The doctor allowed me to ask whatever questions I wanted, so I took advantage and want to share with you guys. He has 30 years experience, and I am not saying I agree or disagree with him on any one point. I told him I would post this here tonight:
Seeding: they do a lot of it, said it works best with gleason 6, they will do it with gleason7, but only if taking along with external beam radiation. he said if it fails, that the freezing method (cybo?) has best results as a salvage.
HIFU - he said it positively will be approved in the US eventually, but feels its has a lot of potential dangers to it, has a collegue in Canada that had a failry young patient die from it, detroyed his kidneys, his bladder, and gave him the marsa infection. he also said that the hifu people really aggerate their success and claims about side effects. he said that anyone that goes out of the country to have it done, is taking their life in their own hands. he showed me a study on his computer, based on 100 people that had hifu in europe with gleason 6 cases, cherry picked, and in 10 years, the sucess rate was 63%.
Gleason 7: something we talk about here a lot. he agree they are dangerous, and if you are young when you get your dx, that surgery is the best option available as a primary treatment.
about the bias between radiation doctors like him and surgeons like my other doctor, he said its mostly a myth in the patients mind. he said they swap information and cases all the time, he said in my area, they compare notes and try to find the best solution for the patient, though ultimately, its the patient that makes the choice in the end.
He is totally opposed to salvage surgery, he said it was brutal at best, that in his 30 years of practice, he only knew of one case that it worked.
Surgery: he said what we all say to our new friends, its all about the experience factor, not the method, he said robotic and open were equal in his mind.
If I can remember more, I will add it on later, brain fried and I am remembering all this in my head.
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
Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsule, one post. margin, clear lymph nodes
2009 PSA 2/9 .05, 5/9 .10, 6/9 .11, 8/9 .16
Lastest 7/13 met with Rad. Oncl, considering options, 7/20 Catheter #6 after complete blockage, scarring closed up bladder neck, corrective laser surgery scheduled for 8/18,
meeting with Rad. Oncl on 8/14 about lastest PSA