; I rearched the concept of "vanishing cancer" and found a tumor classification of tP0 and asked Doc if it applied to me. He said that it was unlikely because if a pathologist had done a much more detailed analysis of the tissue, he would likely find more foci somewhere, and biopsy found "needle in the haystack as opposed to the tip of the iceberg"; Nevertheless, it is a blessing;
Regardless of the science, my family says "miracle."
Now working w/ post-surgery issues....
 


wee_one
New Member


Date Joined May 2009
Total Posts : 5
   Posted 6/4/2009 9:31 PM (GMT -6)   
Folks,

I have read a lot of the topics on this forum and want to thank all of you for your support and helpful information. I had my Pre-Op physical today, didn't get much sleep last night. When I woke up at 2:30, my mind was jsut racing, and I couldn't go back to sleep. I didn't think I'd be worked up about this, but I guess it really is wearing on me, even though I hate to admit it. After I left the clinic, it was 'heavy sigh', perhaps because I was 'on the way' I have started the RP process, and will not look back. Now for positive attitude and just keeping my focus on looking forward.

Tuesday is hospital bloodwork and Wednesday is surgery. I covet your thoughts and prayers.

Thanks, folks,

Wayne
___________________________
Age 54;
Biopsy1, 11/2006, PSA 6.1, DRE non-suspicious, Small focus of atypical glands
Biopsy2, 3/2008, PSA 7.5, DRE abnormal, 3% cancer on one sample, Gleason 3+3=6,
Oral hormone finasteride prescribed
Biopsy3, 4/29/2009, PSA 1.7, DRE non-suspicious, 2 hits, right apex 30%, left base lateral 20%,
Gleason 3+3=6 on both samples
Open RP scheduled for 6/10/2009


DS Can
Regular Member


Date Joined May 2009
Total Posts : 195
   Posted 6/4/2009 10:12 PM (GMT -6)   

Wayne,

Stay confident in your decision to have surgery.  I hope you have someone to help you get through the rough spots over the next few weeks.  My wife was very good to me and a big help, too.  Best wishes for a successful surgery and good recovery.  You are in my prayers tonight.

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!
 
 


TeddyG
Regular Member


Date Joined Apr 2009
Total Posts : 133
   Posted 6/4/2009 10:23 PM (GMT -6)   

Wayne,

Congrats on the decision. The hard sigh was a sigh of relief that there is a decision and one of determination to just do what you have to do and get on with it! Give it to the Docs and God, you have done all that you can and from what I read previously, you did it well.

Now in prep for the second chapter: post op, reconcile that you will be out of pocket for 2 weeks. For me, the worst part of the journey was the chapter that you just completed. One step at a time...

Best wishes and keep us posted.

TeddyG

 


Background:
Age 55, two teens, very fit cyclist (avg 2000+ miles per year) and weight, diet, etc. consistent with good habits. Stressful job as attorney; very supporting wife who is helping me through every stage of this war.
Stats:
2006 PSA - 1.5
2007 PSA - 2.3
2008 PSA - 5.3 (18 mos.)
2009 Jan. 20 - Biopsy 12 samples
        Feb 3 Dx 2/12 samples positive, low volume  (5% and 7-10%)
Gleason 3+4, later downgraded by second opinion at Johns-Hopkins to 3+3, but "it's still PCa" as my Doc said.
Laproscopic surgery April 9,  University of KY Medical Center, Lexington, 3 days in hospital, catheter removal April 21.
Pathology: clear margins, no cancer in prostate: told that this is very rare and Doc has only seen it in 3 out of over 1400 cases; I rearched the concept of "vanishing cancer" and found a tumor classification of tP0 and asked Doc if it applied to me. He said that it was unlikely because if a pathologist had done a much more detailed analysis of the tissue, he would likely find more foci somewhere, and biopsy found "needle in the haystack as opposed to the tip of the iceberg"; Nevertheless, it is a blessing;
Regardless of the science, my family says "miracle."
Now working w/ post-surgery issues....
 


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 6/5/2009 9:19 AM (GMT -6)   
As soon as you made the appointment for surgery, your case was assigned to this group’s Worry Committee. Between now and Wednesday they will worry about every possible issue up to and including the sky falling on you on your way to the hospital. Your assignment is to be proud that you have learned about your options and made a choice. Spend the time looking for little joys and remembering that you have voted in favor of more of them. We have your back on the rest.
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
Post surgical pathology report. Lymph nodes negative, Seminal vesicles negative
Surgical margins positive, Capsular penetration extensive Gleason 4 + 3 = 7
At 6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.


joec_49
New Member


Date Joined Jun 2009
Total Posts : 14
   Posted 6/5/2009 11:54 AM (GMT -6)   
Wayne,
I think you made the correct choice. Nerve sparing is something you may have a choice in.
If your sexual nerves (they lay across the prostate) are cancerous, ask them to graft a nerve in their place, ie. the sural nerve
as one choice. When I had my surgery, the removed the cancerous prostate and 19 lymph glands and 1/3 of my bladder, all
cancerous. The good news is the surgeon was able to see the cancer and remove it. I recovered uneventfully and
my bladder is working fine. Expect incotinence after surgery but it will go away over time.

Good luck!

Joe
Dx: age 55, now 58
Dx: Small cell anaplastic androgen-independent adenocarcinoma of the prostate
PSA: 3.15 (from 2.54)
Gleason: 9 (5+4)
1/06: Radical Retropubic Prostatecomy (removed 19 lymph glands and 1/3 of my bladder)
9/06-2/07: chemo: first taxotere and then etoposide/cisplatin
5/07: radiation: 55 grey units over 30 days
Cancer in remission 2/07-4/09
Next: surgery (6/9) to deal with cancers return
casodex to follow surgery and then watchful waiting.
full story at: http://prostate-cancer-log.blogspot.com


Frank1205
Regular Member


Date Joined Feb 2008
Total Posts : 308
   Posted 6/5/2009 4:09 PM (GMT -6)   
Wee_one,
 
Your situation seems to have certain similarities to mine. They missed finding the cancer once and barely on the second try.  Hind sight my cancer was larger in area than the biopsy showed.  I rarely see here where the pathological results are less than the biopsy.  Usually greater and sometimes equal too.  I went from a predicted 3+3 (6) to a 3+4 (7).  A T1 (single side) to a T2 (both sides).  Then I had the bad margin.  Doc's assistant says post surgery is like baseball in a way.  Strike one ( bad margin), strike two (prostatic extension) strike three ( lymph node,fat tissue or seminal vessel intrusion).  I did not think he was very funny with his analogy for I had just swung at a high and outside pitch,  Yikes!!  strike one.
 
The surgeon and his little robot buddy thought they got it all and that the margin was from smashing and squeezing it in the hand off between the fellow and the pathologist.  I choose to wait and see what that small margin would do through the PSA and so far (15 months and undetectable). My odds of success seem to increase every 3 months according to charts and studies. 
 
My ED funtion worked better than before surgery right after the operation.  Holy cow I thought,  I am young again.  Then about two weeks of ya ba da ba dooooing my functioning dropped like a rock.  And slowly I am returning back to pre-surgical status with the help of my little blue friends.
 
Contnence was a little slow to come around for me and I still have leakage for no particular reason.  Not enough to require a pad or change cloths and then it goes away. 
 
Your batting score you post here looks very very good.  Surgery, if you choose,  is a piece of cake. Easier for me than that G_ _ darn biopsy was.  With your numbers you should expect a good outcome.  Be prepared for the ED issues you will likely have some. 
 
Something I have not seen much talk about here is putting some little buddies in the freezer for you never know what life will bring you and after their done with the roto rooter those guys are gone forever.  This is especially for the younger guys we see more and more on this site.
 
All the best,  you will be just fine. Ask questions of everyone,  seek other Doctor opinions.  Keep in touch with this site.  They got me through. 
 
Another thing
 
Here is a great tip that a Doctor from a University Hosp. gave me,  operating rooms get booked up.  Its not that the Surgeons are too busy it is the room.  After you see a Doc, book a date even if you dont like him/her or are unsure.  And every time you see someone else book the surgical room.  Once you decide who you want then cancel the others.  This is done all the time and there is no penalty or inconveinance to the hospital.  There are folks waiting in line for that room. This will get you in surgery faster for once you decide your path of choice for your cure, believe me,  you will want to get er dun pronto!!
 
Frank
 
 
 
Currently 55, surgery at 54
Normal , 2004 Biospy negative - 2008 Biopsy positive (01-08-08)
10 cores, 1 positive and at 1% of that one core
PSA @ surgery 6 
Bone and Ct scans negative
clinicaly Staged at T1C - Gleason 3+3 = 6
Robotic Da Vinci performed March 27th, 2008, University of Chicago.
Catheter out in 7 days normaly expected leakage
Post Pathology T2C, Gleason 7, (3+4) 10 % of both portions of prostate
Seminal vessels clear, fat tissue clear, single positve margin at apex measuring less than 1/2mm. 
PSA Six week < 0.1 4 month PSA <.05 6 month PSA<0.01,9 month<0.01,12 month <.008
Watching PSA @ 6 months for 2 years,  will do salvage radiation if necessary.
Fair to Good results with Viagra,  side effects are bothersome at times. Tried Levetra about the same as Viagra.  Tried Cialis, think I will stay with the Viagra at 50 mg.  Side effects worse at 100 mg.  


Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4112
   Posted 6/5/2009 7:21 PM (GMT -6)   
Wayne: I hope that your suregery will be a easy as mine was. I had more difficulty getting my wisdom teeth out. My suregery was on a Tuesday and on the next Saturday I went to an LSU Fooltball party at a friends home. I never had a probelm with contanence but am in the process of working on the ED. I am still hopful for that recovery. My Dr. and some of my freinds on this side have said I should be the Poster child for the surgery. Good luck my friend. I do hope all goes well. On thing I forgot to mention is forget the monesty.. It will b e gone after Wed. :)


Jeff
Jeff T Age 57
9/08 PSA 5.4, referred to Urologist
9/08 Biopsy: GS 3/4=7
10/08 Nerve sparing open RRP- Path Report: GS 3+3=7 Stg. pT2c, margins clear
3 mts: PSA .05 undetectable
 ED- 5 mg Cialis daily, pump daily,


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 6/5/2009 9:04 PM (GMT -6)   
Wayne-
Welcome to Healingwell! It never gets old seeing the enormous amount of support from veteran members reaching out to those that are just starting their journey. I hope you feel the love and I hope as you head into next week, you stay confident and know that you have a family at HW that will be here when you get back and begin your recovery cancer free. Please stick around and ask away. I remember living on the forum the week my dad was heading into surgery and I know he benefited from all the advice from the members! Keep us posted and peace and strength be with you!
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.

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