Overtreatment Thoughts

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t-dog
Regular Member


Date Joined Dec 2009
Total Posts : 154
   Posted 12/20/2009 6:10 PM (GMT -6)   
Hey folks, since i`m still very new to this problem i`ve been reading alot and this issue struck me as very interesting. With the scope of what i`m about to put my body thru to repair this problem i keep having these thoughts of what if this would of never come to be a significant issue? I would be very interested to know how you got past this. My numbers point to very early detection, and i have confered with 3 very well respected doctors that all say do the robot and i`m ok with that if thats what is needed but dang its hard to pull that trigger when you`re feeling good and all seems well. Thanks for your thoughts, Tim

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 12/20/2009 6:22 PM (GMT -6)   
t-dog,

you do bring up a good point that all of us have to struggle with. Now some men, have had prostate troubles (non cancerous) for years and years before they ever had prostate cancer. others, such as myself, never had a single issue. felt fine done there, nothing but negative DRE's for years, no infections, no swelling, ability to hold urinating for as many hours as needed, never having to get up at night to pee, etc. If it wasn't for having regular PSA tests since age 50, I still probably wouldn't know that I have cancer. Its scary too, thinking of that, that despite my surgery, corrective surgeries, lingering issues associated to my prostate cancer, I would still probably not even know I had it, let alone know that was raging war deep inside my body.

so yes, directly before my diagnosis, I was feeling great, no major health issues at all. and yes, it was a bit hard to come to the decision to agree to a very complex surgery with well know side effects and quality of life issues.

I don't remember your age, Tim, but I was only 56 at dx, and got a wonderful wife and family to think of, so that was all the motivation I needed to push on ahead once I knew I had cancer.

We are all guilty at times playing the "rewind" button in our minds, and the "what if" a thousand times, afraid that part is human nature.

My real choice, of course, would never to have had prostate cancer.

Glad you are still working through your cancer, treatment options, and thoughts on the subject in general. Keep us posted, and ask as many questions as you wish, or if you need to vent, or bounce something off the wall, we are here for you brother.

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
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA:
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 in place


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4229
   Posted 12/20/2009 6:57 PM (GMT -6)   
Tim,
It's basically a personal decision; quantity of life vs quality of life. I don't know your stats, but if they meet the Hopkins criteria your chance of dying PC is about 2% on Active Survelience. And guess what? Your chance of dying after being treated is 2%. The upsides of AS is that you may never have to be treated and if you do get treatment later you have bought a few years without any side affects and virtually no risk. If your PC is small; lets say 1mm, and doubling time is 6 years, in 18 years your tumor will be 4mm or still a pretty small tumor. If your PSA doubling time drops to under 3 years, get treated and it's still in a very non agressive stage.
The down side is you have to get PSA test at least every 6 months and a biopsy after the 1st year and probably every two years after that, and you will worry that the pc has escaped. For those of us that have been treated, we also have to get a psa every 6 months and worry that we don't have a
reoccurrance and the pc has escaped.
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


t-dog
Regular Member


Date Joined Dec 2009
Total Posts : 154
   Posted 12/20/2009 10:10 PM (GMT -6)   
David, i`m 50 and my current psa is 2.6 it was also 2.6 last year. It was 1.4 in 2001 when i began having it tested. The free fraction number seems to be what the concern was, it was 14 in one test and 16 in another, 3 positive samples in biopsy all in one quadrant on right side, left side was clear. Gleason 6.

kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 12/20/2009 10:27 PM (GMT -6)   
Everyone will have different reasons for the choices we make. Myself, I was 43 at diagnosis. It was very likely if I had waited till 50 to get my first test the PCa would have jumped outside the prostate. You have to make the decision that is right for you!

Good Luck, KW
    43 at Dx and Surgery (RRP)
    PSA 5.7, Biopsy 3 of 12 positive (up to 75%) all on left side of prostate, Gleason 7
    RRP on Oct. 17, 2006 - Nerves on right side saved. All Lab's clear. 
    Cathiter in for 28 days due to complications in healing. Removed Nov. 9, 2006
     Dec. 2006 – Oct. 2008 Cystoscope, Two Collagen injections,Second Opinion   
    Consultation for Incontinance at OU Medical Center, Bio-Feedback       
    training, Chiropractic, Accupuncture , AdVance Male Sling, Two More Collagen 
    injections, AUS Installed and Activated (Dr. Morey at UT Southwestern Dallas TX)
    All to try to resolve incontinence (using 6-8 Depends Guards a day)

    To Date All PSA's 0.00.

   http://www.healingwell.com/community/default.aspx?f=35&m=721171

    http://www.healingwell.com/community/default.aspx?f=35&m=978691


mspt98
Regular Member


Date Joined Dec 2008
Total Posts : 375
   Posted 12/20/2009 11:34 PM (GMT -6)   
Well there is nothing to get really past for you, just a tough decision we all have to make with this diagnosis, Everybody's different, for me my biggest push towards surgery was due to strong family history of cancers that killed my mother and father, breast and colon cancer. I wanted it out and be done with it, no repeat psas and biopsies for me. Now prostate cancer is nothing like breast and colon cancer if you have a low gleason score of 3+3= 6 with 2 cores positive like I had. But that's where my head was at. There are many alternatives, AS, radiation, hifu, cryo, besides surgery. You will have to make this tough call, no clear cut answers how to treat this cancer compared to other cancers.............
my age=52 when all this happened,
DRE=negative
PSA went from 1.9 to 2.85 in one year, urologist ordered biopsy,
First biopsy on 03/08, "suspicious for cancer but not diagnostic"
Second biopsy on 08/14/08, 2/12 cores positive on R side, 1 core=5% Ca, other core = 25% Ca, Gleason Score= 6 both cores,
Clinical Stage T1C
Bilateral nerve sparing Robotic Surgery on 09/11/08, pathological stage T2A at surgery
No signs of spread, organ contained,
4 0's in a row now, 14 months out
Incontinence gone in early December '08,
ED remains,  still taking daily viagra for penile rehab, uro said try oral meds and then trimix for sex only now, Peyronie's Disease stabilized, no progression, yay! 


Franchot
Regular Member


Date Joined Jun 2009
Total Posts : 130
   Posted 12/21/2009 3:13 AM (GMT -6)   
If you're still having second thoughts, I'd confer with a doctor who thought that Active Surveillance was a reasonable way to treat the disease and see what his take was on it. I went through several "well-respected" doctors who suggested aggressive forms of treatment, but instead elected for AS after I went through some more testing and had my cancer staged with a color doppler test.

If possible, I'd seek out a doctor who does color doppler testing. Take your time and continue researching. It sounds like your numbers are low enough that you don't need to rush into any treatment.
Age: 53 6' 0" Weight: 170 Caucasian

Rising PSA over the last six years (from when I started being tested) from 3.9 to 5.2 to 4.6 to 4.5.

DX with PC in January 2009 after biopsy. Bone scan--negative

Consulted Cedars-Sinai Beverly Hills urologist--recommended surgery
Consulted Cedars-Sinai Beverly Hills radiologist--recommended IMRT
Consulted San Diego Cyber-Blade doctor--recommended treatments
Consulted Long Beach radiologist--recommended IGRT
Consulted Loma Linda radiologist--recommended Hypo-fractionated Proton treatments

Insurance approved any treatment I wanted.

Consulted Marnia del Rey urologist Dr. Scholz.
Dr. Scholz referred me to Dr. Bahn for a Color Doppler test.
Scholz and Bahn recommended Active Surveillance, some diet changes, and steady exercise.

I am currently on Active Surveillance.


MrGimpy
Veteran Member


Date Joined Jul 2009
Total Posts : 504
   Posted 12/21/2009 5:55 AM (GMT -6)   
T-Dog,

The decision is tougher when there are no side effects, I was in the same position. But the reality is that the PC is always going to grow, even though its growing slowly, it is in there and will need to be addressed

I chose to get it removed via Robotic Surgery and just passed 8 months post op and am past all the issued except ED, and ever that in all honesty is far better and way more fun with the medication I am taking when I want to play

Active Surveillance was not for me, I felt that Biopsy's 2-3 times a year and waiting for those reports would be far more stressful to bear. Looking back to where I was last year I 100% made the right call

There are other factors aside from PC that you may also want to consider

1) Are you healthy enough to have surgery now ? What would happen in 5 years if you had a heart attack and could not have surgery ?
2) Medical insurance, that is a big ? for everyone now with this new heath care reform bill, who knows what will be covered in 5 years

There is no dispute that recovery will be easier the younger you are.
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


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 12/21/2009 8:00 AM (GMT -6)   
A thorough education that you go and get is your best friend, PCa has has been looked into by tens of thousands of patients and various docs for years...guess what??? No total concensus, no preciseness, no definitives...atleast to the 100% level...so you have to sort through this twilight zone and jungle to get your best decision you can, for your scenario. Your ##s appear very low end, again "appear" is the key words, even that can be reassessed or found different than you know of right now. It can be the twilight zone and a jungle, no answers are that easy or clear cut you will likely find out. You have alot of choices including nothing at this juncture, could even chose drug therapies for control and wait alot,did the docs even mention that was possible?????????????????????????????????????????????? Huh....how much is treatment worth??
Guessing your numbers appeared low, you might want a copy of your pathology as to atleast what they found in those few findings.
Youth is wasted on the Young-(W.C. Fields)


Ziggy9
Veteran Member


Date Joined Jul 2008
Total Posts : 981
   Posted 12/21/2009 10:26 AM (GMT -6)   
t-dog said...
Hey folks, since i`m still very new to this problem i`ve been reading alot and this issue struck me as very interesting. With the scope of what i`m about to put my body thru to repair this problem i keep having these thoughts of what if this would of never come to be a significant issue? I would be very interested to know how you got past this. My numbers point to very early detection, and i have confered with 3 very well respected doctors that all say do the robot and i`m ok with that if thats what is needed but dang its hard to pull that trigger when you`re feeling good and all seems well. Thanks for your thoughts, Tim


I can identify with this. I never had any symptoms and always felt fine. That said you must pick what to do ranging from a radical treatment to AS. There are the after effects to consider and weigh in as to quality of life issues against added possible longevity. Tragically it's really a crap shoot as to the severity and how long the effects can happen there are guys who after a couple of months are continent and others who never are again. This is a very pro surgery site so you must consider that in recommendations here. The key to surgery is are you really looking at it rationally? Many here with low numbers opt for it to" get it out of them" but are they treating anxiety more than they are treating cancer? If it's local great if it's systemic there really isn't any long time successful getting it out of them. It's a complicated sometime contradictory maze you'll be wandering choosing what to do. Take your time deciding for if you go with a common radical treatment there aren't any do overs afterward.
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
 
 
 


JoeyG
Regular Member


Date Joined Jul 2009
Total Posts : 162
   Posted 12/21/2009 10:45 AM (GMT -6)   
I really like the idea of AS in cases where the cancer is minimal and non-aggressive. To be frank, we all go through AS whether we treat the disease or don't treat the disease. So if my best friend had a small cancer with a GS 5 or 6, I would highly recommernd doing nothing except (1) changing diet and lifestyle and (2) getting tested until the pca begins doubling at a faster rate.
 
As to most of us who feel great (no symptoms) when diagnosed....that is the beauty (maybe that word is too optimistic) with psa testing. Those who find out they have pca because they have back or bone pain usually have psa's into the hundreds or thousands- way too late for primary treatments.
Age -57; Diagnosed 10/05 PSA 13.4 GS 9 Organ confined (T2B)
Cryoablation 4/06 Allegheny Hosp-Dr Ralph Miller (Cohen/Miller)
Post Cryo Nadir 8/06 0.2
Rising steadily to 0.7 4/09 :-(
Steady at 0.7 (7/09) (Pomegranate???)
Looking to take next steps soon
Hoping to qualify for salvage cryo or radiation


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4229
   Posted 12/21/2009 11:13 AM (GMT -6)   
T Dog,
Looking at your stats, expecially the PSA; it hasn't moved in a year and took 8 or 9 years to go from 1.4 to 2.6. The free psa tells you nothing; it only indicates the probability of PC and not what it is doing. Only tracking PSA over time will give you a good idea of how the pc is manifesting itself. Right now all indications are that it is slow growing or not growing. You have pleanty of time to make a decision. I agree with Franchot, get a color doppler and see a doctor that is experience in AS, before you subject yourself to a radical treatment you may never need.
Most of us would trade numbers with you any day. Pick up a copy of Strums book "A Primer on Prostate Cancer" and educated yourself. Remember, most doctors have been taught that if Cancer is Dxed you must get it out. This is proving not to be true and in most cases the cure is worse than the disease.
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


Zen9
Regular Member


Date Joined Oct 2009
Total Posts : 310
   Posted 12/21/2009 11:21 AM (GMT -6)   
t-dog:
 
We have discussed this ad nauseam in threads before you came aboard.  There are some strong opinions about the topic of overtreatment.  You might want to scroll back and look through some of them.
 
My advice in a nutshell:
 
1. Take your time.  Do not let anyone rush you.
 
2.  Question everything someone in a white coat tells you about prostate cancer.  Question it, don't necessarily reject it.  Most advice will match up quite nicely with the doctor's financial interests; advice that doesn't is rare and especially valuable.  But above all, make your own decisions - at this point doctors are only advisors.
 
3. To put yourself in a position to make those decisions, go straight to the medical literature, armed with a good online medical dictionary.  I found these two articles very helpful when I went through this process in mid-2008: (1) Timothy Wilt et al., "Systematic Review: Comparative Effectiveness and Harms of Treatments for Clinically Localized Prostate Cancer," 148 Annals of Internal Medicine Issue 6 (March 18, 2008); and (2) Martin G. Sanda et al., "Quality of Life and Satisfaction with Outcome among Prostate Cancer Survivors," 358 New England Journal of Medicine 1250 (March 20, 2008). I believe that at least the former is available online. There are other good articles that came out after my surgery last August.  Do your own research.
 
4. In addition, there was a recent thread (last week?) about Dr. Peter Scardino's recent presentation to the New York Chapter of the American Urology Association.  Find that link and study that presentation.  But again, this is only one doctor's opinion (although one I personally think highly of).
 
5. Finally, read and understand Dr. Otis Brawley's piece entitled "Prostate Cancer Screening: Is This a Teachable Moment?" published in the Journal of the National Cancer Institute and online on August 31, 2009.  Dr. Brawley is controversial, to say the least, but whatever you end up thinking about him, he is an important voice that you should at least understand.  He has been widely vilified, misquoted and quoted out of context - so read him in the original, slowly, and in full to get his nuanced approach, then make up your own mind.
 
Good luck.
 
Zen9   
No family history of PC.  PSA reading in 2000 was around 3.0 .  Annual PSA readings gradually rose; no one said anything to me until my PSA reached 4.0 in September 2007, at which point my internist advised me to see a urologist.   
Urologist advised a repeat PSA reading in six months = 4.0 .  Diagnosed May 2008 at age 56 as a result of 12 core biopsy.  Biopsy report by Bostwick Laboratories = Gleason 3 + 3. 
Interviewed two urologists - the one who did the biopsy and another - the latter had the biopsy slides re-examined = Gleason 3 + 3. 
Then went to M. D. Anderson Cancer Center in Houston in July 2008 and met with a urologist and a radiologist.  Biopsy slides re-examined yet again, this time by MDA's internal pathology department = Gleason 3 + 4.   
Chose da Vinci surgery over proton beam therapy; surgery performed at M. D. Anderson Cancer Center on August 15, 2008.  Post-operative pathology report = four tumors, carcinoma contained in prostate, clean (negative) margins, lymph nodes clear, seminal vesicles clear.  Gleason = 4 + 3. 
Minor temporary incontinence; current extent of ED uncertain due to lack of sexual partner; refused treatments for ED as being pointless under the circumstances. 
PSA readings: 
November 2008 = <0.1 ["undetectable"]
June 2009 = <0.1   
December 2009 = <0.1
 


t-dog
Regular Member


Date Joined Dec 2009
Total Posts : 154
   Posted 12/21/2009 2:16 PM (GMT -6)   
Thanks alot for the input guys. If i just took the rosy outcome the doctors say this deal will produce at face value this would be a no brainer. But obviously after doing a lot of reading here this deal is hardly a cakewalk. Also a big consideration for me is from Mar. thru Oct. i strap my self into a racecar 2 times a week or so and i have to be sure this will still be possible after the surgery. Doc says should not be a problem, but...... My wife who is in the medical field is a get it out of there kind of person and is behind me 100% whatever we do. If you`ve ever known anyone involved in professional motorsports you know that mortality issues seldomly are thought of, we all have the i`m ten feet tall and bulletproof mindset and i`m finding my inner voice telling me to wait it out. And my doctors saying do it. Dang lifes hard!

MrGimpy
Veteran Member


Date Joined Jul 2009
Total Posts : 504
   Posted 12/21/2009 3:03 PM (GMT -6)   
T-dog,

Once they take out the catheter, which is likely 10 days, you should be able to slowly get yourself back to where in maybe a month you can do anything really. At worst you will need a pad for a few months to deal with any leakage

How would you feel if you passed on the operation due to racing this year and come October 2nd you discover the PC has spread and you are now having symptoms, if you could deal with that happening then waiting may be ok for you. Would each year be the same deal with racing ? if so then you may want get get it removes asap while you are younger and can recover quicker
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


Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 12/21/2009 3:05 PM (GMT -6)   
Most of us have no physical symptoms of PCa -- if we do, then it's too late. I was Gleason 9 at biopsy, no symptoms but fortunately organ confined, so surgery was the standout best option for me.

However at your age (50) and low numbers, I would have chosen AS. Of course if you go to doctors who do surgery, that's what they will recommend. If you are the worrying type, you may want to "have it out" and be done with it. You will have ongoing PSA tests anyway regardless of what treatment you chose. The difference with AS is of course ongoing biopsies.

With surgery, you can expect to have ED, at least for a time. How significant is that for you? Incontinence is more of a problem with robotic surgery than open -- at least that's what the stats show. I imagine you don't want to be incontinent while bouncing around in a race car!

I agree with the other posters here -- AS deserves your serious consideration.
Pre-op:
Age 63 at diagnosis, now 64.
No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4 of 12 cores.
Operation:
Non-nerve sparing RRP on 7 March 2008.
Two nights in hospital; catheter out after 7 days.
Post-op:
Continent; no pads needed from the get-go.
Pathology showed organ confined and negative margins. Gleason downgraded to 4+4=8.
PSAs:
6-week : <0.05
7-month: <0.05
13-month: 0.07 (start of a trend?)
19-month: 0.09 (maybe)
ED:
After a learning curve, Bimix injections (0.2ml) worked well. From 14 months, occasional nocturnal erections. Have "graduated" to just the pump.


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 12/21/2009 3:55 PM (GMT -6)   
The parallel question for me is how does a G7, 8 or 9 get there ?

Does it start as an HPIN, grow to a 6, then progress up the ladder to a 9 ?

You will find mutiple opinions on that question. If the original cancer starts out as a G9, then time is important to get that aggressive cancer out after it is diagnosed.

If there is a growth progression, which I have never found a good answer to, then time is also important that it doesn't grow to an aggressive cancer and begin spreading.

Obviously, for me starting out as a 9, I was left with few options. But if I had a 6, and could not find an answer that satisfied this question sufficiently for me, then I would probably decside to move sooner than later.

While AS may stall off the potential side effects for a few months or years, to me it would like having a time bomb around my neck, (or in my crotch), always waiting for the buzzer to go off.

Goodlife
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injections

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