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Julietinthewoods
Regular Member


Date Joined Sep 2010
Total Posts : 309
   Posted 9/19/2010 4:40 PM (GMT -6)   
Just wanted to say hello to all, and that I'm grateful to have found this forum. My husband was just diagnosed last week. Our first consultation with the urologist is next week, and the information I have found here has really helped us to formulate our questions.

Carter is 60 years old, and the cancer was found on second biopsy; one out of six cores positive (not sure why more weren't taken); tumor occupies 20% of biopsied material; Gleason 7 (3 plus 4); stage T1C. He also has low and high grade PIN on one side. We have requested a second pathologist's reading. PSA March '09: 5. PSA August '10: 6.7. Free PSA 12 (both years). PCA3: 43.6

We have much to learn, but I wondered if you guys think brachytherapy is even a possibility since he is above a Gleason 6. Work is a huge issue for him, and he is leaning toward radiation in the hopes that a cure can be found without the need for weeks and weeks away from work.

Thanks so much! We wish the best for all of you. (We've already been praying for Purgatory).

Juliet

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6978
   Posted 9/19/2010 5:42 PM (GMT -6)   
Juliet,
Welcome, and as is the case with all the new friends, I wish you didn't have a reason to join us.

I did DaVinci surgery (at age 56), post op G 4+5. My biopsy was 7 of 12 cores G 4+4, 2 of 12 G 4+3, so I did not qualify for seeds (BT). With my post-op report, I was off to IGRT as soon as it was practical.
Many insurance companies only pay for 6 cores (as mine), but my uro will do no less than 12. We got that worked out.

I wanted to do seeds, but all of the doctors I talked to ruled it out. There are a number of members who have done seeds, as well as a combo of seeds with IGRT. I'm sure they will speak up.

My Radiation story is in the link (here on HW) in my signature.
My IGRT journey -
www.healingwell.com/community/default.aspx?f=35&m=1756808

Post Edited (142) : 9/19/2010 4:45:49 PM (GMT-6)


Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3779
   Posted 9/19/2010 6:14 PM (GMT -6)   
Hi J-woods! Welcome to the place no one wants to be..Have you read Walsh's book?, You will find it very helpful..Available anywhere, any library. Get the revised 2007 edition..

Seed implantation can be tricky because it's just not done everywhere. You may have to travel to get a real expert with the latest equipment..While some men who have had it claim it is side-effect free, others have had problems..ALL of these treatments have their downsides...I had robotic surgery and it was a pretty smooth ride, but it did not cure my cancer, my pathology came back with a positive margin and positive vesicles..I'm Gleason 9 and that's always a tough one...And don't forget to check with your insurance company before you sign up for ANY treatment...Ask for "pre-approval" to rule out any ugly surprises..
Age 68.
PSA at age 55: 3.5, DRE negative. Advice, "Keep an eye on it".
PSA at age 58: 4.5
PSA at age 61: 5.2
PSA at age 64: 7.5, DRE "Abnormal"
PSA at age 65: 8.5, DRE " normal", biopsy, 12 core, negative...
PSA age 66 9.0 DRE "normal", 2ed biopsy, negative, BPH, Proscar
PSA at age 67 4.5 DRE "normal"
PSA at age 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RRP performed Sept 3 2010

60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2229
   Posted 9/19/2010 7:03 PM (GMT -6)   
Welcome Julie,
Cant answer your question about brachy,but most of us who have had surgery have gone back to work fairly quickly. I was back in 2 weeks, but had to take it easy. Not sure what Carter does for a lving but construction work would keep him out for a longer period of time. Glad you are here and educating yourselfs about PCa and looking at all options.
Michael

pipedream
Regular Member


Date Joined Aug 2010
Total Posts : 64
   Posted 9/19/2010 7:37 PM (GMT -6)   
Hi, Julie - Before you decide on BT, (in addition to Patrick Walsh's book) check out "How we survived Prostate Cancer - What we did and What we should have done" by Victoria Hallerman. Her husband had a terrible time with seeds stretching over 5 years. Victoria details their mistakes and gives a lot of information about how to avoid them and what to consider before making the decision. She is not one-sided in her approach and sprinkles her book with "What we know now" inserts. Her husband also comments throughout.

It is a frightening book but if you are like me, you want to know the down sides as well as the up sides of each treatment option.
Husband DX @ 64; 7.5 year survivor colon cancer; father had PCa @ age 65
04/09 - PSA 3.06 - retest in 6 mo
10/09 - PSA 1.55 Free PSA 7.74% - retest in 6 mo
04/10 - PSA 4.26

Biopsy 7/10
R base - 3+3=6 10%
R mid & apex - benign
R anterior horn - 3+4=7 20%
L base - 3+4=7 90%
L mid - atypical small acinar prolif
L apex - 3+3=6 < 5%
L anterior horn - 4+3=7 60%

RP Surgery - October 1, 2010

Julietinthewoods
Regular Member


Date Joined Sep 2010
Total Posts : 309
   Posted 9/20/2010 8:37 AM (GMT -6)   
Thanks to each of you for taking the time to welcome us!

142, I read your journey, and it was helpful. We have much to learn about the differences between BT and other forms of radiation. Your story, and Fairwind's, are troubling in that surgery was not completely successful and radiation was still necessary. At this point, we are starting to consider that possibility, and may decide against BT knowing that followup treatments would be more problematic if the cancer was not eradicated.

Fairwind, I hadn't even thought about the travel issue. Time spent traveling to treatments for weeks on end could end up being far more time off of work than just recovering from surgery.

60Michael, good to hear that many can return to work quickly. I had read "5 to 7 weeks", which would be a sad situation for Carter. He is up for a promotion the first of the year, and convinced he won't get it if anyone thinks he can't perform at his usual fast pace. His job involves mostly sitting, but a fair amount of walking between buildings and not always easy access to restrooms.

Pipedream, thanks for the book suggestion. I will definitely go look for it, and the Walsh book as well.

I'm sure we'll have lots more questions. Consultation is tomorrow.

Thanks again!

Juliet

ejn
Regular Member


Date Joined Jun 2010
Total Posts : 87
   Posted 9/20/2010 8:49 AM (GMT -6)   
Julie,  I had Davinci on 8/11/10 and was back to work on 8/25/10 without any problems.  I could have went back a couple of days earlier but decided to wait for the next pay period just because I could.  I have a desk job and also walk between buildings during the day and have no problems.  Once the Cath comes out (usually 1 week) the healing speeds up quickly.  Do your homework and try to relax.  Make an informed decision and move forward. 
 
Ed
53

Pre OP PSA: 1/2008=5.9, 2/2010=6.0 (free=9%)

Biopsy, 4/10/2010 This was my 2nd Biopsy. The Uro put me out and took 36 samples. 3 samples positive 1%, 2%, 2% no evidence of perineural invasion. T1c

April 2010


CT Scan: Negative


DaVinci: Coming up 8/11/10, Dr David Bryan, SSM DePaul-St Louis
Post Op Path:
Gleason 3+3=6
Tumor involves left lobe only
Tumor constitutes less than 5% of gland volumne
No vascular or neural invasion detected
No capsular invasion detected
Distal urethral margin of resection free of tumor
Proximinal urethral margin of resection free of tumor
Radial margin of resection free of tumor
Seminal vesicles uninvolved by carcinoma
TM stage T2a (unilateral less than 1/2 of one side), NX, MX
ALL Margins uninvolved
Extra Porsaatic extension: Absent

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 9/20/2010 10:27 AM (GMT -6)   
Juliet,

The Gleason 7 alone shouldn't stop Carter from having seeding. The size of his prostate could. Do you know how big they estimate his in c.c.? If it is too large, they can try to shrink it down to be suitable for the seeding procedure. The seeding method would probably allow him to get back to work the soonest. I had open Surgery, and then had complications. It would have been at least 3-4 months before I would have been healed and fit enough to return to work, but fortunately/unfortunately, I was also unemployed at the time.

The healing times from the robotic surgery men vary a whole bunch. It ranges from 48 hours later, they say they are as good as new, to those that are 2 months out, and still having physical and pain issues. Don't be fooled, even with robotic surgery, your husband would still be undergoing a very serious and complex surgery.

With his one core being Gleason 7, and all that High Grade PIN being found, its very possible there is more cancer that a low core biopsy like he had is missing the rest. In my opinion, being a confirmed Gleason 7, I would not reccomend AS or watchful waiting. You don't need to rush or be forced into a treatment, as you have sufficient time to do that, but the "4" element of that Gleason 7 is dangerous and unpredictible. Just my take.

Please keep us well posted.

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 Sess/72 gy ended 11/09, on Catheter #21, will be having Ileal Conduit Surgery in Sept.

LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 9/20/2010 10:29 AM (GMT -6)   
Welcome Julie,

As you can tell..lots to think about. Unfortunately, a biopsy by itself doesn't determine the coarse of treatment. The only thing the biopsy did was confirm that cancer was present. Follow up with your doctors advice on what to do, and then make your decision from that. IF treatment is needed, you will have lots of methods to choose from and you will find one that best fits your husband needs.

Good luck and take your time and research carefully.
You are beating back cancer, so hold your head up with dignity

Les

Signature details in Sticky Post above - page 2

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3834
   Posted 9/20/2010 10:37 AM (GMT -6)   

Juliet -  i can understand your hesitation for BT as a stand alone treatment.  i went with the combination of HT, BT and IGRT, which is about as aggressive as it gets.  good luck in whatever you decide.

ed


JoeFL
Regular Member


Date Joined Oct 2009
Total Posts : 420
   Posted 9/20/2010 10:53 AM (GMT -6)   
Julie,
 
I chose BT combined with IGRT and would do it all over again (somewhat due to what I read on this site). I was out of the hospital same day. Side effects were relatively mild and have mostly gone away. IMO there are 2 key questions for you. 1) Are there uros/radiols in your area who have a lot of experience with these treatments? 2) How do they feel about the Gleason 7?
 
There are several other men here who have had BT who will probably weigh in. Please feel free to contact me if you want....my email is in my profile. One last thought....take your time and do a lot of research. You don't have to make any quick decisions.
 
Sorry you are here....but you will learn a lot on this site. Best wishes,
 
Joe
Age 67 PSA 4.5 Biopsy 9/4/09 Bostwick Labs 5 of 8 sections (5 of 11 cores) positive-Gleason 3+3=6 Stage T1
BT on 12/11/09 (84 seeds of Palladium 103) Home same day/no catheter. Some burning, frequency, urgency for 6 weeks. No incontinence, mild ED. Normal activity within 3 days. 25 IGRT sessions ending 3/22/10 - some fatigue until 30 days after last treatment. PSA on 5/26 - 0.1 PSA on 9/1 - 0.1

Julietinthewoods
Regular Member


Date Joined Sep 2010
Total Posts : 309
   Posted 9/20/2010 3:33 PM (GMT -6)   
Thanks so much for the additional thoughts, guys. I am trying to learn as much as I can now about all the forms of radiation, and how they are combined. I am thinking we can find a radiation specialist fairly nearby, but would probably have to travel a bit for robotic surgery.

I do know the urologist told Carter his prostate was 'small', but didn't mention cc's. I added that to my list of questions and will ask tomorrow. If it is, that should mean a greater chance of success with regard to all radiation.... or just seeds?

I haven't noticed a lot of mention here of bone scans, but wouldn't that be necessary (or MRI) before proceeding with either treatment choice? Do we have to decide and schedule that ourselves? Or do we pick a treatment and then that specialist schedules additional screening tests? Should we find a medical oncologist? I googled 'prostate oncologist' but didn't find it near here.

Thanks for the warning on the 4 Gleason numbers. That is what makes me feel a bit pressured to hurry and decide. That and the fact that six cores (the same amount done on both biopsies) is, I agree, not a lot to use for assessment. We're feeling a bit overwhelmed, and trying to keep up with concentration at work and not tell anyone what is going on is stressful.

I'll try to start a new thread with any other questions after our appt. tomorrow. Thanks again.

Juliet

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6978
   Posted 9/20/2010 4:01 PM (GMT -6)   
Juliet,
 
I will start with Bone Scans. Many here believe that they are a waste of money and excessive radiation exposure, and in most cases that would appear to be true, as they really do only detect significant metastasis. On the other hand, it did give me a sense of some hope in general that mine was negative after a very ugly biopsy. I also found out how many times I really had broken my legs over the years (all that shows up).
 
The doctor you choose for primary treatment would decide if he thinks the bone and CT scans are needed. If you do IGRT/IMRT, they will do at least one CT scan for the planning of the dosage and delivery.
 
Prostate size is important, but for different reasons in different cases. For BT, it is the area to treat vs. the number of seeds. In robotic surgery, it makes it harder to get out through the standard incisions. So for now, a size estimate is useful regardless of the treatment choice.
 
I had a G 4+4 in 7 of 12 cores. My Uro (later surgeon for my DaVinci) did not want me to hurry my treatment choice, but he did want me to be deliberate and not waste any time. Since the post-op path showed G 4+5, in retrospect he was right in telling me to put aside all of the rather mundane day to day problems, and get busy with killing cancer.
 
My work environment was also a complication - I had to be careful (and still do) about who knew what. It might have been fortunate that I had a lot of paid time off left, so was able to take the time I needed. On the other hand, I should have been enjoying myself before falling off this cliff.

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3779
   Posted 9/20/2010 4:12 PM (GMT -6)   
Yes, they will do additional screening tests, two or three of them, mostly for CYA purposes..These tests seldom find anything at this stage..Sometimes they find other problems not related to the PC which might have a bearing on treatment..

Remember, each specialist you see is going to try and sell you his product and bad-mouth the other guys product..Seeing a Medical Oncologist is worthwhile..Their insights on surgery and radiation are not likely to be biased as they do neither..But they have seen it all...Whatever treatment option you choose, that decision creates a big paycheck for many people...They will fight for your business...

Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 9/20/2010 4:33 PM (GMT -6)   
Juliet,
I had the DeVinci surgery and was able to walk 2 miles 4 days afterword. The only thing my doctor cautioned me about was lifting anything heavier than 15 pounds. Carter should be able to go back to a desk job that involves some walking in few weeks. Good luck.
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09 Dr Fagin, Austin TX
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm in circumference.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 5 months
2 months PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1
8 months PSA test 10/9/09 result <0.1
11 months PSA test 1/21/10 result 0.004
14 months PSA test 4/19/10 result 0.005

Kongo
Regular Member


Date Joined May 2010
Total Posts : 36
   Posted 9/20/2010 5:03 PM (GMT -6)   
Juliet,
 
I suspect that you and your husband are feeling like information overload and it's only just begining.  The follow-up appointment with your urologist will be an important first step in gathering the information you need to make informed decisions about potential treatment options.  Just keep in mind that almost all urologists are surgeons and they almost always suggest surgery as the correct treatment.  Your doctor is required to inform you of other options as well but it has been my experience that surgeons will want to cut.  Radiation specialists, on the other hand, will present excellent arguments about why PCa is best treated with radiation.  I hope you meet with several specialists in different fields to get a balanced opinion.
 
There are potential side effects with just about any treatment course and they range from relatively mild to severely debilitating, as some of the posts in this forum detail.  When you are doing your consultations, insist that the doctors give you a full explanation of potential side effects in a manner that you and your husband can understand. 
 
Besides BT, there are other forms of radiation you ought to research as well and these include IMRT, HDR Brachytherapy, SBRT (CyberKnife or Novalis), and proton radiation.  Depending on how your husband's cancer is evaluated some or all of these may be options.
 
Hormone treatment in conjunction with either surgery or radiation is also often done.
 
I would also question why only six biopsy samples were taken.  While there is some controversy about the right number, it usually surrounds whether 8 or 12 is the right number.  Having only six may indicate your urologist may not be following the most up-to-date techniques.  The more cores that are taken the more likely it is that cancer will be found but it also helps to properly stage the disease with the appropriate Gleason score, a critical factor in determining a treatment.  (For example, if your doctor had taken more cores the first time, you may have been able to avoid the second biopsy...but then again, hitting a cancer spot is pretty much a guess unless they're going after a nodule felt on the DRE)
 
A second opinon on the biopsy is a good idea.
 
Good luck to you both.
 
 
 
 
============================
Age:  59
Dx:  March 2010
PSA @ Dx:  4.3 (Latest PSA = 2.8 after elimination of dairy)
Gleason:  3+3=6 (confirmed by second pathologist)
Biopsy:  1 of 12 cores contained adenocarcinoma at 15% involvement and no evidence of perineural invasion
DRE: Normal
Stage:  T1c
Bone scan and chest x-rays:  Negative
Prostate Volume: 47 cc
PSA Velocity:  0.19 ng/ml/yr
PSA Density:  0.092 ng/ml/ccm
PSA Doubling Time:  > 10 Years
Treatment Decision:  CyberKnife radiation treatment in June 2010.  Side effects:  None
 
 
 

stevmac1
Regular Member


Date Joined May 2010
Total Posts : 129
   Posted 9/20/2010 5:17 PM (GMT -6)   
Juliet,
Welcome. At the consult, take some notes and ask for a transcript. Lots of info to absorb.
Good luck to you and to Carter, of course.
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.
Perineural invasion present :(
Totally continent @ 8 weeks post-op. (!!!)
1st post-op PSA @ 12 weeks - Less than 0.05

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4177
   Posted 9/20/2010 5:56 PM (GMT -6)   
Dear Juliet:
 
Welcome to Healing Well.  Sorry you have to be here but I think you will find lots of support and lots of good info on this site.  I am one of several brachytherapy (seed) patients who post here and will try to give you some perspective from my angle.  If you would like to see my "journey" with the seeds, feel free to cut and paste the link in my signature.
 
Your post raises a whole host of issues and I'll try to repond to all of them:
 
1.  A six core biopsy is hardly state of the art as you surmised (unless it is done in conjuction with a color doppler scan).  Most men here have 10 or more...I had 16.  So, sorry to say, that alone should give you some question about the competency of your current urologist.  At the very least you should inquire as to why he took so few cores.
 
2.  The question about prostate size is pertinent.  Most radiation docs like to seed prostates that are 50cc in size or smaller for best results.
 
3.  You should consult a radiation oncologist and a prostate oncologist (in addition to a surgeon) before settling on a treatment.  You definitely want to become educated re the options.  You may want to ask them about color doppler staging given the small number of cores in hubby's biopsy.
 
4.  BT alone is frequently done for men with Gleason 6 graded cancer OR G7 men with a small percentage of cores and/or a small percentage of cancer in the cores.  You will want to discuss this in depth with the radiation oncologist and the prostate oncologist.  They may want to add IMRT to the BT depending on their assessment of the cancer. 
 
5.  BT is HIGHLY CURATIVE in men who are eligible for the procedure.  The success rate is as high as for men who have surgery but with much less onerous side effects.  If quality of life is a concern, I suggest you seriously consider this option.  You may want to Google "New England Journal of Medicine Quality of Life" to read an interesting study re that topic.
 
6.  The books I suggest reading are Walsh's "Guide to Surviving Prostate Cancer" (a good primer), Strum's book (title escapes me now) and a brand new book by Blum-Scholz called "Invasion of the Prostate Snatchers".  Despite the title of the latter, it provides valuable perspective that I believe every patient should have..especially about quality of life.
 
7.  Experience matters.  Whatever treatment you choose, please make sure that the doctor has done hundreds of procedures.  Studies show that success is better at 250+ procedures and then it levels off.  It's no guarantee, but it gives you better odds.
 
8.  There are men who bounce back quickly from the surgery but I would say the norm is that it takes a while...don't be fooled by the da vinci ads. 
 
9.  The scans at this time are very unlikely to show anything and are likely a waste of time and money with G7 and PSA under 10.
 
I have tried to be fair in my assessments about but I can tell you that I am absolutely biased in favor of brachytherapy based on my research of this cancer as well as my own personal experience...so that's my qualifier.
 
Please feel free to email me or ask any other questions.  This decision IS a big deal.  You don't have to rush and you should get all of the info available before jumping.  Best of luck and please keep us informed about your hubby's path.
 
Tudpock (Jim)
Age 62 (64 now), G 3 + 4 = 7, T1C, PSA 4.2, 2/16 cancerous, 27cc. Brachytherapy 12/9/08. 73 Iodine-125 seeds. Procedure went great, catheter out before I went home, only minor discomfort. Everything continues to function normally as of 9/10/10. 6 month PSA 1.4, 1 year PSA at 1.0. My docs are "delighted"! My journey:
http://www.healingwell.com/community/default.aspx?f=35&m=1305643

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6978
   Posted 9/20/2010 6:13 PM (GMT -6)   
Juliet,
 
Take a pocket tape recorder. You'll be amazed what you listened to but didn't hear. I went back over the tapes at home with a bit of calm. Whole new discussion -
 
Just read Jim's notes on BT - very good points. I would have done BT if they would have taken me.
 
Kongo,
Many insurance companies only pay for 6 core biopsies (mine, a really big one, for one). Only by negotiation between the uro and lab did I get 12. The difference was over 2 thousand dollars (the insurance denied the "extra" 6 as excessive, so they did not even count toward deductible), and without the consideration of the lab and many hours on the phone, I would have already been in trouble before I ever hit my ultra-high deductible.
 
Interestingly enough, looking at where the 6 cores would have been if that was the number taken, I would not have shown up nearly as bad-off, and would have chosen a completely different, and likely inadequate, course of treatment.
 
Again, wait to get PCa until you are on Medicare unless you are retired military (I am not).

Post Edited (142) : 9/20/2010 5:36:50 PM (GMT-6)


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4235
   Posted 9/20/2010 6:50 PM (GMT -6)   
Juliet,
I have nothing to add to Tud's post. If your husband has current urinary issures then Brachytherapy may not be the best choice other than that as most studies have shown it has similar or better results than surgery across all grades with less short and long term side affects. You husband should be back to work the next day with no major issues.
JT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT


Aimzee
Veteran Member


Date Joined May 2010
Total Posts : 1406
   Posted 9/23/2010 11:13 PM (GMT -6)   
Welcome Julie!  I left a message for you on the "Thanks to all..." but wanted to make sure you know there are WONDERFUL people here who will provide information and compassionate support.  In the AUGUST SURGERIES thread there is information on how many of the wives felt about the diagnosis and the method used to deal with prostate cancer.  Several of the guys joined us.
 
Feeling overwhelmed seems to be par for the course.  As you can see from my husband's stats, having the DaVinci (robotic) surgery was the wise decision.  Recovery varies from man to man, so it may be difficult to predict when your husband can go back to work.
 
I wish you both the best in making this decision.  Research and learn as much as you can.  I am still learning! 
 
Best regards,
Aimzee
 
 
Husband Ron, age 63
4/1/10 PSA 5.5 Prostate size = 50 cc.
Biopsy on 4/20/10 12 samples... Adenocarcinoma: 3 positive on right side, one core left base (5% ` 0.5 mm) - two cores of left lateral mid
(20% ~ 2mm, 10%, 10% ~ 1mm) - No Perineural Invasion
Gleason 6 (3+3)
Bone Scan/CT Negative (2 lesions on liver)
8/18/10 - Da Vinci Prostatectomy
Post Op: Gleason 7 (3+4)
Negative surgical margins and lymph nodes
Both nerve bundles spared
Catheter - 13 days

Post Edited (Aimzee) : 9/23/2010 10:17:47 PM (GMT-6)


Julietinthewoods
Regular Member


Date Joined Sep 2010
Total Posts : 309
   Posted 9/24/2010 10:26 AM (GMT -6)   
Thank you, Aimzee! I will go read that thread right now. We are totally overwhelmed, and I am getting more anxious instead of less so. I have more questions for the group, and am so impressed with the willingness of so many to offer advice and encouragement. Hopefully, someday we can give back instead of just taking!

Juliet

Aimzee
Veteran Member


Date Joined May 2010
Total Posts : 1406
   Posted 9/25/2010 2:07 AM (GMT -6)   
For me, it is an ongoing process!  I know the AUGUST SURGERIES thread is long, but maybe just read the first few pages.  Right away, you'll notice we all had lots of questions.
 
My husband was required to go to a conference, meeting with 6 different doctors.  All the different methods of treatment were presented.  The doctors evaluated his case, and surgery was recommended.  Then we had to decide which method of prostate removal would be used.
 
You are wise to do the research.   I  purchased, "How We Survived Prostate Cancer" and did not like what I read regarding Brachytherapy.  However, each couple must make the decision for themselves.  Some doctors will steer you into what they feel is the right way to go.
 
Fairwind, I was surprised but radiation was not recommended by the doctor explaining this treatment.  The difficulty of "salvage" surgery was an issue for Ron.
 
Juliet, just know that so many here do/did feel totally overwhelmed, especially in the beginning.  Also, you may be convinced that one method is the best, but Carter may not agree.  There are many here that will provide knowledge and support!  Again, good luck!
 
Aimzee
 
 


Husband Ron, age 63
4/1/10 PSA 5.5 Prostate size = 50 cc.
Biopsy on 4/20/10 12 samples... Adenocarcinoma: 3 positive on right side, one core left base (5% ` 0.5 mm) - two cores of left lateral mid
(20% ~ 2mm, 10%, 10% ~ 1mm) - No Perineural Invasion
Gleason 6 (3+3)
Bone Scan/CT Negative (2 lesions on liver)
8/18/10 - Da Vinci Prostatectomy
Post Op: Gleason 7 (3+4)
Negative surgical margins and lymph nodes
Both nerve bundles spared
Catheter - 13 days

Post Edited (Aimzee) : 9/25/2010 1:20:58 AM (GMT-6)

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