Helping a Friend Decide PC Treatment

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neutron37
New Member


Date Joined Jul 2008
Total Posts : 2
   Posted 5/12/2010 1:52 PM (GMT -6)   
All,
I had prostate cancer surgery (Di Vinci) 18 months ago with very good results.  A close friend was recently diagnoised with PC and is having a tough time deciding on treatment. 
 
He was set on surgery then met with a Radiation Oncologist and is now undecided.  He's concerns are with post surgery side affects; impotence & incontinence.
 
I explained my decision process which helps but I can't speak to radiation or seeds from personal experience.
 
Please share your  thoughts, insight, experience in this area.
 
I'm 58 (surgery at 56), he's 61.
 
thanks
rick
 

60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2222
   Posted 5/12/2010 1:57 PM (GMT -6)   
Rick,
Do you have any idea about his biopsy results and any other stats?
Michael
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed, 61 yo 2010
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
2 pads per day, 1 depends but getting better,
 started ED tx 7/17, slow go
Post op dx of neuropathy
T2C left lateral and left posterior margins involved
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5 on 11/28/10
Starting IMRT on 1/18/10, Completed 39 tx at 70 gys on 3/12/10
6 week Post IMRT PSA .44 a drop from .5 but maybe more
Great family and friends
Michael


Galileo
Veteran Member


Date Joined Nov 2008
Total Posts : 697
   Posted 5/12/2010 2:04 PM (GMT -6)   
The ACS has a decision tool that guides the patient through the various options. The patient inputs their Gleason, PSA, age, and a lot of other individual data points and the tool guides them on a process (without making a decision for them) and gives them talking points to print out and take with them to their doctor's office. It links to relevant recent abstracts of studies. http://www.cancer.org/docroot/eto/meta/meta_profilers.asp?CB=265

I'm not saying its the end-all and be-all of the process, but it could help. Also, Walsh's book is a good foundation and for something very quick, Paul Lange's Prostate Cancer for Dummies can sketch out the more popular choices.

just my 2 cents.
Galileo

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NX MX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
PSA 6/07 0.1, 9/07 and thereafter <0.1
http://pcabefore50.blogspot.com


neutron37
New Member


Date Joined Jul 2008
Total Posts : 2
   Posted 5/12/2010 2:05 PM (GMT -6)   
His Gleason score 3+4. I don't have his PSA number but it's been a gradual increase.

Sorry that's all I have. Can get more if that would help.

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 5/12/2010 2:29 PM (GMT -6)   
It will make a lot of difference to consider the number of positive biopsy cores. 3+4 was presented to me as borderline to require surgery. But, if it was one core of 24, it could be much less significant than 9 of 12 -
That was what pushed me to surgery instead of radiation.
As we say often here - the surgeon sells surgery, the rad. oncologist sells radiation. I had the same experience - convinced for DaVinci, then considered radiation. But the success numbers of radiation for my profile were only 70%, so I went DaVinci.

I suspect you need more information at this point.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 5/12/2010 2:34 PM (GMT -6)   
Definitely need some more info and data on your friend, though as a Gleason 7 at biopsy, he will need to address his PC at some point, while it's hopefully still contained.
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, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one:  July
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 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 4/23 put in

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