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hey  room got some more questions  to throw at u al while i got signal on my laptop

I hope they don't find it has spread, but, all I can tell you is that when they found PCa in my brother-in-law, they found it had spread outside the prostate and told him that surgery would not make much sense as it would be difficult if not impossible to cut out all the tumour. So he had radiation therapy and he is doing fine about 7 years on from that.

Alfred

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Age at Dx 48 No Family history of Prostate Cancer
Married 25 years, and I cannot thank my wife enough for her support.
April 2009: PSA 8.6 DRE: negative. Tumour in 2 out of 12 cores. Gleason 3+3.
RALP (nerve-sparing) at AVL-NKI Hospital Amsterdam on 29th July 2009. Stay 1 night.
Partial erections on while catheter still in. Catheter out on 6th Aug 2009.
Dry at night after catheter came out
Post-op Gleason 3+4. Tumour mainly in left near neck of bladder.
Left Seminal Vesicle invaded, (=T3b!)
no perineraul invasion, no vascular invasion. clear margins,
Erection 100% on 15th Aug 2009, but lots of leaking
Stopped wearing pads on 21st Sept 2009
Pre-op style intercourse on 24th Oct 2009 !! No use of tablets, jabs, VED etc.
Nov 17th 2009 PSA = 0.1
Mar 17th 2010 PSA = 0.4!!! referred to radiation therapist

BD, I think it depends on how invasive the cancer is. If there is a single focus of extraprostetic extension, surgery can still take care of that. The trick, of course, is knowing this before surgery. Some surgeons are better at figuring this out than others.

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Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (solitary focus of extraprostatic extension). Perineural tumor infiltration present. Apex margin, bladder neck and SVs 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, March 2010 0.0. Next PSA in 6 months. Thank you God!

Great question and what are the facts about PCa, not the wishful thinking. Even with using nomograms, Partin Tables, Bluestein and other assessment tools (which many uro-docs/surgeons don't even bother with using those basics, let alone the other blood markers and urine tests)..there is no guarantee even for low stats or maybe indolent PCa cases, nobody can know or properly assess with absolute certainty where the heck is the PCa. Soooooooo, everybodies treatment herein is based upon the so called good hunch, best guess, s.w.a.g. (scientific wild a__ guess) and such considerations or even worse. This is the wonderful world of PCa only a few docs will mention this is how it is, but some do. This is one reason why Dr. Leibowitz and some other oncologists may appear to more sane than you first thought about using their protocols even as primary treatment.

So based upon knowing such, how motivated are you (anyone) as a patient to know what is what, am I being treated the way I wish to be treated, are my factors like quality of life placed into the "real" perspective and I am or was I informed of every possible choice or future prognosis's based upon my findings, (rarely are you informed like this..plenty is hidden). Question everything is not exactly being dumb.

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

A couple of high numbers there (PSA and Gleason) Would seem a CT and bone scan would be in order before making any decisions for sure. If I missed any prior posts....How were the biopsy's? If the cancer is near the bladder connection / urethra, zapping it would be difficult without damaging the bladder / urethra. One statement my urologist made that was encouraging was that prostate cancer cells do not slough off as the organ is being removed as some cancers do.

74 years old. Gleason 3+4=7...PSA 6.7 Vatikutti robotic prostatectomy 2/10/10, margins clear, five week PSA undetectable, nights and mornings no pads but wear one for heavy activity, lifting, etc. It's great to be rid of the big "C".