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bcc
Regular Member


Date Joined Oct 2009
Total Posts : 46
   Posted 12/25/2009 1:18 AM (GMT -6)   
what do i do .Originally looked at radical then heard about hifu but we first thought we could zap bits to help preserve erections but template biopsy revealed more extensive cancer on both sides .now considering brachy. my main thought is to retain erections as i am lucky and have a younge wife.Are there any web sites that show outcomes of different treatments?.Happy christmas to one and all barry
PSA Aug 07 was 3, Mid 08, 3.5, mid 09, 7.27

First biopsy july 09 - t2a on left . 11 samples taken from 6 blocks. 4 blocks show positive for adenocarcinoma. 1 block 10%, 3 blocks 5%, overall gleason 3 plus 4. No perineural invasion seen. Seminal vesicles clear.

End Oct 2009, bone scan all clear, MRI shows 6mm lesion on bottom left and rest of gland diffused image. Late Nov 2009, a template biopsy of 32 from 20 sites adenocarcinoma, gleason 3 plus 4 at 10 sites; unfortunately spread over both left and right.


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 12/25/2009 8:19 AM (GMT -6)   
BCC, here's a link to an article published in 2007 about ED and seeds...according to the article, ED can occur with seeds but it may take a few years. Looks like a bit more research is in order before you make your treatment decision.

I wish you well, and hope you'll stick around and keep us posted.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (single small EPE in posterior left). Perineural tumor infiltration present. Apex margin, bladder neck and SV negative. Final Gleason 3+4. PSA: 0.0 til July 2009. August 2009- 0.1, September 0.3, October back to 0.0, December 0.0. Thank you God!


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 12/25/2009 9:38 AM (GMT -6)   
Barry, you have Gleason 7 Prostate Cancer, you first concern should be to eliminate or contain the cancer, keeping your errections, while understandable important, should not be the deciding factor in your treatment choice. Just my opinion.

Keep researching, but look for what is best for the cancer.

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


Sonny3
Veteran Member


Date Joined Aug 2009
Total Posts : 2447
   Posted 12/25/2009 9:52 AM (GMT -6)   
Barry,

Try this link for an overall look at the various treatments and side effect outcomes. It has a pretty good study basis and large group. Quite a bit of information.

http://www.cancer.gov/cancertopics/factsheet/pcos

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
Post Surgery Pathology:
Gleason: Changed to (4+3) = 7
Stage: T3a
Tumor Volume 12.5%
NERVES SPARED-positive margin, extra-prostatic extension
30 day PSA 0.4, 50 day psa 0.53, 64 day psa 0.6
IMRT scheduled to begin Nov 30,2009 (74 days post surgery)


bcc
Regular Member


Date Joined Oct 2009
Total Posts : 46
   Posted 12/25/2009 10:14 AM (GMT -6)   
hi many thanks for all of your comments .good to be part of this forum as i have no help from my family as many of you do .mine is a lonely journy barry
PSA Aug 07 was 3, Mid 08, 3.5, mid 09, 7.27

First biopsy july 09 - t2a on left . 11 samples taken from 6 blocks. 4 blocks show positive for adenocarcinoma. 1 block 10%, 3 blocks 5%, overall gleason 3 plus 4. No perineural invasion seen. Seminal vesicles clear.

End Oct 2009, bone scan all clear, MRI shows 6mm lesion on bottom left and rest of gland diffused image. Late Nov 2009, a template biopsy of 32 from 20 sites adenocarcinoma, gleason 3 plus 4 at 10 sites; unfortunately spread over both left and right.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 12/25/2009 10:41 AM (GMT -6)   
well, barry,

we will be happy to substitue for the family support you dont have. Please keep us posted and ask as many questions as you wish.

more than glad to assist you through your journey.

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


Paul1959
Veteran Member


Date Joined Nov 2007
Total Posts : 598
   Posted 12/25/2009 11:05 AM (GMT -6)   
Barry,
I understand your concern about erections, but rest assured, you have to be in the mortuary before it is impossible to get an erection these days. You will need to be aggressive in ED treatment if you want to make sure you stay active. Even implants, while they are the last in the line, are hugely successful and men love them. Make sure you are around to have sex!
Paul
www.franktalk.org ED website for PCa guys

46 at Diagnosis.
Father died of Pca 4/07 at 86.
10/07 PSA 5.06 (Biopsy 11/07 1 of 12 with 8% involvment) (1mm)
Da Vinci surgery Jan 5, '08 at Mt. Sinai Hosp. NYC www.roboticoncology.com
Saved both nerve bundles.
Path Report: Stage T2cNxMx
-Gleason (3+3)6
Pad free on March 14 - (10 weeks.) Never a problem since.
ED - at one year, ED is fine with viagra.
Two year PSA - undetectable!


MrGimpy
Veteran Member


Date Joined Jul 2009
Total Posts : 504
   Posted 12/25/2009 12:28 PM (GMT -6)   
Hi BCC,

Deal with getting rid of the cancer, There are more treatments for ED that you will have your young wife begging for a break. It should be low on your worry list.
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


bcc
Regular Member


Date Joined Oct 2009
Total Posts : 46
   Posted 12/25/2009 1:28 PM (GMT -6)   
thank you all for your help and advice ithink i am going to just hit the radical route and look for the best in the world .any names please .kirby is the man i believe in the uk and a friend had a great outcome after treatment by mostyn in the u/s .any thoughts please barry ps just met some great guys on the slopes in chamonix france from the american army stationed in germany previously in irac good guys cheers barry
PSA Aug 07 was 3, Mid 08, 3.5, mid 09, 7.27

First biopsy july 09 - t2a on left . 11 samples taken from 6 blocks. 4 blocks show positive for adenocarcinoma. 1 block 10%, 3 blocks 5%, overall gleason 3 plus 4. No perineural invasion seen. Seminal vesicles clear.

End Oct 2009, bone scan all clear, MRI shows 6mm lesion on bottom left and rest of gland diffused image. Late Nov 2009, a template biopsy of 32 from 20 sites adenocarcinoma, gleason 3 plus 4 at 10 sites; unfortunately spread over both left and right.


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 12/26/2009 5:50 AM (GMT -6)   
Barry, just wanted to wish you luck in finding a surgeon in the UK. Stay with us as there is no better website for prostate cancer, and you will not only receive great advice but make wonderful friends here as well.

Where in the UK are you. My half sister lives in Manchester and a good friend (and my former boss) lives up in the Lake District but commutes periodically to London. I know the UK has nationalized healthcare so working with a doctor is different than in the U.S.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (single small EPE in posterior left). Perineural tumor infiltration present. Apex margin, bladder neck and SV negative. Final Gleason 3+4. PSA: 0.0 til July 2009. August 2009- 0.1, September 0.3, October back to 0.0, December 0.0. Thank you God!


skeener
Regular Member


Date Joined Dec 2009
Total Posts : 214
   Posted 12/26/2009 6:01 AM (GMT -6)   
Barry - Glad to see that you have made the decision to take the radical route. Getting rid of the cancer is the first priority. Please keep us posted on your progress.

Skeener
Age:  63
 
Biopsy May 09 showed 2 of 12 cores positive for prostate cancer -- 1 at 5% and 1 at 25%.  Cancer indicated as non aggressive.  Gleason score 3+3.
 
Considering all the controversy about whether action is needed or not (I could die with prostate cancer not from it), gave consideration to active surveillance.
 
Had open RRP on Oct 23/09 in London, Ontario.  Excellent surgeon.
 
7 Weeks Post Op -  The fears I had about bad things about the operation and recovery did not materialise except of course ED!!.  Otherwise, everything went very smoothly.  Incontinence not a problem.  Wear a pad when out just in case. Pain was never a problem.  Forum tells me can't do anything about ED right now.  Give it a rest!!
 
Nothing of concern in the pathology report. 
 
First followup PSA and visit in Feb 09.      


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 12/26/2009 7:01 AM (GMT -6)   
Barry,
Here is a link to another study. It compares Robotic vs. open for about 8000 cases. It shows that robotic surgery has shorter hospital stays and recovery time but higher incidence of ED and incontinence.
http://www.psa-rising.com/mednews/surgery/95-mirp-1109
(From an earlier post I made on this subject: "The study tracked surgeries performed from 2001 -2006 with 2 year follow up. open beat Robotic for incontinence and ED performance. Similar to what I have found here with my ~90 responses.
The results from our unscientific study here show that at 3 months you are 2.5x more likely to be wearing a pad if you had Robotic surgery. At one year, only Robotic patients were still wearing pads.
The good news is that at 3 months 67% are continent and at one year 91% are continent.
For my fellow three month leakers, 2/3 of us will be dry at one year. Don't give up."

Go to the real paper not just the summary to get the details.
As everyone has said, the priority should be cancer first then continence then ED. But if there is a treatment with the same success rate for cancer, why not select the one that gives the best rates for numbers 2 and 3 as well?
You will get plenty of support here. (Although we won't do your laundry or help change your overnight pee bags. Sorry, Pal. )
Good luck,
Jeff
DX Age 56. First routine PSA test on April 8th: 17.8. Start 2 weeks of Cipro to rule out protatitis.
May PSA: 22.6, 3 weeks later: PSA: 23.2.
Biopsy 6/10/09: 7/12 scores positive, Gleason 6=3+3. Bone scan and C/T scan negative.
RP DaVinci -7/21/2009 @ Univ of Roch Medical Center
Left nerve gone, right partial spared.
Catheter removed - 7/31/2009 Pathology report received:
Gleason 3+4=7, Tumor size: 2.5 x 1.8 cm, location: both lobes and apex.
Extraprostatic extension present; Perineural invasion: present, extensive.
No Malignancy in Seminal Vesicle, vasa deferentia, lymph nodes 0/13
Prostate mass 56 grams. Pathologic Stage: pT3aN0MX
Post Surgery Status:
Potency - 12/11 5 months, Still no activity, zip. Using pump daily since 11/11. No effect with 20 mg of Cialis or 100 mg of Viagra. Shots next?
Incontinence - 8/20 4 full pads per day
.. 9/7 3-4 full pads per day (I'm going to try cutting down on fluids. Bad idea. I know.)
. 9/27 2 months: Still 3 pads per day.
11/14 4 months: Still 3 pads per day. 420ml/day, 91 um leak.
12/11 5 months: Still 3 pads per day. 400-450ml/day Experimenting with Nyquil for 10 days: Can sleep through the night but withdrawal is bad. Stopped 12/20.
Post Surgery PSA - 9/3 6 weeks - 0.05; 10/13 3 months - 0.04 undetectable.

Post Edited (Worried Guy) : 12/26/2009 6:09:58 AM (GMT-7)


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 12/26/2009 7:04 AM (GMT -6)   
Only you have to weigh all the alternatives and make a decision as to what do I do????
Here is another possible choice, not saying it is the correct choice but there are  no guarantees with any choice, especially with some stats that are less than indolent looking. There are some people whom have gone this route, it also buys time for some period and that fluctuates by patient. Here is Rick K's protocol he chose:
 

Rick K. (Michigan) dx-(1995) psa 11.0 (2- pos. biopsies gleason 2+3's in each back then)
Uncommon treatment of ADT3 hormonal drug therapy for 13 months, quit, stayed on proscar only. Manhood and all functions back to normal within few months....fast forward (2009) his psa finally moved upwards so now he is doing another round of ADT3 for 13 months and will see outcome. Also, he can still do "all" treatments as to invasive or serious PCa protocols. So Rick had around 12 yrs. of being totally normal(after this second round possibly another round in maybe similar fashion) and yes his future is unknown, his choice and he is pleased with it. Just worth an observation in the world of PCa and various treatments.


Youth is wasted on the Young-(W.C. Fields)

Post Edited (zufus) : 12/26/2009 12:07:18 PM (GMT-7)


Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4106
   Posted 12/26/2009 9:38 AM (GMT -6)   
bcc, Good luck and do keep us posted as you go through this jounrey. The guys on her are great and always willing to help with info. We don't always agree but just offer different options. I made the decision on radical almost 15 months ago. So far I think it was the right decision for me. Was 57 at the time of surgery. I this point in my life I am a very happy man. Great famly and friends.

Take care and please keep us posted.

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
1year psa <0.01
ED- 5 mg Cialis daily, pump daily, going to try MUSE next. Next step injections.


brainsurgeon
Regular Member


Date Joined Jul 2009
Total Posts : 137
   Posted 12/27/2009 6:33 AM (GMT -6)   
Barry,
Should you decide to have a meeting with the robot, I can give you some names in Switzerland. I was pleasantly surprised at the cost compared to what I hear about the USA. Of course, if you are a British citizen, that may not be a factor.
70 years old (1939) USA citizen
Prostatic carcinoma dxed June 2009 by PSA (7.0) and then Bx
PSAs yearly since 2001 ranged 1.52 to 7.0
Neg. CT and Bone Scan
4 of 8 biopsies positive (all right side) Gleason Score 3+4=7
Robotic assisted total prostatectomy and node excision July 2009 in Luzern, Switzerland by Dr. A. Mattei in the Kantonsspital
pT2c G3 pN0 (0/14)
Catheter out in 5 days (home in 3 days)
No incontinence
Positional neurpraxia resolved in 5 months.
Potency: beginning tumescence??? at 3 weeks post-op. Still happens at 3 months PO. Nearly usable one month later. At 5 mo. with 100 mg Vitamin V, pretty good.
3month PSA less than 0.01

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