What should I expect

Woodworker,

First, welcome to HW Prostate Cancer. This was a great place to come to, now that you have a PCa diagnosis.

My first thought, is that you were only diagnosed 5 days ago. And you have already made up your mind about your primary treatment? That sure isn't give you much time to think about options and choices. With a Gleason 7, I agree that it needs to be treated, but have you thought through all of your choices? Not questioning your decision, as much as the shortness of time. Robotic Surgery is a common and well used treatment here, but like any surgery, it can come with a big price as far as side effects and quality of life issues.

Some here would reccomend getting a second opinion on your diagnosis.

I had open surgery with an agressive and fast acting Gleason 7 myself. If you go for surgery, we can help you with any phase of your surgery, pre-surgery and post surgery, dealing with incontinence issues, and ED issues.

My "specialty" from experience only is in the areas of catheter use and care, and a good understanding of pain managament. Be happy to help answer any questions you have.

We will support any decision a man makes here for treatment, but just wanted to make sure that your weren't rushing into surgery before you had a chance to slow down and think about what that really means. Whether it be robotic or open, PC surgery is a very complex and invasive, life changing surgery. So its important that one newly diagnosed knows what he is getting into, and what the risks and rewards can be.

No such thing as a dumb question here. The brothers and our dear sisters here, will more than eager to help you and support you along the way.

Please keep us well posted.

David in SC

David

I appreciate your response. When I spoke to the surgeon he did point out to me that a surgeon would have a tendency to push surgery and an oncologist would lean towards radiation. The surgeon did offer to make me an appointment with an oncologist for a second opinion. I passed on the offer.

Instead I made an appointment with my Primary Care Physician. It is his attention to detail that got me in for the biopsy. My wife (a retired nurse) and I went through a lot of doctors  before we found one that we felt was competent and actually talked to you.  As a result we trust his judgment. 

When I asked his opinion he immediately told me surgery and why.  When he found out who my surgeon was he was not happy with that and immediately made arrangements for somebody that he thought was better qualified. After reading the background of both surgeons I agree. 

I left that appointment with the feeling that my PCP was making a deliberate effort to make sure my best interests were served.

Before making my decision, I did look at radiation as well.

I considered the side affects of both radiation and surgery. I also read the stories of quite a few prostate cancer survivors as well.  I was leaning towards surgery before I met with my Primary Care Physician. He was the straw that finalized the decision.

It is my understanding that with surgery the prostate is sent to the lab and tested to see how bad the cancer was (level) how wide spread it was and if it made it to the outer part of the prostate( which would lead one to believe that cancer may have spread beyond the prostate).  I did not see anything that indicated to me that this information would be available by any method other than surgery.

It is because of this information collection  and my PCPs input that I chose surgery.  I realize there are not any absolutes. But I felt like this was the closest thing to it.

Kevin

You've been busy in the last 5 days.

best wishes...

Woodworker,
Welcome. I would echo David's question, although I had done a lot of the research before I got the full biopsy report (the DRE was basically bad enough that they shuffled schedules to get the biopsy in as soon as possible), so I had a short (several week) decision path. I had several full professional additional opinions, and because I have some family connections to the medical world, I had a lot of short conversations with some leading professionals, and patients (through local contacts).
My pathology was fairly brutal (age 56 myself at first diagnosis, 12 core biopsy, 9 positive, Gleason 4+3 in 2, Gleason 4+4 in 7).
I did not want Radiation combined with the expected long-term HT, due to the lifestyle changes, and the relatively low success rate the doctors quoted.
I was very excited about seeds, since that was a technology I followed closely many years ago, thinking it would be one of the most exciting uses of radiation (I once did programming for radiology labs, and felt like it was some of the most valuable work from the point of impact on others I ever did). Pity that every doctor to the last one interviewed said I was too far along for seeds.
HIFU is not considered by my insurance.
Proton theraphy would have been a viable option, but a combination of medical and job considerations ruled me out of the nearest program.
I finally did DaVinci, more because I trust the surgeon, and he doesn't do open anymore. I don't regret or question my decision, but I do wish I had found it earlier.

So we all look at time to decision thinking about our own paths, and compare our numbers to yours.

I have posted a lot both here and over on CSN's prostate page (same id) about preparation, and some things about "afterwards" - I am not the poster child for painless and dry recovery, so don't be too discouraged by my stories - 98% do better if you accept the publicity. On this site, we have a member who has consolidated a lot of our thoughts in a post that shows up at the top of the forum - start with that.

Again, welcome.

(added)
Tells you everyone is active here - I started my post after David's, and 5 more were added before I hit "submit".

Post Edited (142) : 4/2/2010 10:25:52 AM (GMT-6)

Adding to the books - Michael Korda, "Man to Man"
Written in 1996, but if I'd written one last week, wouldn't be much different. It is a quick read. I read it after the fact, and was amazed how close the stories could be - but I didn't have the ER run afterwards, luckily.

Kevin, I will not try to change your mind about surgery and if that is your choice, good luck.  However, I must say that I really agree with David's (Purgatory) advice.  Making a decision within 5 days after talking with only a PCP and a surgeon is not good due diligence.  If you don't take the time to talk with a radiation oncologist and a prostate oncologist you are not doing your homework, IMHO.  This is a potential LIFE CHANGING decision that you are making.  Do yourself a favor and do your research before you leap...

Tudpock

Hi woodworker,I hope you know there is a difference between(4+3)and (3+4)the later is worse than the first.yes it is soon to make that choise,but for me the sooner I get pc out of my system the beter it will be. the surgery is a life changing but I guess any other procedure is.In my humble opinion you made the right move.good luck and we are here to stay with you every step of the way.God bless you.

Gold Horse

I appreciate you cluing me in about the Gleason score. I just looked at the pathology report and it says:

LEFT APEX PROSTATE: ADENOCARCINOMA GLEASON SCORE 7 (3+4)
-CARCINOMA INOLVES 25% OF THE SPECIMEN
-2 OF 2 CORES POSITIVE

All other portions of the prostate indicated benign

Kevin

Woodworker

 

Sounds to me like you have done enough due dilligence and are comfortable with your decision.

 

You are lucky to have such a good PCP.

 

Best wishes as your PCa journey progresses.

 

Skeener

Goldhorse

you might want to revise what you said. 4+3=7 is a worse diagnosis than a 3+4=7 as it quantitifies what grade cells are predomoninate.

Woodworker,

Like the others I would not make a treatment decision without first speaking to a rafiation oncologist. You cannot have to much first hand information.

Bill

Billy Mac it is my understading that (3+4) is worse than (4+3),but I may be wrong let some of the brothers provide more info.

thanks I look the gleason againg (4+3) is worse.