A Decision Has Been Made on another Operation

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Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 8/16/2010 2:34 PM (GMT -6)   
You can read about my latest cath change in the other post.  The main reason we went to uro today was to discuss what to do long term.  And I wanted my wife there so she could hear first hand.  I had a list of 25 questions about the urinary diversion surgery, and we went over each and every one, slowly.  This visit lasted just shy of an hour, and my dr. was in no hour, despite having a full lobby.
 
He told us  that my bladder was in very bad shape from the radiation, and that he fully believed that it would never get better or heal on its own, not as long as urine kept entering it.  He also said that despite 6 operations to keep the bladder neck open from strictures, that it was never going to cease being a problem.  There' more evidence then ever, that my SRT should have never been done the way that it was, and that most of the damage will be lingering and perm.
 
Looking at doing a Ileal Conduit Urinary Diversion Surgery sometime in mid-to-late September.  It is a major but common urological surgery, often done for people with bladder cancer.  He has done lots of them in his career, and its considered the "gold standard" of those types of surgery.  He expects 2 to 2 1/2 hours of surgery, and 4-7 days in the hospital, and about 6 weeks of at home recouperation time.
 
My hospitial, St. Francis, has an excellent stoma/ostomy nursing staff to teach us how to live this new way of urinating.  And its the same hospital that has the best patient care in the state of SC year after year.  This will be my 8th surgery since 11/2008.
 
He said in theory, it could be re-versiable, but why?  He doesn't want to remove my bladder, because it would add a lot more complications and surgery and healing time.  He said its possible one day, they may have too if there is ever any evidence of bladder cancer.
 
The prep for this surgery is very involved, and I will be spending time with a stoma nurse experimenting with the future placement of a  stoma.
 
They usually use a piece of the lower bowel in this op, but he said if it looks too radiation damaged when he's in me, they will have to use some material from the colon higher up, which will add to the surgery time.  He said there is no way to know until he's in there.
 
This is good and scary at the same time.  I need quality of life here, and I think I have done all I can in tryin to tough it out all this months hoping for a natural healing situation.  But that's not meant to be.
 
While this started out as a chronic stricture problem from the initial surgery, it has become a mega disaster from the SRT.  I am still mad at me for going against my own gut feeling.  For me, the worse case scernio from RT happened.
 
As far as my rising PSA, he's deeply concerned, but said what I have said, let's wait till the next reading in November, if it goes up at all again, then probably would mean the SRT failed.  Worry about one thing at the time was the attitude.
 
He said he definitely would not do HT at this time, that its important not to mask the natural direction of the PSA at this point.  He said it may come down to HT ultimately, if I plan on living longer, but we need to watch the psa right now.
 
My PC journey is about to take a new twist, and enter a new phase.  I don't look forward to another major surgery, but then, I can't keep going in this world of pain and hurt all the time.
 
David in SC
 
 
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 ?
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4184
   Posted 8/16/2010 2:47 PM (GMT -6)   

Dear David:

I am happy that you have found a reasonable path forward and I pray that this will be successful and relieve your misery.  What a hel* of a time you have had!!!

That said, and in your spare time, have you considered legal action re your radiation treatment?  I remember well how you questioned the process (no filling of the bladder) and the severe burning that you experienced during the process that you felt was not normal.  I also recall your commentary that you were reassured by the radiation folks that all was well - when it obviously was not.  Anyway, food for thought...

Good luck and I'm sure all of us will continue to wish the best for you.

Tudpock (Jim)


Age 62, Gleason 3 + 4 = 7, T1C, PSA 4.2, 2 of 16 cores cancerous, 27cc
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 4/10/10.  6 month PSA 1.4 and now 1 year PSA at 1.0.  My docs are "delighted"!

Arnie
Regular Member


Date Joined Aug 2009
Total Posts : 372
   Posted 8/16/2010 2:59 PM (GMT -6)   

David....at least you've made the decision.We'll all hope for the best. Not sure I can picture the procedure/outcome of this particular surgery, but I'll google it so I know what's in store. You have multiple QOL issues going on, so this will take one/some of them off the table. Bravo for bringing the hammer down on the decision; I know it ain't been easy.

Arnie in DE

 


Age 56 (biopsy & surgery)
PSA at Diagnosis-3.9
Biposy 8/19/08--4 of 12 cores positive; 5% involvement, Gleason 6 (3+3)
 
Surgery 1/26/09-DaVinci Robotic Prostatectomy at Presbyterian Medical Center/HUP-Phila, PA
Dr. David Lee
 
Pathology Report- Adenocarcinoma, no capsular involvement, seminal vesicles clear, lymph nodes clear, negative margins, Gleason 7 (3+4), Stage T2C, NO MX, Prostate 61.8 grams, gland involvement 2-10%
 
Catheter removed after 8 days, totally dry at 3 months. ED issues continue, Viagra (via ADC) nightly (100mgs), VED use in earnest at 6 months. "Ball Park Frank" plumping at this point......ED at 10 months continues to improve, albeit slowly. Continued daily use of 100mg Viagra (ADC). Discontinued pump use; manual stimulation to varying states of erections; achieved penetratable erection on a couple of occasions----At 13 months, nocturnal erections are frequent. Still taking 100mg of ADC Viagra nightly. Libido still in the dumper, but working on it with doctors.
3 month PSA--<0.1
6 month PSA--<0.1
10 month PSA--<0.1
13 monthPSA--<0.1
18 month PSA--<0.1

stevmac1
Regular Member


Date Joined May 2010
Total Posts : 129
   Posted 8/16/2010 3:13 PM (GMT -6)   
David,
Sounds like the right thing to do. I'm rooting for you!
steve
50 Yrs. old. DX Feb, 2010 w/6.6 PSA.
Biopsy 04-24-10, Gleason 3+3=6
4 of 5 cores left side inv. 4 of 6 rt side
RRP 06-07-10....
16 days post-op, catheter out.
Gleason upgraded to 3+4
No involvement of lymph nodes & seminal vesicle.
Totally continent @ 8 weeks post-op. (!!!)

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 8/16/2010 3:42 PM (GMT -6)   
Tud, am pondering possible litigation or at least investigating it. My uro all but directly blames blotched radiation for my condition, and feels that much of it is perm. damage. It was my uro that interceded a couple of times to the radiation clinic. Stupid me, toughed out those 39 treatments, as I thought that is what I was suppose to do. We shall see.

Thank you Steve, I am hoping it is. Sure beats the alternative of staying in this hell that I have been living for all these months. I am a broken man on the pain front, honestly just can't keep taking it. The pain won, I lost, I admit it.
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 ?
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39

Zen9
Regular Member


Date Joined Oct 2009
Total Posts : 314
   Posted 8/16/2010 3:45 PM (GMT -6)   
Let me see if I can take some pressure off of my friend, Purg:
 
1. Suing his radiation doctors: A lawyer might tell him he has a good suit.  But is Purg in any condition to take on a lawsuit on top of everything else he has going on?  When you sue a doctor, you have to be as focused as a laser and as tough as nails.  Under different circumstances, Purg may be exactly that.  But Purg has so many important things on his plate right now that there is probably no way he can see a lawsuit through.  The medical profession and their insurers generally count on being able to wear down an opponent financially and emotionally, and they are often able to do so.  So ... as much as many would like to see him sue, I can understand his reluctance.
 
2. Having his surgery done out of state by a specialist/expert: Several people have hinted to Purg that this would be a good idea.  I agree.  But the short answer is that Purg is over 18, it's his life, and he will live with the consequences, good or bad.  At least in this context truth is very subjective.
 
3. His decision not to take hormone therapy if his PSA keeps rising: I realize that many reading this are already on hormone therapy.  As with so many things in life, it's a kind of cost-benefit analysis made with very imperfect knowledge and involving intimate value judgments; different people will see things differently and reach different conclusions.  For what it's worth, I agree with him on this one.
 
Like everyone else, I am very happy he has made his decision and I fervently hope that (i) his surgery is "successful" (however Purg defines "success" in this context) and (ii) his PSA turns around and starts falling.
 
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
 July 2010 = <0.1

Post Edited (Zen9) : 8/16/2010 3:34:26 PM (GMT-6)


lewvino
Regular Member


Date Joined Jul 2009
Total Posts : 384
   Posted 8/16/2010 3:53 PM (GMT -6)   
I cringed and jumped in my chair reading your other post. This one sounds like a plan to me! Not what you had planned way back when but as you know we have to deal with the cards as they fall. Now you have to think up a new name to use on this forum. I feel your days of purgatory are coming to an end.

Larry
Age 55 / age at diagnosis 54, PSA 5.1
Robotic surgery 08/12/09 at Vanderbilt, Nashville TN. 
Final Path report:
20% of the prostate Involved
Tumor graded at T2C
Overall Gleason 3+4 (7)
Lymph Glands Clear, Positive Margin Noted in Right Apex
 
First post Surgery PSA - 0
Six month PSA - 0
Ten month PSA - 0

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 8/16/2010 4:06 PM (GMT -6)   
Speechless, wish you better days and fast healing when the time comes. Your wife will be there to help and is experienced in nursing things, that is in the plus column.
Youth is wasted on the Young-(W.C. Fields)

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6983
   Posted 8/16/2010 4:08 PM (GMT -6)   
David,

I am relieved to hear that you see viable options and have come to a decision. I don't know the procedure, but I trust that you, of all people, have made an informed decision.

You have my 110% support, for what little that might count, and you always have my best wishes that improvement is on the horizon. The near horizon. Very near.

Zen9 got the legal angle right, for the part that I know something about.

As always, hang in there.

60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2229
   Posted 8/16/2010 4:08 PM (GMT -6)   
David,
That does sound like a plan and I know you are ready for a better QOL.  While the SRT was a disaster it does not serve you to be mad at yourself. It wont reverse the damage and it wont ease the pain, in the body and in the mind. Will be looking forward to that post from you one day that is full of joy and of hope, and it just has to be on it's way.
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

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4184
   Posted 8/16/2010 4:14 PM (GMT -6)   

Zen, I agree that David is a big boy and I am not trying to pressure him into litigation.  Rather, after reading all of his posts about his radiation process and problems, it occurred to me that he might have a case.   Many medical malpractice lawsuits are taken on a contingency basis, so David would not bear the financial burden.  And, as for the "tough as nails" part...I think most of us could agree that David already meets that criteria in spades!

Anyway, it was just a thought...not a topic for debate...

Tudpock (Jim)


Age 62, Gleason 3 + 4 = 7, T1C, PSA 4.2, 2 of 16 cores cancerous, 27cc
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 4/10/10.  6 month PSA 1.4 and now 1 year PSA at 1.0.  My docs are "delighted"!

keysailfisher
Regular Member


Date Joined Dec 2009
Total Posts : 346
   Posted 8/16/2010 4:44 PM (GMT -6)   
David, glad to hear that a fix is in your future. I know you have been alot of misery and hopefully the end of it is here. If you trust your doctor then good for you because no one else knows your situation better than him. Looking forward to that happy post.
Take care my friend,
 
Neal
age 45 at diagnosis Biopsy results 12/9
psa 3.09
Davinci Feb. 5th 2010/ cath removal 2/16

Gleason-3+4=7
Stage-T2c NO Mx
PSA 3/29/10 <0.01
PSA 6/23/10 <0.01

Sonny3
Veteran Member


Date Joined Aug 2009
Total Posts : 2447
   Posted 8/16/2010 4:46 PM (GMT -6)   
David,

I am as pleased as everyone that there may light at the end on this tunnel for you and QoL. I know that you will be in very good hands. Your doc has been through this with you from the beginning as much as he could. He knows what you have endured and most probably wants to be the one to bring all of this to an end for you. It goes without saying that knowing what he does he will go to extraordinary measures to insure that all goes well and everything is successful.

Mid September is when Lynn and I are leaving to head north, I can definitely see a stop in Easley as the first part of the trip. Headin your way brother, look out.

On the legal note for you and the others; after my conversation with you about this a little while back, Lynn has been working with her contacts to set you up with the right legal folks to take this on when you are ready. For those that don't know, Lynn was the Executive Director of a very large law firm in the SE before she was forced into disability retirement. She is using her contacts to take care of David in this arena. A good part of their practice was dealing with medical malpractice on both sides of the issue.

So brother David, the decision is done. Make ready for the day and get ready to start a life with a much higher level of QoL. You have definitely earned it.

Sonny
60 years old when diagnosed
PSA 11/07 3.0
PSA 5/09 6.4
da Vinci 9/17/09
Post Surgery Pathology: GS 4+3=7
Stage: T3a
Tumor Volume 12.5%
positive margin, extra-prostatic extension
30 day PSA 0.4, 50 day psa 0.53, 64 day psa 0.6
IMRT completed 1/15/10 35 treatments- 70Gy

2/24/10 FIRST POST RAD PSA 1.0---CARRRP --waiting for the next test.
3/22/10 Second Post RAD PSA 1.5 Dammmmnnn stubborn son of a gun
4/19/10 YAHOO PSA dropped to 1.2 Moving in the right direction.
5/7/10 PSA test 1.3 Sodium Fluoride PET Scan & CT SCAN -performed
5/20/10 PSA test 1.2 Holding off on future tests for 3 months- single lytic lesion found and scheduling radiation.
7/22/10 PSA test 1.3 - Begin radiation for MET on leg
8/9/10 - Met radiation completed

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 8/16/2010 4:47 PM (GMT -6)   
zen - thanks for a good post. the legal part, perhaps at some point further down line- would have to be a atty that would work for contingency only, as i am out of work over 2 years, the surgery - this is a routine urological surgery, all uro surgeons learn it, its the least complicated of them, and my guy has done hundreds, no reason to take it out of state, and the HT, glad to see that Sonny and I and a handful of others have non-HT thoughts in our head, even my own dr today understoon my reservations about HT, still not saying i positiviely wouldn't do it.

larry- name will change, been using purgatory online for more then 10 years, thought it fits my current mode, had nothing to do with my pc journey

zufus - thanks brother

142, thanks as usual, and say hey to mom!

michael - yeah, i made the choice about srt, knowing i was in for extreme side effects, but as my own uro said several times, without it, i would have been a dead man from the pc in a fairly short order. it was a tough call for me to make, only did it, as it was the only curative card left in the deck, the jury is still out, we will all be anxiusly waiting for the november psa reading

tud - thanks again, i know where you are coming from, no problem
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 ?
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39

daveshan
Regular Member


Date Joined Jan 2010
Total Posts : 363
   Posted 8/16/2010 5:11 PM (GMT -6)   
David,
Glad a path has been chosen, wishing you an easy journey and a quick recovery.
Dave in Durango CO

6071
Regular Member


Date Joined Jul 2008
Total Posts : 112
   Posted 8/16/2010 5:34 PM (GMT -6)   
hi dave
i do not know what i can say i am lost for words
Good luck and I wish the best for you
Age 61 at DX
Biopsy 7/2008 Positive 1 of 12 cores positive 3+4 5% To 10%
Open Radical Prostatectomy 15/10/2008
Stage pt2c
Post op staging Gleason's Score 3+4=7
apical margin is focally positive
no extraprostatic extension
Seminal vesicles and lymph nodes clear
Catheter out on the 13/11/2008
4 week PSA < 0.1
26/1/2009  < 0.1
20/4/2009 < 0.1
11/6/2009 ultra sensitive psa 0.07
20/7/2009 < 0.1
26/8/09 Starting photon 3D CRT
13/10/09 Radiation Finished
25/11/09 ultra sensitive psa < 0.05
26/4/10   ultra sensitive psa < 0.05







Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 8/16/2010 5:35 PM (GMT -6)   
So the key question in any litigation will be who messed up ~ the surgeon or the radiation center, or both? From what I've read since you had issues after surgery neither has been stellar. It may come down to what they find after the next intervention if there is even a litigation possible, or that both failed to perform at minimal standards. I can't really say. But...

You know my thoughts ~ before you allow anyone to touch you again, verify the procedure with 2nd or 3rd opinions. Where would I go if it was me? Mayo and MSK have outstanding reputations in reparative surgeries. Maybe one of those extremely experienced surgeons? Catalona, Menon, Walsh?

What a mess, David...

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
RALP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino

don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 8/16/2010 5:53 PM (GMT -6)   
David,

Sorry to hear that you must endure another operation. I do tend to agree with Tony that now may be the time to look at an alternative provider. Skill is more important than bedside manner at this point and it would do no harm to at least talk. Either way. bless you, and here is hoping for good results and the start of healing.

Best Regards,
Don
Diagnosed 04/10/08 Age 58
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
IGRT/IMRT with adjuvant HT (lupron) 2yrs
PSA:
02/08 21.5
07/08 0.82
10/08 .642
09/09 0.32
03/10 0.32
06/10 0.32
07/10 0.10

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7213
   Posted 8/16/2010 5:56 PM (GMT -6)   
David:
 
Frankly, from reading all your posts and being here at arms length, I would say your decision to have surgery is truly a no-brainer. Your QOL is horrible and I hope that this time you will have a good surgical outcome.
 
On the one hand, you keep calling this surgery very routine. But, it sure doesn't quite sound like it. This is MAJOR surgery. But, I guess it is like a heart bypass. Very routine...yet very major. However, if I have to have a heart bypass, if I am well enough and have the time I would seek out an experienced, excellent surgeon. One wants to have a lot of confidence in his/her surgeon. You appear to have a great deal of confidence in your guy, so there's not much more to say on that score.
 
Regarding the possible lawsuit, from everything I've read, you have a great case. But, good luck proving it. If your current surgeon would truly testify, that would go a long way. In fact, it might result in an out-of-court settlement. The only problem, this would be very stressful. I think of myself. Suppose my family doctor neglected to alert me about a rising PSA and here I am. I'm feeling okay, but fighting PC is so stressful in itself. I don't think I would want to add the stress of a protracted lawsuit. Of course, the medicos count on that too! In your case, you would have to PROVE that the radiology folks did something outside of the usual standard of care. Given your history, I still think you have a case. But the emotional price is steep.
 
Anyway, David, I wish you the best.
PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (PSAf: 24%), PCA3 =75 .
Biopsy 11/30/09. Gleason 4+3. Stage: T1C. Current Age: 64
Surgery: Dr. Menon @Ford Hospital, 1/26/10.
Pathology Report: G 4+3. Nodes: Clear. PNI: yes. SVI: No. EPE: yes. Pos. Margin: Yes-- focal-- 1 spot .5mm. 100% continent by 3/10. ED- in progress. First post-op PSA on 3/10/10-: 0.01. PSA on 6/21/10--0.02. Next PSA late Sept.

April6th
Regular Member


Date Joined May 2010
Total Posts : 264
   Posted 8/16/2010 5:57 PM (GMT -6)   
Good luck on the upcoming surgery and my best wishes for a speedy recovery. You are more than due for some relief!

Dan
Here are some of my stats:
Age:54
Father diagnosed with PC at age 72 - wasn't contained to prostate when found in 1992.
My PSA rose from 3.2 to 5.1 over the course of 1.5 years with Free PSA at 25% for the last two tests.
DRE showed no evidence of tumor but Uro thought my prostate was a little large for someone my age
PCa diagnosed 4/6/10 after biopsy on 4/1/10
1 out of 12 biopsy samples was positive with 5% of biopsy sample cancerous
Gleason 3+4
Da Vinci surgery on 6/1/10
Pathology report shows cancer confined to prostate and all other tissue clean
PSA tested on 7/15/10: Zero Club membership card issued (trial membership with 90 day renewal)

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 8/16/2010 6:02 PM (GMT -6)   
sony, thanks for the advice, i am interested at some point in making a local legal contact here, will need some guidence and advice for sure. we can talk about that at depth some time.

tony, yes, it is a mess. the lingering damage has only been post srt. the original stricture issues are no one's fault, my body's annoying way of over-scarring all the time. except for the recurrance issue that forced the srt, i was a pretty well healed person at that point in time. i fault the radiation clinic's denial that there was burning and scattering going on, with just the catheter in place, instead of a bladder full of urine/water for protection. They could have chosen to fill my bladder via the cath and close it off while being zapped. i suggested that and was told it wouldnt be needed. i think the whole problem is that my entire urinary systems was subject to direct high doses of radiation without any protection in place. but what do i know, i am not a doctor.

thanks also to 6071 and dave
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 ?
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39

Jakester
Regular Member


Date Joined Aug 2009
Total Posts : 286
   Posted 8/16/2010 6:13 PM (GMT -6)   
Saddened for all the pain and stress this has caused you but making your decision to have the surgery hopefully will ease your load; you desire a nice long break to concentrate on the wonderful family you mention frequently.

Our best to you and the others,
Jake
Diagnosed 8/2008 Pre-op psa 4.2, Age 60 at dx
7 of 12 biopsies positive 3+3
DaVinci LRP 11/08
Post Op pathology clear margins, confined to prostate, absent extraprostatic extension, vascular or perineural. Gleason 3+4=7, 5-10% of 4 and location in right mid-gland.
3 month psa .1 2/09, 6 month .1 5/09, 9 month .2 8/09
broke ankle bones 6/09
9/21/09 Bone scan clear, psa still .2
11/12/09 chest xray was clear, psa however up to .3,
01/05/10 psa still .3, radiation setup done with tats, 01/19/10 started 39 sessions 70.2gy, psa at 6th week salvage IMRT up to .4
Post SRT psa at 10 weeks (5/31/2010) down to .2

mikey1955
Veteran Member


Date Joined Dec 2008
Total Posts : 673
   Posted 8/16/2010 8:14 PM (GMT -6)   
David,

Good luck with your choice. I just hope it improves QoL.

At a complete loss of words to add anything else...

Thinking of you often.
-Nov/Dec 07, March 08 and Dec 08: Severe perineum pain . Septra/Bactrim for 8 months for diagnosed prostatitis.
-PSA start of 2008: 5.3..... PSA June of 2008: 7.3
-14 DRE all benign or nothing felt
-TRUS Biopsy Nov 08: 5 of 8 cores positive GS 3+3 or 6. 30-65%. Perineural invasion.
-General Health: pretty good, 5' 10", 180 lbs, slim.
-Open RP surgery: May 09 both nerve bundles spared. Bilateral lymph node dissection performed. Discharged 48 hours after surgery.
-Post Surgery Pathology: pT3a N0 MX, extraprostatic extension (EPE), stage III prostate cancer, lymph nodes clear, seminal vesicles clear, Gleason upraded to 3+4 GS 7. EPE within surgical margins. Other than prostate and EPE, all tissue removed negative for cancer involvement.
-Bladder control within 48 hours of catheter removal
-ED ongoing but improving. ED oral meds didn't do much initially. TRIMIX was working very well. Initial dose of 0.1 mL too much. Had priapism at 0.075 mL that ended up in a humiliating ER visit. Doses recently after 50% dilution by Uro about 0.025 mL or less. Don't use Trimix anymore...I'm too sensitive to it, even at very low doses and the Alprostadil is pretty consistent in causing erection pain...had a few episodes of 3+ hour wood with pain.
-Levitra now starting to work at low doses of 5 mG to 10 mG. Sometimes the side effects like stuffy nose aren't fun...sometimes OK.
-Was supposed to see ED doc last week, but due to his schedule, will now be late August. Will discuss bimix with him.
 

rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1131
   Posted 8/16/2010 8:19 PM (GMT -6)   
I am happy you have made a decision and so sorry you are in such pain. I hope the pain meds kick in and you have a good night.
 
Age 48 at diagnosis
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
Robotic Surgery May 9, 2008 - houston, tx
Pathology report -gleason 8, clear margins
22 month  PSA <.04
continent at 10 weeks (no pads!)
ED is still an issue

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 8/16/2010 9:02 PM (GMT -6)   
don, thanks of course

mel - my srt was out of the ordinary, they had never done one with my circumstances before, right now, can't even think about the hassle, got to get through this next surgery and concentrate on that. i want to be better, or mostly better before the holiday season, as my last 2 years were so messed up

thank you dan and jake, yeah, i got a great family, couldnt make it without their support

mikey, weve known each other quite a while now, hard to believe this is still going on. thanks.


rob, thanks working on that pain relief part as we talk
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 ?
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39
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