Required Reading For The Newly Diagnosed

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Uncle Harley
Regular Member


Date Joined Feb 2009
Total Posts : 79
   Posted 10/14/2009 3:02 PM (GMT -6)   
I just finished reading books by Dr Walsh & Dr Scardino. Both are excellent & are listed in the sticky thread at the top of this forum. Both should be (must be) read by anyone newly diagnosed before you make any decisions about what you "might" do. Remember, you've got time to make a good decision, so take the time to read at least these books. I was fortunate to find both at my local library but have seen them at the large on-line book reseller, (Am_z_n), for next to nothing.
PSA History
3/99 1.2
3/00 1.04
3/01 1.16
7/02 1.24
2/06 1.59
3/07 1.79
3/08 2.54
8/08 2.3
4/09 2.3
7/09 2.6
12 needle prostate biopsy Jan 09
Dx of (1) core adenocarcinoma 20%
All other cores benign
Gleason 3+3 T1C
Currently in Active Surveillence
Age 60


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4188
   Posted 10/14/2009 4:05 PM (GMT -6)   
Add the books by Strum "A Primer on Prostate Cancer and Myers' Beating Prostate Cancer through Hormone Therapy and Diet" and then you will have a more complete overview instead of just a surgical overvew. Both Walsh and Scardino's books are excellent, but they only tell half the story.
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 DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology 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. G7, 4+3, approx 16mmX18mm.

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. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT


Uncle Harley
Regular Member


Date Joined Feb 2009
Total Posts : 79
   Posted 10/14/2009 4:25 PM (GMT -6)   
Thanks for you input John T. I recommended both only because they advocate Active Surveilence as a viable option, given the right circumstances. Something my original urologist didn't do. Since then I've talked to a surgeon who's in complete agreement with my AS decision. That said, I've become an advocate for not rushing to make any quick decision. Read all you can about ALL treatment options. The first couple of weeks after my dx were a blur trying to find out just what I was dealing with.
PSA History
3/99 1.2
3/00 1.04
3/01 1.16
7/02 1.24
2/06 1.59
3/07 1.79
3/08 2.54
8/08 2.3
4/09 2.3
7/09 2.6
12 needle prostate biopsy Jan 09
Dx of (1) core adenocarcinoma 20%
All other cores benign
Gleason 3+3 T1C
Currently in Active Surveillence
Age 60


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 10/14/2009 4:44 PM (GMT -6)   
All good book titles, had most of them read before I ever had my dx.
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/09 met 2 rad. oncl, 7/09 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 - out  38 days, 9/14/9 - met 3rd rad. oncl.agree to start radiation, mapping on 9/21/9, 9/24 - mtg with uro/surg, 9/29- pre-op, 10/1 - 3rd corr. surgery - suprapubic cath/hard dialation, 10/5 - began IMRT SRT - 39 sessions/72 gys.


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4188
   Posted 10/14/2009 5:47 PM (GMT -6)   
Harley,
The PCRI website has a secton of papers on AS that are very informative. You may also want to get a color doppler ultrasound to get a baseline. Any future ultrasounds can be compared to the baseline to identify any changes. This would eliminate the need for annual biopsies as a biopsy would only be done if a change is noticed. Dr Bahn has a paper on the site about using color doppler in AS.
JT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology 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. G7, 4+3, approx 16mmX18mm.

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. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT

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