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Gmike
Regular Member


Date Joined Jan 2009
Total Posts : 48
   Posted 6/19/2009 1:03 PM (GMT -7)   
I had pretty much decided on IMRT radiation. Yesterday I failed a flowrate test at my urologist's office . He is now going do a cystoscopy and says I might need TUMT (transurethral microwave therapy of the prostate) which would delay radiation for 3 months. I researched TUMT and it has side effects and cure rates just as everything else. Is anybody familar with the greenlight laser procedure? It may be better than TUMT.

All this has me thinking that maybe I should just have my prostate removed and not worry about the BPH problems. It gets more complicated all the time.

Thanks for listening
Mike
PSA
2004: 2.0
2006: 4.0 (40% Free)
2007: 3.1
2008: 5.03
2009: 5.2 (21% Free)

Biopsy(s)
August 2008(age 58): 1 core of 12 was "atypical"
May 21, 2009(age 59): 1 core of 12 positive (10%), Gleason 6, Stage T1c, 1 core atypical, prostate 45 grams
June 4th Bone scan (negative)


Family history: Father and Grandfather both had PCa


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 6/19/2009 1:27 PM (GMT -7)   
Gee Mike,

I dunno...almost like trading a stomach ache for a headache. Trying to fix blockage of urine flow from BPH with one surgery or have incontinence with the other type of surgery for awhile. Not a pleasant choice no matter what.

With your age, I would have to say, just take the dang thing out and get it over with. Having to go through the one surgery to help with BPH, then several months later have the radiation for cancer doesn't seem any less invasive to me. At least with the prostectomy, its done and over with along with the ability to have a path report afterwards.

Just my .02 worth
You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral w/PNI - Gleason (3+3)6 Stage T1C
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (3+4) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
PSA 5 week Oct 2008 <.05
                   3 month Jan 2009 .06
                   6 month April 2009 .06


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25353
   Posted 6/19/2009 2:08 PM (GMT -7)   
Hello Mike,

With you family history and your current complications, I would tend to agree with LV above. That's a lot to go through, and then have the Radiation treatment, and hoping all the time that your PC is as low grade at this point as indicated. I would at least consider surgery now as an alternative to the Radiation, either Robotic or open.

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, 5/9 .10 doubled in 3 months, new test in six weeks, then possibly off for salvage radiation
 
 


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 6/19/2009 3:21 PM (GMT -7)   
I personally would ditto the other posts. The BPH stuff also has some period of incontinence, along with probably more discomfort than a Da Vinci prostatectomy.

However, as was mentioned, the long term potential for incontinence and ED is a risk with the RP, but you also have a potential risk with IMRT as well,

Lots to consider. Good luck !
Age 58
PSA 4.47
Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09
Nerves spared
0/23 lymph nodes involved
pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks due to anatomical issues with location of ureters with respect to bladder neck.
Try 3 tubes where no tubes are supposed to be for 2 weeks !
Neg Margins, bladder neck negative
Thankful for early diagnosis, and U.S. healthcare
Living the Good Life, cancer free
6 week PSA undetectable. 


Gmike
Regular Member


Date Joined Jan 2009
Total Posts : 48
   Posted 6/21/2009 6:35 PM (GMT -7)   
I'm agreeing pretty much with what you all are saying. At this point I don't believe I want to go through the BPH procedure (which may or may be work) and still be nearly 6 months away from finishing radiation.

When researching PCa treatment options one of the things that stood out with the new beam radiation machines, was that incontinence was not even listed as a side affect. I surely didn't consider possible BPH complications. My score on the American Urological Association Symptom Index is 6 or 7, which is classified as mild. (Generally, no treatment is needed.) My Urologist is a bit perplexed by this, hence the cystoscopy. I'm concerned since I worked 30 years in an environmentally unfriendly job, and know of at least 3 co-workers with bladder cancer. I'll know more after the cystoscopy on Wednesday.

Mike
PSA
2004: 2.0
2006: 4.0 (40% Free)
2007: 3.1
2008: 5.03
2009: 5.2 (21% Free)

Biopsy(s)
August 2008(age 58): 1 core of 12 was "atypical"
May 21, 2009(age 59): 1 core of 12 positive (10%), Gleason 6, Stage T1c, 1 core atypical, prostate 45 grams
June 4th Bone scan (negative)


Family history: Father and Grandfather both had PCa

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