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Whistling Gus
New Member

Date Joined Nov 2009
Total Posts : 5
   Posted 11/6/2009 2:28 PM (GMT -6)   
Hi: I've just been diagnosed with PCa. My next step is to have an appointment (hopefully within a month) with another doctor, who I think specializes in brachytherapy. Yesterday, the first doctor who gave me the biopsy outlined the results and outlined the treatment options as: 1) Watchful Waiting; 2) Radiation therapy; and 3) Surgery. Because of my calendar during the next 7 months, my inclination is to consider selecting the brachytherapy option, to be performed about June/2010. I'm now 70, live in Canada, & my Gleason score in 1 of the 12 specimens was 3+4=7 in 90% of the left medial prostatic base. As I await the next appointment, I hope to come up the learning curve as to my various options & their pros/cons. Therefore, any opinions &/or advice will be welcomed! Many thanks. Newly Diagnosed

Veteran Member

Date Joined Jan 2009
Total Posts : 2211
   Posted 11/6/2009 2:46 PM (GMT -6)   
Welcome Newly Diagnosed,
I would just suggest educating yourself about your treatment options, and really it sounds like you have. There are existing threads on here that go into detail about brachytherapy so have a look at those as well. There will be some posts on here from others, so use those as well. Find the best Dr. possible at whatever tx. you chose. Sorry your here but you are at a good place for PCa support.
Dx with PCA 12/08 2 out of 12 cores positive
59 yo when diagnosed
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
Margins not involved
2 pads per day, 1 depends but getting better,
8/5 1 depend at night only
 started ED tx 7/17, slow go
Great family

Veteran Member

Date Joined Jul 2008
Total Posts : 966
   Posted 11/6/2009 3:35 PM (GMT -6)   
Welcome Newly Diagnosed...sorry that you had to be here, but it is the best place to be for information.

Sounds from your post that you have all the options available to you. I went the surgery route, but from those that have had the seeds, it sounds like a pretty good option to be looking into. Keep searching and as you formulate questions, ask away.

The folks that have had the seeds will chime in shortly.
You are beating back cancer, so hold your head up with dignity
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 

John T
Veteran Member

Date Joined Nov 2008
Total Posts : 4171
   Posted 11/6/2009 4:48 PM (GMT -6)   
With a gleason 7 and 90% core watchful waiting is not an option for you. Waiting until June 2010 is also not a very good idea. If you do wait for brachytherapy until then, conside a diet change to a no red meat and no dairy diet and take supplements like Vit D3 and pomegranite. Also go on Casodex as it will stop any cancer from growing and also make the brachytherapy more effective by shrinking the prostate and the tumor. You may also want to ask your doctor about combining Brachytherapy with IMRT to get a better kill and a wider margin.

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.


Regular Member

Date Joined Jul 2006
Total Posts : 201
   Posted 11/6/2009 5:30 PM (GMT -6)   
Although the PCa was only in the one core, the fact that it was 90% and the 4 in your gleason score makes me concur with JohnT.  I wouldn't wait until June for treatment.
What's you're PSA?
PSA 5/22/06: 5.6
DaVinci surgery: 9/14/06
Gleason: 3+3
Organ confined, clean margins.
Both nerve bundles spared.

Cajun Jeff
Veteran Member

Date Joined Mar 2009
Total Posts : 4069
   Posted 11/6/2009 5:50 PM (GMT -6)   
Newly, Good luck with you research. Read as many post as you can. I must agree with the others with a 4 in you gleeson you must know that there are added risk. Just be aware and make the decision that you must make on your own. You stated you age as 70 is you general health good? Best of luck.
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
1year psa <0.01
ED- 5 mg Cialis daily, pump daily, going to try MUSE next. Next step injections.

Veteran Member

Date Joined Jul 2009
Total Posts : 1267
   Posted 11/6/2009 5:53 PM (GMT -6)   
Hello Newly Diagnosed, I'm sorry you have to be here, but if you've got PCa you've come to an excellent place to learn and for support. I know from nothing when it comes to seed implants, but as you can see if you do a search on JohnT the guy may know more about seeds than Noah (didn't he collect a few of each, along with the animals?)

Canadian eh? You'll find the Americans here blame us for the cold weather at this time of year as their televisions tell them a cold front is moving down from Canada. What they don't know is our television told us a few days previously that a cold front was moving in from Alaska. It's their cold front --- all we did was look after it and warm it up for them, but we get scant thanks.

It would be helpful if you created a signature for us. Up top, I think it's the "control panel" beside the log off where you can click and do so. The more info you can provide on your PSA history and pathology the better. One core involving 90% is interesting.  One thing about these cores, it's sort of like shooting 12 half inch round pictures at race horses headed to the finish line and strung out along the rail, while wearing a blind fold. You might, or might not hit a horse, and if you do and you hit a tail, or an ear, you'll have a very different idea of what was passing, when you take off the blind fold and look at the pictures, than you would if you have a picture of a shoulder. Bit like reading tea leaves I suppose.

Which leads me to the piece of advice I give all newly arrived: Get a second read on your biopsy slides. A second read changed my treatment decision. Didn't mean the second read was any more likely correct than the first, but the possibility it might be right (and post surgical pathology said it was) led me in a different direction.

Like JohnT I'd be concerned about delaying treatment if you have some "4" cells in the mix. These can be nasty little devils and I'd want to give them a good whacking as a Christmas present.

Keep in touch and let us know how the next appointment goes.

Sheldon AKA Sleepless

Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9, so far, so good
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"
First post op PSA Sept 09  less than 0.02
PSA on Oct 23 test again less than 0.02
Oct 1st 09 -- dry at night, during day some stress issues, but better every week. 
Feel free to email me at:  sheldonprostate@yahoo.com    

Post Edited (Sleepless09) : 11/6/2009 4:56:54 PM (GMT-7)

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 11/6/2009 9:03 PM (GMT -6)   
Agree with John on this, if you are waiting for treatment keep the PCa at bay with casodex or other alternative drug therapies that work against PCa, thus you are buying time until your main treatment method. This can be done in alot of scenarios, alot of times this is not mentioned to the prospective patient, the reasons.....get alot of opinions and information then you decide for yourself on that one.

Dx2002 Feb-Mar (bpsa 46.6 12/12 all 75-95%-gleasons 7,8,9's on both sides) :-)

Regular Member

Date Joined May 2009
Total Posts : 215
   Posted 11/7/2009 7:22 AM (GMT -6)   
Hi Newly Diagnosed,

Sorry that you had to join our club, but you have come to the right place for support. It is difficult making your treatment decision and it does deserve careful consideration of all the options. We are all different and I dare say all of our diagnosis are different. Each diagnosis will make many or few options available and it is basically up to you to decide what is the correct route to take. Educating yourself on all the possibilities will make the decision easier for you. It is a personal decision and yours alone to make.

I chose Robotic Surgery in London Ontario as my circumstances allowed for the time to wait for surgery and it was the route that seemed the best in my mind.

Good luck with your search and I wish you well on the road ahead.



Whistling Gus
New Member

Date Joined Nov 2009
Total Posts : 5
   Posted 11/7/2009 10:49 AM (GMT -6)   
Hi new friends! Many thanks to each of you for your thoughts and ideas, which are all much appreciated. As I originally indicated, my next step is to meet with another doctor, hopefully within the next month, and then make a decision as to the route I'll follow. In the meantime, I'll try to come up the learning curve. Cheers to all!

Regular Member

Date Joined Jun 2008
Total Posts : 407
   Posted 11/7/2009 11:34 AM (GMT -6)   
Choosing a therapy/treatment primarily on the basis of a "schedule" and not because it may be the best course to follow seems foolish to me.  My health and desire to live a longer/healthier was the primary concern for me - not inconvenience.  Best wishes as you deal with this challenge.

Age:  60 (58 at diagnosis - June, 2008)

April '08 PSA 4.8 ("free PSA" 7.9), up from 3.5 year prior

June '08 had biopsy, 2 days later told results positive but in less than 1% of sample

Gleason's 3+3=6

Developed sepsis 2 days post-biopsy, seriously ill in hospital for 3 days

Dr. recommended robotic removal using da Vinci

Surgery 9/10/08

Northwestern Memorial Hospital, Chicago, IL

Dr. Robert Nadler, Urologist/Surgeon

Post-op Gleason's:  3+3, Tertiary 4

Margins:  Free

Bladder & Urethral:  Free

Seminal vesicles:  Not involved

Lymphatic/Vascular Invasion:  Not involved

Tumor:  T2c; Location:  Bilateral; Volume:  20%

Catheter:  Removed 12-days after surgery

Incontinent:  Yes (1/2 light pads per day)

Combination of Cialis and MUSE (alprostadil) three times weekly started 9-27-08

Returned to work 9-29-08 (18-19 days post-op)

PSA test result, post-op, 10/08: 0.0; 12/08: 0.0; 4/09: 0.0; 9/09: 0.0


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