Surgery in Nov, or wait to January? Pros/cons?

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denverSurvivor
New Member


Date Joined Oct 2009
Total Posts : 7
   Posted 10/21/2009 3:53 PM (GMT -6)   
 
Wow, I just found out that my doctor has an opening for Robotic Surgery November 16. Which is just a little more than 3 weeks. The next available dates for me would be in January.
 
I was just diagnosed 2 weeks ago - PSA 5.1, Gleason 6 (3+3) in 1 core out of 12.
 
It just all seems really sudden! But then I worry about waiting too long and this cancer growing or spreading.  But I hear that it is 'slow-growing'.
 
Does anyone have any feel for this? Is it better just to get on with it and get it done? Or does it help to give yourself time to let everything sink in and mentally prepare - or is 3 weeks plenty of time to prepare?
Age: 52 yrs old
PSA: 5.1 in Sept, 2009, last PSA was 2.6 over a year ago
Biopsy: Gleason 6 (3+3) in 1 of 12 cores, the Right Lateral Apex. 4 PINs, 1 Atypical
Doctor does not see anything on ultrasound, nor feel any lumps, etc.


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 10/21/2009 4:03 PM (GMT -6)   
Hi Denver....actually in your situation, whatever decision you are most comfortable with. I am actually surprised a little about given the opportunity for surgery so soon after biopsy. My uro said it needs to be at least 8 weeks to let the inflammation "cool" down. But I guess it is left up to the doc to make that kind of call.

Your current stage and gleason actually indicates no need to rush if that is what you would like to do. Waiting until next year would be my choice, but that is only because of insurance deductibles restart in January for me and for the fact I am not one to take major surgery lightly. (And you get to live without the cathater or ED issues that much longer)

Best of luck in whichever way you decide.
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 Apr 2009 .06
                   9 month Jul  2009 .08
                 12 month Oct 2009 .09 


MrGimpy
Veteran Member


Date Joined Jul 2009
Total Posts : 504
   Posted 10/21/2009 4:18 PM (GMT -6)   
Hi Denver,

You could go either way, but its up to you to decide if you are most comfortable with the evaluation of all the available treatment options. Did you speak to anyone about Radiation yet ?

Another thing to think of is the Thanksgiving and Xmas Holiday season, you may still have a catheter and very likely will be on pads during that period.
Stats:
Age: 52
PSA (2008)=1.9
Biopsy on Jan 09, 2009
One (1) out of twelve (12) cores was positive, plus external nodule found
Gleason Score = 3+3
Surgery (Da Vinci, robotic prostatectomy): 4/7/09
Removed Catheter: 04/19/09
100% bladder control - Pad free 7/09
PSA 7/09 undetectable, under .0


denverSurvivor
New Member


Date Joined Oct 2009
Total Posts : 7
   Posted 10/21/2009 4:36 PM (GMT -6)   

 

Thanks, guys.

And yes, MrGimpy, I'm scheduled to talk to a radiation oncologist next week, but I'm 95% sure that I will go with Robotic removal (at least at this point).  I was thinking the Holidays would be a good time to be 'gimpy', because work seems to slow down a little bit during that time and just seems like a better time for taking it easy. But just hope the doctor wouldn't be in too much of a holiday mood. 

LV-X, I'll check with my doc about the 8 weeks waiting period. I was just talking with the scheduler, and maybe she didn't know that my biopsy was only 3 weeks ago.


Age: 52 yrs old
PSA: 5.1 in Sept, 2009, last PSA was 2.6 over a year ago
Biopsy: Gleason 6 (3+3) in 1 of 12 cores, the Right Lateral Apex. 4 PINs, 1 Atypical
Doctor does not see anything on ultrasound, nor feel any lumps, etc.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 10/21/2009 4:39 PM (GMT -6)   
Hello and welcome,

With your low level stats, not sure I would be agreeing to either surgical date at this point. You have plenty of time to think through all your options and to get other opinions. Not downplaying the fact that you have cancer, and I am a surgery and now radiation person.

I went through all last Thanksgiving and Christmas season after my surgery, and it was miserable time for me and can't remember any of the good from the holidays. So if you don't have to, I sure wouldn't mess up my holiday season on purpose.

With your stats, you should have a full range of options, even aside from surgery.

Please keep us posted of your journey and once again, welcome here.

david in sc
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.


Ziggy9
Veteran Member


Date Joined Jul 2008
Total Posts : 981
   Posted 10/21/2009 4:47 PM (GMT -6)   
Don't schedule any surgery this soon after diagnosis. It's only been 3 weeks. You should be checking on all options be it surgery, radiation or just watchful waiting. Your numbers are low. If you want recommendations to other Urologists, Radiologists or Urological Oncologists let me know I'm in the Denver area too. You have much to learn and evaluate before you make any decision. I understand your present anxiety to "get it out of you asap!!!" but you have much time. There are no do overs with radical treatments, understand that and know what you are possibly getting yourself into.
Diagnosed 11/08/07 - Age: 58 - 3 of 12 @5%
Psa: 2.3 - 3+3=6 - Size: 34g -T-2-A
 
2/22/08 - 3D Mapping Saturation Biopsy - 1 of 45 @2% - Psa:2.1 - 3+3=6 - 28g after taking Avodart - Catheter for 1 day -Good Candidate for TFT(Targeted Focal Therapy) Cryosurgery(Ice Balls) - Clinical Research Study
 
4/22/08 - TFT performed at University of Colorado Medical Center - Catheter for 4 days - Slight soreness for 2 weeks but afterward life returns as normal
 
7/30/08 - Psa: .32
11/10/08 - Psa.62 - Not unexpected bounce after the 80% drop the quarter earlier. Along with urine flow readings, an acceptable amount left in bladder measured by sonic. Results warrant skipping third quarter tests, and to return April, 2009 for final biopsy scheduled to
complete clinical research study 
 
April 2009 12 of 12 Negative biopsy
10/12/09 - Psa .30
 
 
 

Post Edited (realziggy) : 10/21/2009 4:27:39 PM (GMT-6)


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4237
   Posted 10/21/2009 4:56 PM (GMT -6)   
Research all your options and get 2nd opinions. Your PC is slow growing and you probably have years before it gets to the point that it may hurt you. Get information on AS as it could be your best option. Throughly research all side affects as they may affect you much more than your PC ever would.
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


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 10/21/2009 5:00 PM (GMT -6)   
Denver I would heed the advice you are receiving in this thread. You have plenty of time to get a better education about your diagnosis.

Sorry to do so, but welcome to the club that has all reluctant membership. This is a great forum and many will answer your questions with experience.

Tony
Age 47 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Gleason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
Hormone Therapy May '07 to September '09 ~ Currently off.
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (October 7, 2009): <0.1

My journey is at: www.caringbridge.org/visit/tonycrispino

My InfoLink page is at Tony's Prostate Cancer InfoLink Page

STAY POSITIVE!


wesd40
Regular Member


Date Joined Sep 2009
Total Posts : 41
   Posted 10/21/2009 6:03 PM (GMT -6)   
Hi Denver,
I am 51 as of this month.My initial psa was 4.2 in July. The biopsey was 4 out of 10 cancer with gleason score of 6 which was upgraded to a 7 after the path report post surgery.I took a month to reasearch all of my treatment options and decided that robotic surgery was my choice and it would be no matter how long I waited be it years or days.I was scheduled for surgery on Sept. 25 but an opening came up a week earlier and I took it. In my case I decided to go ahead with the surgery and I am glad I did as it put me one week ahead in recovery if you want to think of it that way. I stress that there is no rush as others agree here, but decide what you want to do and be confident in your choice. I am waiting on my first psa test on Dec .11th .I do not think the cancer will grow a lot in 3 months but I do know what it is like to worry about it. Good luck , Wes

Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 10/21/2009 8:15 PM (GMT -6)   
Hi Denver,
My doctor will not operate in less than 6 weeks after the biopsy. This allows for healing. In your situation I don't think that waiting till January is going to make your PCa any worse. Enjoy Thanksgiving and Christmas without the side effects of PC surgery.
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09 Dr Fagin, Austin TX
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 4 months
8 weeks PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1


Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4110
   Posted 10/21/2009 8:29 PM (GMT -6)   
Denver: You have been given very good advise from other members however, you are the person that must make the decision of what is best for you. I know that like many of us "I wanted to get rid of that thing (cancer) that was in us to be taken out". You do have time to make the decision. I would suggest that you read and find out as much as you can about what the complications can be for each kink of treatment.

Please keep us informed.

Jeff T
Cajun Country
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
 10th month  PSA <0.01
ED- 5 mg Cialis daily, pump daily, going to try MUSE next


Paralleli
Regular Member


Date Joined Jul 2008
Total Posts : 123
   Posted 10/21/2009 9:13 PM (GMT -6)   
As many have suggested, spend some time researching your options. Don’t be rushed because it fits some surgeon’s schedule! You’ve got time.

I wasn’t ready for the snow here in Denver today. It is supposed to wait until Halloween….
@ 53 yrs PSA 4.8
T1c – Gleason 3 + 3
IMRT 1/07 thru 2/07 (42 treatments)
PSA 6/07 – 0.76
PSA 12/07 – 0.36
PSA 6/08 – 0.72
PSA 12/08 - 1.06
PSA 6/09 - 1.02


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4183
   Posted 10/21/2009 9:17 PM (GMT -6)   

Denver:

My advice is similar to what you are getting from many of the posters on this thread.  With your stats you should have plenty of time and do not need to rush it.  This is a HUGE decision.  Seek mulitiple medical opinions from docs in different fields, read, study and learn as much as you can and get informed/educated.  And, whatever treatment you choose, use a doctor with plenty of experience in the specialty.  They will be messing with very important real estate and you want to get this one chance right...

Good 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 9/1/09.  6 month PSA  1.4 and my docs are "delighted"!

Tim G
Veteran Member


Date Joined Jul 2006
Total Posts : 2305
   Posted 10/21/2009 9:55 PM (GMT -6)   
I agree with the advice others have given. I waited six months and was much better educated about prostate cancer and felt infinitely more comfortable with my treatment decision by the time I had my cancerous prostate surgical removed. Enjoy the holidays!


PSA quadrupled in 1 yr (0.6 to 2.5)  
DRE negative  1 of 12 biopsies positive (< 5%) 
Open surgery June 2006 at age 57
Organ-confined to one small area, Gleason 5   
PSA's undetectable  < 0.1  


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4834
   Posted 10/22/2009 5:36 AM (GMT -6)   
INSURANCE. You probably start a new deductible on January 1st smhair
Age 54   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
06/25/08 - Da Vinci robotic laparoscopy
05/14/09  - 4th Quarter PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 10/22/2009 7:35 AM (GMT -6)   
Denver, as already stated, you have some time to decide on your treatment. And, I definitely agree about 3 weeks from biopsy being too soon - our urologist said he wouldn't do the surgery for at least 6 weeks after the biopsy because the prostate gland needs to "heal" from the biopsy procedure.

Take this time to research and to "interview" different doctors. I'm a big believer in picking brains for information and if your budget (or insurance company) allows second and even third opinions, you should consider it.

Please keep us posted, and good luck with your decision.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (extraprostectic extension in posterior left). Perineural tumor infiltration present. Apex margin, bladder neck and SV negative. Gleason 3+4 (no change from biopsy). PSA results: April 2008 0.1; May 2008 0.0; August 2008 0.0; November 0.0; February 2009 0.0; May 2009 0.0; August 2009 0.1; September 2009 0.3. Met with radiation oncologist and began process for salvage radiation. CT scan and bone scan done on October 8. One spot on bone scan (clavicle) being investigated. Third PSA taken on October 16 - PSA IS UNDETECTABLE! Next PSA scheduled for early December. Urged not to begin radiation treatment until it's needed (no problem there!).


CPA
Veteran Member


Date Joined Feb 2008
Total Posts : 655
   Posted 10/22/2009 11:39 AM (GMT -6)   

Greetings, Denver.  I don't have much different advice to add but rather to reinforce what some others have said. 

1.  You have time so don't feel rushed - my doc is just like many others here and said that you need to wait at least 6 weeks to heal from the biopsy.

2.  Look at all your options.  There are many good options that can be right for you in your particular circumstances.  Look at all of them.  I chose open surgery and still believe that was right for me.  Others have chosen radiation or brachotherapy and those were the right decisions for them.  Take the time to consult with a couple of different medical professionals in the various specialties and do the research and find the treatment that is right for you. 

3.  For what it's worth - and probably not much - while Active Surveillance may be good for some I'm not a big fan.  Mainly because it is not unusual to find out that the cancer is somewhat more agressive than originally thought.  In my case I went from 3 +3 to 4+3 and so was glad I had chosen to have an active treatment and glad that I had gotten it out. 

Best wishes on your upcoming treatment.  Don't be shy about asking questions here - I have found the people on this board to have more personal knowledge on the various issues because we have already been right where you are.  Hang in there!  David


Diagnosed Dec 2007 during annual routine physical at age 55
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 pos; 2 marginal
Gleason 3+3; upgraded to 4+3 post surgery
RRP 4 Feb 08; both nerves spared
Good pathology - no margins - all encapsulated
Catheter out Feb 13 - pad free Feb 16
PSA every 90 days - ZERO's everytime!
Great wife and family who take very good care of me


Dave7
Regular Member


Date Joined Jul 2006
Total Posts : 202
   Posted 10/22/2009 12:18 PM (GMT -6)   
Since you are reading here, you know the extent of the potential side affects that accompany surgery. While hopefully you will be one of the lucky ones in the side affect area, you just never know with PC.

If you enjoy an active sex life, enjoy it for another 3 months. It may never be the same after surgery. The same can be said for continance.

I fully understand the idea of wanting to get the treatment over with and move on with your life, it's just not always that simple. Enjoy your current life for another 3 months and take the time to fully educate yourself. And make sure your surgeon has the necessary experience.

Good luck.
Dave
Age:54
PSA 5/22/06: 5.6
DaVinci surgery: 9/14/06
Gleason: 3+3
Organ confined, clean margins.
Both nerve bundles spared.


Sonny3
Veteran Member


Date Joined Aug 2009
Total Posts : 2447
   Posted 10/22/2009 12:22 PM (GMT -6)   
Denver,

You are getting some very good advice here.

Just wanted to chime in on the surgery date. My surgery doc (supposedly one of the top 5 in the world) would not consider surgery until at least 8 weeks following biopsy.

The main reasons stated were to give the prostate time to heal from the biopsy. It needs time to recover and reduce the trauma and inflammation. A swollen and inflamed prostate presents a whole other set of complications during surgery. If it is swollen the space and tissues around it may also be inflamed. Doing surgery this delicate requires a clear field of vision and room to work.

While the holidays may look like a good time for surgery as far as time off and so on; don't minimize the importance of the time we spend with our families and how much we depend on them for support through this process. While you may be willing to tough it out through the holidays, your family and loved ones will be along for the ride and it will impact their holidays as well. IMHO.

Good luck and God bless,

Sonny
61 years old
PSA 11/07 3.0
PSA 5/09 6.4
Diagnosis confirmed July 9, 2009
12 Needle Biopsy = 9 clear , 3 postive
<5%, 90%, 40%
Gleason Score (3+4) 7 in all positive cores
CT Organ Scan - negative
Nuclear Bone Scan - Negative

da Vinci 9/17/09 Dr. Mani Menon Henry Ford Medical Institute

Post Surgery Pathology:
Gleason: Changed to (4+3) = 7
Stage: T3a
Tumor Volume 12.5%
ALL NERVES SPARED
Margins: focally positive right posterior mid level
Perineural Invasion: present
Seminal Invasion: absent
Venous Invasion: absent
Angiolymphatic Invasion: absent
Left Internal iliac lymph node: reveals zero
Right Internal lymph node: reveals zero


Arnie
Regular Member


Date Joined Aug 2009
Total Posts : 372
   Posted 10/22/2009 4:34 PM (GMT -6)   
Hi Denver........I was diagnosed in 8/08 with somewhat similar stats. I consulted 3 surgeons, including my own treating urologist, a Brachytherapist, and an oncologist who specializes in PC and had no dog in the race-----all concurred that I could wait as long as 6 months to research, decide and schedule whatever treatment. If one had said that wating might be a problem, it would have given me pause for concern, but might not have altered my ultimate decision. I was able to confidently select a treatment (Robotic prostatectomy), and schedule it 5 months after the biopsy in a time period that worked well for me. That said, everyone has a different anxiety threshold, and you have to do what's right for you. I would say as long as you feel you have enough time to research your options and weigh everything and make a reasoned decision, then go ahead and schedule.
           Arnie in DE
Age 56 (biopsy & surgery)
PSA at Diagnosis-3.9
Biposy 8/19/08--4 of 12 cores positive; 5% involvement, Gleason 6 (3+3)
 
Surgery 1/26/09-DaVinci Robotic Prostatectomy at Presbyterian Medical Center/HUP-Phila, PA
Dr. David Lee
 
Pathology Report- Adenocarcinoma, no capsular involvement, seminal vesicles clear, lymph nodes clear, negative margins, Gleason 7 (3+4), Stage T2C, Prostate 61.8 grams, gland involvement 2-10%
 
Catheter removed after 8 days, totally dry at 3 months. ED issues continue, Viagra (via ADC) nightly (100mgs), VED use in earnest at 6 months. "Ball Park Frank" plumping at this point.
3 month PSA--<0.1
6 month PSA--<0.1


Doc
New Member


Date Joined Sep 2009
Total Posts : 18
   Posted 10/22/2009 7:36 PM (GMT -6)   
Hi Denver -

I cut my upper lip shaving the other day. It scabbed over a bit and made shaving the next few days tricky - I did not want to re-open the wound and had to sort of shave around it.

The injury to your prostate from the recent biopsies is similar. Twelve needles passed through the rectum, through the perirectal and periprostatic soft tissues, and into the back side of the prostate. If you choose surgery, your urologist will have to "develop a tissue plane" between the rectum and back side fo the prostate in order to separate one from the other. The inflammatory reaction caused by the needles will make it more difficult to "get a clean shave" when separating these tissues. Also, there are LOTS of nerves in that area, and you ideally want to minimize injury to those nerves in order to protect erectile function. Finally, all indications at this point are that you have a low grade cancer. Your poor pathologist will have to determine where the cancer ends and the inflammatory healing reaction of benigh prostate glands begins, and in the face of an acute injury and a low grade tumor this can be challenging.

So, in addtion to all the "what's the rush" answers others have provided, I think that there is also medical justificaiton to waiting until the biopsy injury has totally healed. Most suggest a minimum of 8 weeks for that. You can objectively guage your healing progress to some degree by how long it takes for your semen to return to normal color, and the contractions of your orgasms feel normal again.

Best wishes.

Doc
PCa Dx 07/09: 3+3 in 2 cores
Age at Dx 54
daVinci RRP 09/17/09
Final path 3+3, <5%, margins neg, pT2a.
 


Franchot
Regular Member


Date Joined Jun 2009
Total Posts : 130
   Posted 10/23/2009 11:46 AM (GMT -6)   
Denver,

I agree with the majority of the people in this thread. Wait. Wait and research. Read everything you can about the disease and the treatments. Get a color doppler test to see how advanced your cancer is. With your low numbers Active Surveillance might be a good alternative to surgery or radiation.

stxdave
Regular Member


Date Joined Nov 2008
Total Posts : 65
   Posted 10/23/2009 12:16 PM (GMT -6)   
Last Christmas I was walking around with a Foley catheter with a urine bag attached while the house was full of children and grandchildren. Miserable!!! Wait until after the Holidays whatever your reason.

Dave
Dx'd 1999, Age 60, PSA 43, Gleason (3+4=7), T3c
42-3d EBRT w/Lupron/Casodex for 24 months.
July 2001 - Intermittent ADT. Lupron only, MDAnderson biopsy revised Gleason (4+5=9).
March 2007 - Diminishing returns with Lupron, Prostate biopsy (5+4=9) in unradiated lobe.
August 2007 - RRP and bilateral orchiectomy. PSA <0.1
99% continent immediately
Sept 2008 - PSA 0.45, Nov 2008 - PSA 0.67,
Dec 2008 - Resume Casodex, Stricture in bladder neck requiring surgical removal. 99% incontinent immediately.


Mbshine
Regular Member


Date Joined Aug 2008
Total Posts : 67
   Posted 10/24/2009 11:44 AM (GMT -6)   
hate to say ste ve hits the target but there are usually financially concerns..
 
if you have had lots of medical bills this year either to meet deductibles or copays or to achieve an I
rs deduction finishing before dec 31 could be a huge advantage..
 
If things have been relatively affordable, and you know in a dvance you face a major surgery and los of related follow up care in 2010 you might want to start the clock early in2010.  I passed up a mid dec surgery last year because kids had already made xmas plans to visit, and knowing I needed bariatric and davinci operations in the same year i scheduled to first fr jan 23 and the second, the da vinci was this week, so I had at lest 9 plus months of recovery..
 
you are ina great area with great docs in colo springs, pueblo and denver, and listen to others who advise second and third opinions...having said that also seriously consider that  watchful waiting or hormone treatments are not without side effects....early one i was adviced to get a copy of Dr Peter Scardino's prostate book and it remains the best thing I have read on the subject although the latest edition is now probably three years old and you will need to go online or post here for further questions..
 
take control...become the expert...listen to urologists but dont be afraid to actuallybecome more knowledgeable about Pca than many primary care physicians.
 
good luck
 
Mbshine
angel fire, nm
 

AGE 62  davinci  10/19/09

DX 7/08 

psa HAD GONE FROM 1.7 TO 4.3 IN THREE YEARS...DIGITAL AND ULTRA SOUND EXAM SHOWED NO ENLARGEMENT.

BIOPSY SHOWED 2 OF 12 CORES POSITIVE.

TWO TUMORS SHOWED GLEASON 4+3 AND 3+4

NO INDICATION OF ESCAPE FROM CAPSULE OR METASTASIS

STARTED CONSULTATIONS AT SLOAN KETTERING 8/09

DR GUILLONNEAU SAID NO SURGERY UNLESS MASSIVE WEIGHT LOSS.

AT DX 333 LBS, SLEEP APNEA, AND HIGH BP

BARIATRIC SURGERY RECOMMENDED.

LAP BAND SURGERY IN EL PASO, TX 1/23/09

10/1/09  276 LBS, TRIGLYC AND CHOL NORMAL, NO SIGNS OF  SLEEP APNEA, ONE BP RX REMOVED AND OTHERS CUT DOSAGE IN HALF;

 

  STARTED QUARTERLY ZOLODEX BY TAOS,NM UROLOGIST, WHO TRAINED AT MSKCC, INJECTIONS AND CASODEX 50MG DAILY 9/08


RacingOyster
Regular Member


Date Joined Aug 2009
Total Posts : 31
   Posted 10/24/2009 9:12 PM (GMT -6)   
I had surgery just 4 weeks after my positive biopsy, and this contributed to my developing an anal fissure. It is a side effect that I didn't expect, and that has been negatively affecting my quality of life (as if I needed any more problems considering incontinence and ED).

IMHO you should wait until your rectum has had plenty of time to heal before inflicting more trauma on it.
Living in the northern Atlanta suburbs.
Good health and no symptoms when my annual physical uncovered an elevated PSA.
Diagnosis at age 55: PSA 4.6 - positive biopsy 3 of 12 cores - Gleason 3+3=6.
open Radical Retropubic Prostatectomy with bilateral lymphadenectomy on 6/18/2009.
Pathology report after surgery showed negative margins, cancer contained in capsule
(60 gram sample, Gleason 3+3=6, T2c N0 MX).
PSA at 4 months after surgery <0.1 (all other problems are minor considering being cancer-free).
Catheters required on-and-off for 34 days after surgery due to recurring urinary retention.
Anal fissure due to trauma to rectum from biopsy, surgery, and antibiotic-induced diarrhea.
Scheduled for repair of Spigelian Hernia due to pulling of abdominal muscles during RRP.
Using 1 pad during the day for occasional stress incontinence, dry at night (16 weeks after surgery).
Taking Cialis for ED with no joy so far.

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