Prostate cancer treatment successes

New Topic Post Reply Printable Version
35 posts in this thread.
Viewing Page :
 1  2 
[ << Previous Thread | Next Thread >> ]

ttrapski
New Member


Date Joined Jul 2009
Total Posts : 16
   Posted 7/17/2009 4:38 PM (GMT -6)   
Hello, I have just been diagnosed with prostate cancer and I don't know which treatment options will be best. So far it is between radical prostectomy surgery or radiation a la brachytherapy. I am especially cocerned with incontinence issues and impotency.
 
I am an otherwise extremely fit and active 57 year old  with a younger wife. My PSA was 7 my Gleason 3+4 and I am T2B with a mildly aggresive form. Two of the eight biopsies tested positive.
 
Surgery puts me out for 8 weeks and the surgeon says that sexual function WILL be different. There are also no guarantees on the incontinence part but given my physical condition he feels that will be no problem.  Brachytherapy is day surgery and from what I understand there is no incontinence issue. Sexual function is normal BUT begins to fade after about a year to impotency.
 
Is this information correct ? I look forward to hearing from those who have had both treatments.
 
Thank you

CapnLarry
Regular Member


Date Joined Apr 2009
Total Posts : 75
   Posted 7/17/2009 4:51 PM (GMT -6)   
"Surgery puts me out for 8 weeks." Depends on what you mean by "out," but not in my case, or those I've heard of. A week after my robotic surgery I easily walked four miles, and 12 days after I took a cross-country plane ride and was moving furniture around.

I believe you are correct to note that the side effects of radiation accrue as time goes on, while surgery has its side effects (and benefits) right up front.

You'll get lots of advice, here and elsewhere. I would encourage you to go to the American Cancer Society's Treatment Decision Tools site (https://www.cancer.nexcura.com/Secure/InterfaceSecure.asp?CB=265). It will ask for lots of information, some of which you won't have. Fill in what you can. Out the other end you'll get some customized feedback, and if you're of an analytical mind, you'll have access to the underlying studies that the information came from.

Welcome to the club nobody wants to be in.
Larry Shick
Personal homepage incl. PCa story: www.sv-moira.com.
01/09: Diagnosed (age 60) biopsy PSA 4.4, free PSA 9%, T2c stage, Gleason 7 (3+4), 7 of 14 cores; 6'2", 200 lbs.
03/09: Robotic surgery (Dr. Kawachi, City of Hope) 47 gms, 10% involved, staging/Gleason unchanged (pT2cNXMX), margins clear, no ECE/sem ves involvement, fully continent from day 1, some success w/Viagra 50mg/day.
Followup: 05/09 0.006


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 7/17/2009 4:59 PM (GMT -6)   
Hello ttrapski,

Information is somewhat correct in that the surgery usually doesn't mean you are out for 8 weeks. Most surgery guys will tell you that normal activities all though limited on lifting and anything that would stress the surgical area in about 3 to 4 weeks. I was back at the office after 3 weeks.

The incontinence, yeah that can go the full spectrum with any type treatment because it is based on your own physical characteristics. Surgery you can expect up to 12 months or longer sometimes dealing with incontinence. I took around 8 months, but many are dry almost immediately. ED will usually take a little longer depending on whether nerves are spared or not.

Radiation typically will have the same side effects I have read, but don't set in until after several months.

Makeing the choice between radiation and surgery will be difficult so research and find the one that you are most comfortable with. Most important is to seek out the best surgeon or radiation oncologist, because the more experience the doctor, the general rule will be the better outcomes.

One last point...always remember...it is getting rid of the cancer or keeping it under control is the objective. I know the side effects are the biggest issue, but your wonderful wife will tell you other wise...she would much rather have you around period.

Welcome to Healingwell...you will get lots of responses so stand by
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 : 25393
   Posted 7/17/2009 5:18 PM (GMT -6)   
Hello new friend, glad you found us here. You will have your head spinning with advise and personal experience.

CALLING BRO. TUD!!! Please explain the gist of your "seeding" experience.

I had open surgery. Had some complications, was on catheters for 63 days. Once last catheter was removed, was 100% dry in about a month, and in a rare club, of no ED what so ever even though the left side nerve bundle was removed and the right side noted as damaged.

You will find immense variation in our stories, both good and bad news.

As a Gleason 7 at this point, you are walking on a fence, 7's are hard to predict, it could be higher or it could be lower. If you opt for surgery, then you can deal with radiation as a secondary treatment if the surgery doesn't get it all. If you have radiation first, and it doesn't work, surgery is not reccomended in most cases, and would be difficult at best even if you could find a surgeon that would do salvage surgery.

Right now, you have time to think through all your option, the most important part, is regardless of which treatment you go through, get the very best and most experienced doctor that you have rescources and/or insurance coverage for. That's the real key, experience.

The side effects vary too much and it can be a very subjective subject at best. My surgeon did the classic "3 priorities approach". Cancer first, incontinence second, and ED third.

My best to you, and please keep us posted, and keep firing away your questions.

David in South Carolina


Age 57, 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 capsule, one post. margin, clear lymph nodes 
First PSA Post Surgery   2/9 .05, 5/9 .10, 6/9 .11, 8/11 ?
Lastest 7/13 met with Rad. Oncl, they want to start radiation, 70 gray, I am still considering all options and opinions
 
 


CapnLarry
Regular Member


Date Joined Apr 2009
Total Posts : 75
   Posted 7/17/2009 5:42 PM (GMT -6)   
You might find it valuable to read Mike Stuckey's journey through the process, which is all the more valuable by being contemporary rather than retrospective. He wrestled with the same tradeoffs you are looking at. You may not come down on the same side he did, but have a look at www.msnbc.msn.com/id/13154507/ns/health-mens_health/
Larry Shick
Personal homepage incl. PCa story: www.sv-moira.com.
01/09: Diagnosed (age 60) biopsy PSA 4.4, free PSA 9%, T2c stage, Gleason 7 (3+4), 7 of 14 cores; 6'2", 200 lbs.
03/09: Robotic surgery (Dr. Kawachi, City of Hope) 47 gms, 10% involved, staging/Gleason unchanged (pT2cNXMX), margins clear, no ECE/sem ves involvement, fully continent from day 1, some success w/Viagra 50mg/day.
Followup: 05/09 0.006


ttrapski
New Member


Date Joined Jul 2009
Total Posts : 16
   Posted 7/18/2009 10:20 AM (GMT -6)   
Thanks for your kind words . I will keep you all posted.

T.

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 7/18/2009 12:02 PM (GMT -6)   
Hi ttrapski,
Welcome to HealingWell. The decision for treatment is a very personal one and you have to go with what's in your heart. But do so only after you have done your research. Knowledge is power with prostate cancer and it will take away any fears. We have a great group of people here and they assuredly will be able to speak well from their experiences. You initial evaluations are good, but there is more to uncover. I started our with 4 of 8 cores positive and a 3+4=7. After surgery, I was changed to a 4+3=7. There is a difference and I am glad I chose surgery.

Again, welcome. May peace be with you and yours...

Tony
 Age 47 (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!


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4274
   Posted 7/18/2009 1:49 PM (GMT -6)   

Dear ttrapski:

First of all, I’m sorry you have to be here but I will tell you that you have found a good place for both information and support.  I am the “Tud” that David in SC referenced and am one of the few brachytherapy patients that post on this forum.  You will get lots of good advice from the surgery guys…some of it balanced, some of it clearly pro-surgery.  And you will get what I hope will be balanced advice from me, but it probably will also be a little skewed with a pro-radiation bias.  So, I’ll try to be a little bit organized and provide you with some advice from my perspective.

General

First of all, with early stage cancer you have time to research the heck out of your alternatives so you can feel comfortable that you are making an informed decision.  If you haven’t bought it yet, I advise you read “Dr. Patrick Walsh’s Guide to Surviving Prostate Cancer”.  It’s not perfect, by any means, but is an excellent primer.  Secondly, both of the options you are considering will most likely cure you.  There are multiple long term studies for surgery and brachytherapy that indicate they provide basically the same cure rate for early stage cancer patients.  Of course, each man is different and I suggest you plug your stats into some of the predictors available to see where you fall.

You should also make sure you consult at least three EXPERIENCED doctors to gather your options.  They are your uro-doc surgeon, a radiation oncologist and a prostate oncologist.  Many of the major cancer centers, e.g. Johns Hopkins, Duke, MSK, M.D. Anderson, etc., can provide those three in a multi-disciplinary team setting.  Otherwise, you can and should still do it on your own.  I highlighted “experienced” because there are definitive studies that demonstrate better outcomes if your practitioner has done 250+ procedures…let them learn on someone else. 

You also might consider getting a color doppler biopsy to assist with your baseline.  I didn’t even know such a thing existed but would have gotten one if I had known about them.  In particular, your 8 core biopsy is at the low end of what doctors do these days even for traditional biopsies.  12 is more common and mine was 16 cores.

The bottom line is to make sure you are totally comfortable with the decision.  This is huge and they are messing with pretty important real estate!

Surgery

As I said, you will likely get lots of advice here from the experienced surgery guys.  The two choices I looked at were robotic and open.  Robotic is newer but there are plenty of experienced guys now who can do it.  I would have chosen robotic if I had chosen surgery.  With surgery you get the aforementioned likelihood of cure, the immediate post-procedure knowledge of the pathology of your cancer and the psychological advantage of “having it out”, that is very important to some men (it was not to me). 

But surgery is invasive, even the robotic kind.  You have the inherent risks of major surgery, a catheter for some period of time (a week to months) and some time needed to recover from the operation.  You also almost certainly will experience incontinence – typically improving over a period of months.  You will most likely experience ED.  That improves over time for most men, especially with the help of Viagra, Levitra or Cialis.  There is some clear evidence that ED is psychological as well as physical.  In other words, once you lose the ability to have erections, it’s tough to get them back because you are trying so hard to make it happen.

The things that some surgery docs don’t tell you are that you lose your ejaculate, your penis make get shorter and many men ejaculate urine.

One advantage of surgery that many surgery patients cite is the fact that, if the cancer recurs, you have salvage radiation as an option for further treatment. 

Brachytherapy

This was my choice and, 7 months out, I’m glad I made it.  I’ll let you know in 20 years if I’m still glad!  You can read my “story” if you click the link at the bottom of my signature.

A typical poster-boy candidate for brachytherapy will have Gleason 6 or less, a prostate size of 50cc or smaller, Stage T1-T2, and PSA less than 10.  With G-7, brachytherapy alone may also be used if all of the other criteria are met plus cancer found in only a few cores and with a small %.  Otherwise, the doc will typically use HT to lower the prostate size and/or supplement the brachytherapy with a 4-5 week course of external beam radiation therapy.

Brachytherapy as a procedure is pretty non-invasive and is typically done on an outpatient basis.  There is very little pain involved and the patient pretty much returns to normal activities within 48 hours.  Besides the aforementioned curative power of seeds, the urinary effects are much different than surgery.  There is rarely any incontinence, but a patient may experience some frequency and/or urgency during the first couple of months.  Most docs put men on Flomax for 3 months to assure normal urinary activity.  Pre-procedure, most patients take a written test about their urinary activities.  If things are pretty normal pre-procedure, they are more likely to be normal post. 

The same can be said for ED in brachytherapy patients.  A patient performing well before seeding is more likely to perform well afterward.  In any case, most of the “performing” patients return to sexual activity within a couple of weeks of the procedure.  However, if and when ED occurs in brachytherapy patients, it is likely to be a couple of years down the road.  If that happens, the same little blue pills that help surgery guys will likely do the trick for seed guys.  In general, brachytherapy patients show somewhat less ED than do surgery patients when normalized for age, diagnosis, etc.

While “radiation after surgery” is generally available if the cancer returns for surgery patients, “surgery after radiation” is not usually an option for brachy patients.  There are only a few docs who will do salvage surgery after radiation and many times it turns into a disaster.  Perhaps divo, one of our posters, will weigh in on this thread.  Her husband had a cancer recurrence after brachytherapy and he underwent salvage surgery with pretty disastrous results.  The bottom line for me is that I would NOT have salvage surgery nor recommend it under any circumstances.  So, if cancer returns to a brachytherapy patient, the options are likely to be hormone therapy, cryosurgery or maybe even HIFU.

This got a little long, but I hope it helps.  Best of luck to you; please let us know how you progress.

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 7/1/09.  6 month PSA now at 1.4 and my docs are "delighted"!

CapnLarry
Regular Member


Date Joined Apr 2009
Total Posts : 75
   Posted 7/18/2009 2:03 PM (GMT -6)   
Nicely done, Tud.
Larry Shick
Personal homepage incl. PCa story: www.sv-moira.com.
01/09: Diagnosed (age 60) biopsy PSA 4.4, free PSA 9%, T2c stage, Gleason 7 (3+4), 7 of 14 cores; 6'2", 200 lbs.
03/09: Robotic surgery (Dr. Kawachi, City of Hope) 47 gms, 10% involved, staging/Gleason unchanged (pT2cNXMX), margins clear, no ECE/sem ves involvement, fully continent from day 1, some success w/Viagra 50mg/day.
Followup: 05/09 0.006


ttrapski
New Member


Date Joined Jul 2009
Total Posts : 16
   Posted 7/18/2009 2:22 PM (GMT -6)   
Tud,

Thanks for the new perspective !!

T.

geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 7/18/2009 2:28 PM (GMT -6)   
I had robotic surgery and was back to work (desk job) two and a half weeks later. I could have made it two weeks but my boss told me not to press it.

My younger brother had seeds and was back at work calling on customers a day later. He is now five years out, undetectable PSA, and reports that on the ED front that Viagra is super.

Do take a look at the resources topic at the top of the forum. There are some excellent books on PC choices. By the way, keep your wife in the learning loop too, a great many of us have found our wives to be our strongest allies.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan, Bone scan 1/09 both negative.

Robotic surgery 03/03/09 Catheter Out 03/08/09
Pathology: Lymph nodes & 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 leakage day/1 pad.
3 mo. PSA 0.0


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 7/18/2009 2:53 PM (GMT -6)   
Tud, excellent post and response, that's why you are one of my model citizens!

The Squire
Age 57, 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 capsule, one post. margin, clear lymph nodes 
First PSA Post Surgery   2/9 .05, 5/9 .10, 6/9 .11, 8/11 ?
Lastest 7/13 met with Rad. Oncl, they want to start radiation, 70 gray, I am still considering all options and opinions
 
 


Hopeful in MD
Regular Member


Date Joined Apr 2009
Total Posts : 66
   Posted 7/18/2009 7:03 PM (GMT -6)   

Hi Trappsi,

This is a good time to weigh in with my experience with seeds.  Age 68 at time or implants. Seeds determined to have failed after 16 mos.  Now on Lupron hormone therapy.  Have never had nor do I now have any PC symptoms.  Please see my signature for details.

For me, the seeds caused a few urinary probs - difficulty in urinating, urgency, some frequency in first few weeks.  Later (about 13-14 mos), moderate burning during urination, moderate burning in rectum at the same time.(both of those delayed affects from the seeds I believe).  Those symptoms have passed on (19 mos after seeds). I am still on Flomax but may be ready to give it up.

Some of those symptoms could have partly resulted from IBS which I had before the seed implants.  ED was a problem before the implants as well. 

If you have no urinary or rectal probs now, you will most likely do well with the seeds.  However, you will still have the cancer unless the seeds knock it all out.  TUD seems to be doing great from that procedure.  For me, it wasn't successful.

The procedure is a breeze - home the same day, probably with a catheter for 24 hrs or so.  First few days a little touchy as far as urination.  BUT, as I noted above, side effects months later.  As others have said - get all the info you can and then decide what is best for you.  I fully expected to be cured of my cancer from the seeds.  That did not happen.  I don't think I would have done well with surgery anyway, so I think I made the right decision for me.

All the Best to you,

Gene In Md 


Hopeful in MD
Age 69.
Dx Dec 07. PSA 8.4. DRE confirmed tumor. Three of six biopsies positive. Gleason: 6 (3+3). Seed implants Iodine 125 Jan 08. PSA's 3.9, 1.7 after implants. Rising PSA's: 2.3, 3.4, 3.9, indicating  seed therapy not working.  April 2009 began hormone injection therapy with Lupron 30 MG ea. 4 mos.   So far so good. Slight fever and aches 2nd day after shot. Buttock soreness 2-3 days.  June - hot flashes.  Lot of fatigue cause unknown.  Oncologist says Lupron not the cause.  I wonder. 
 
Oncologist Jun 17.  DRE negative for nodules - hooray!  
 
Began seeing psychologist Jun 4 for anxiety and depression (Lupron?).  Anxiety from serious IBS (irritable bowel) probs.  Doctor using hypno-therapy for the IBS - talk therapy for anxiety.  Taking Celexa for anxiety-depression.   Recommend anyone having difficulty coping with PC or other chronic conditions etc. get professional help. 


hangin-in
Regular Member


Date Joined Sep 2008
Total Posts : 78
   Posted 7/18/2009 10:18 PM (GMT -6)   
Just to pipe in with my experience... While everyone is different, I decided on surgery because I wanted to keep my option of salvage radiation in the case of a recurrence. I had my surgery done laproscopic non-robotic at MSK. I was back at the office in two weeks. I was also of the few lucky ones - no ed or incontinence issues from the time the catheter was taken out.
It's a tough decision to make. Like it was mentioned before the most important factor is EXPERIENCE and comfort with the doctor.
Lots of luck to you
Rising PSA 12/06=1.6 12/07=2.1 5/08=2.6
Biopsy 6/4/08 12 core 4 Positive 15%,15%,8%,3%
Diagnose @ Age 51 Gleason 3+3=6
Bone & Cat Scans Normal
Lapro Surgery 8/18/08 at Memorial Sloan Kettering
Pathology report stage T2c organ confined with positive apical margin Gleason 3+3 = 6 (with tertiary grade 4)
Catheter removed 8/26 - reinserted 8/29 - removed 9/2
No continence or potency problems from the get-go.
First post op PSA 10/2/08  < 0.05
2nd  post op PSA 12/30/08 < 0.05
3rd  post op PSA 3/30/09 < 0.05


ttrapski
New Member


Date Joined Jul 2009
Total Posts : 16
   Posted 7/18/2009 10:21 PM (GMT -6)   
WOW !!!

Again thanks to you all for sharing . I feel like I have joined this weird club. I gues I have . Thanks to Les for reminding me about my wife but , honestly , she is the one who signed me up to this forum. She is my rock.

I don't have the option of robotic surgery and that is why they are saying 6 to 8 weeks recovery.

I am booked into the cancer clinic to discuss options and I guess that is my next step as well as continuing research.

They say I have time , but how much time is reasonable ? Part of me wants it out , like , tomorrow ,but another part of me thinks , maybe I can wait a year or twenty.

Please advise on this. Also , What should I be doing physically to prepare for what will probably be open surgery , but who knows.

Again , thanks to you all.

T.

vegmancsco
New Member


Date Joined Jul 2009
Total Posts : 1
   Posted 7/18/2009 11:27 PM (GMT -6)   
If surgery is an option now, it will not be if you have a recurrence after radiation treatment.  Also, radiation treatment could cause other forms of cancer such as bladder cancer.  I am 48 and was diagnosed with PC in May.  I had a da Vinci radical prostatectomy on June 23 and am just about four weeks into my recovery period.  My cancer was completely contained and my surgery was completely nerve sparing.  I know that regaining continence can take up to 12-18 months for some, but I can already go through most of every day being dry with only a few minimal leaks.  I have not been able to achieve an erection yet, but we'll see how that goes with Viagra and some more time.  My pathology report was clear after surgery and I'll need to have my PSA checked in another two months, but right now I am cancer free and really, as long as the PSA is 0 in September, there is very little chance of any recurrance.  Once surgery is no longer an option, recurrence can then only be treated with more radiation.  My father in law had prostate cancer that was inoperable and although he survived five years after his diagnosis, recurrence led to his death.  I cared for him in his last several months of life and knew then that if I were ever faced with the same disease I would choose surgery if an option.  You sound like a healthy 57 year old and I would encourage surgery for you.  Let me know if you would like to talk or ask more questions.

ttrapski
New Member


Date Joined Jul 2009
Total Posts : 16
   Posted 7/19/2009 1:32 AM (GMT -6)   
thanks

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4274
   Posted 7/19/2009 11:06 AM (GMT -6)   

The chances of getting bladder cancer from a prostate brachytherapy are infinitesimal.  You should be more worried about getting struck by lightening during the procedure.

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 7/1/09.  6 month PSA now at 1.4 and my docs are "delighted"!

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4268
   Posted 7/19/2009 8:24 PM (GMT -6)   
Tud,
Your post was excellent and covered all the basis.
With a G6, Brachyatherapy has about the same cure rates of all the other treatment options with less overall side affects. Surgery may have some benefit for patients in their early 40's; at your age there is no significant benefit. There is no indication of future cancers with either radiation or seeds. This is an old myth when ERBT was given to a large area in the 1950's.

I had seeds 6 weeks ago, no pain and golfing the next day. Urinary frequency for about 4 weeks, (going every hour) but back to normal now even though I've had 3 weeks of IMRT. Side affects from seeds are fairly benign when compared to the other options. Pick up a copy of "Brachytherapy and IMRT" by Danatolli.

Get a good doctor that has done a lot of procedures; at least 500, the more the better.
JohnT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DX BPH and continue to get biopsies yearly. Positive Biopsy in 10-08, 2 cores of 25, G6 less than 5%. Scheduled Surgery as recommended.

2nd Opinion from Dr Sholtz, an Oncologist said DX wrong, path shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G 4+3 approx 2.5cm diameter.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and burining urination. Daily activities resumed day after implants.

Scheduled for 5 weeks IMRT in July

JohnT


Spectre
New Member


Date Joined Jun 2009
Total Posts : 6
   Posted 7/20/2009 2:17 AM (GMT -6)   
I can't add anything to Tud's excellent post other than a personal perspective. I too opted for brachytherapy after some fairly extensive research. I went for brachytherapy based on my prognosis and my perception that it was the least invasive of the options presented to me (Surgery, external or internal radiation plus the newer high-intensity ultrasound).
I was released from hospital the same day as my procedure and following catheter removal.
I had my procedure on a Friday and was back at work on the Monday. I have experienced some relatively minor bladder frequency and urgency plus some minor bowel irritation. I do get quite tired as the day progresses.
I successfully made love to my wife about two weeks post-procedure and continue to do so. I had experienced some ED pre-diagnosis and, if anything, my erections are better if not (in my opinion) optimal.
My oncologist was very happy with my one-month post-procedure CAT-scan and condition. I am due to see my urologist for my first post-op PSA check next month (August).
Your decision is personal but do everything you can to make it an informed decision. Good luck and best wishes!
Age at Diagnosis: 58 PSA: 5.92 (05/03/09)
Bone Scan: 14/04/09 Negative
Biopsy: 4 cores positive Right Quad CS = T1c
Gleason: 2+3=5 Volume: 24.6ml
Brachytherapy: 22/05/09 59 Seeds
Post-brachy CAT Scan: 18/06/09 'Normal'


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 7/20/2009 7:29 AM (GMT -6)   
Spectre, you look like a perfect candidate for seedng from your specs, I hope it continues to work well for you.
Age 57, 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 capsule, one post. margin, clear lymph nodes 
First PSA Post Surgery   2/9 .05, 5/9 .10, 6/9 .11, 8/11 ?
Lastest 7/13 met with Rad. Oncl, they want to start radiation, 70 gray, I am still considering all options and opinions
 
 


KenW
Regular Member


Date Joined Mar 2007
Total Posts : 74
   Posted 7/20/2009 8:39 PM (GMT -6)   
As usual no mention of Proton Beam Treatment. Amazing. If you are concerned about ED please look into it. Nuff said.
Diagnosed with a Gleason 4X3. Second opinion at Stanford came back as 3X4, 1 out of 7 samples, Left Side. DRE showed Normal. Before Biopsy Psa gradually crept to 10. Dropped to 6.4 with Alt. suppliments.
Proton Beam Therapy at Loma Linda 11-06. 1st PSA 4 Months 3.4, PSA at 8 Mo. 1.7. - 1 Yr. PSA 1.8 ( Different Lab ) 4 th PSA Slightly up at 2.19- Free PSA at .33 probably due to BPH. 1 year and 11 mo. Urologist discovered Scar Tissue in the uretha causing frequent urination with burning. Bladder not emptying completely.
Scheduled ( 12/17/07 ) to have the scar tissue sliced to open up the restriction. Good news is PSA is down to 1.14.
Urethrotomy performed. Flow much improved. No more burning.
PSA bump to 3.1. being checked at 3 months now.
New test result 9/29 dropped to 1.03.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 7/20/2009 9:31 PM (GMT -6)   
Ken,

Not many people here have had Proton Beam treatments, probably why it's not mentioned as much. By sheer statistics, surgery is the number one primary treatment method for prostate cancer, perhaps one day it won't be any longer. Looks like you are doing well with your treatment, hope it continues that way for you.

David in SC
Age 57, 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 capsule, one post. margin, clear lymph nodes 
First PSA Post Surgery   2/9 .05, 5/9 .10, 6/9 .11, 8/11 ?
Lastest 7/13 met with Rad. Oncl, they want to start radiation, 70 gray, I am still considering all options and opinions
 
 


KenW
Regular Member


Date Joined Mar 2007
Total Posts : 74
   Posted 7/20/2009 11:51 PM (GMT -6)   
Yep David, I'm doing very well.
I realize that this forum is mostly surgery guys, but just want those that are not aware of Proton Beam Radiation to check it out.
They also do some treatment after surgery if the target area is confined.
Diagnosed with a Gleason 4X3. Second opinion at Stanford came back as 3X4, 1 out of 7 samples, Left Side. DRE showed Normal. Before Biopsy Psa gradually crept to 10. Dropped to 6.4 with Alt. suppliments.
Proton Beam Therapy at Loma Linda 11-06. 1st PSA 4 Months 3.4, PSA at 8 Mo. 1.7. - 1 Yr. PSA 1.8 ( Different Lab ) 4 th PSA Slightly up at 2.19- Free PSA at .33 probably due to BPH. 1 year and 11 mo. Urologist discovered Scar Tissue in the uretha causing frequent urination with burning. Bladder not emptying completely.
Scheduled ( 12/17/07 ) to have the scar tissue sliced to open up the restriction. Good news is PSA is down to 1.14.
Urethrotomy performed. Flow much improved. No more burning.
PSA bump to 3.1. being checked at 3 months now.
New test result 9/29 dropped to 1.03. Recent test now at .8.


jacketch
Regular Member


Date Joined Apr 2009
Total Posts : 179
   Posted 7/21/2009 6:19 AM (GMT -6)   
ttrapski said...
WOW !!!

Again thanks to you all for sharing . I feel like I have joined this weird club. I gues I have . Thanks to Les for reminding me about my wife but , honestly , she is the one who signed me up to this forum. She is my rock. (This is a big positive for you)

I don't have the option of robotic surgery and that is why they are saying 6 to 8 weeks recovery. (I didn't have the optior either but the open RRP worked out fine for me. The surgeons experience/expertise may be a major factor)

I am booked into the cancer clinic to discuss options and I guess that is my next step as well as continuing research. (Check the potential surgeons record - how many surgeries)

They say I have time , but how much time is reasonable ? Part of me wants it out , like , tomorrow ,but another part of me thinks , maybe I can wait a year or twenty. (This may be the toughest part, making the decision and then waiting for the procedure)

Please advise on this. Also , What should I be doing physically to prepare for what will probably be open surgery , but who knows. ( I got ready by excercising, doing lots of lower body excercises like squats, leg lifts and lots of crunches and walking. I also lowered my carb intake and increased my protein. I also did lots of streching. )

Again , thanks to you all.

T.
My open surgery went very well, out of the hospital the next day, catheter out in 8 days, no incontinence issues and no ED. My doctor said I was an exception to the rule but I think we can contribute to the success of our treatment.
62yo
V10.46 Dx Feb-09
RRP 5-5-09
No adverse SE
PSA 6-19-09 -0-
 
Thriving, not just surviving!
 

New Topic Post Reply Printable Version
35 posts in this thread.
Viewing Page :
 1  2 
Forum Information
Currently it is Thursday, September 20, 2018 6:51 PM (GMT -6)
There are a total of 3,005,247 posts in 329,204 threads.
View Active Threads


Who's Online
This forum has 161765 registered members. Please welcome our newest member, lori6666.
298 Guest(s), 9 Registered Member(s) are currently online.  Details
OzLyme, 81GyGuy, PeterDisAbelard., Serenity Now, MauiViv, 18yearsandcounting, InTheShop, Relentlesswill, iPoop