As i said i am 56 in good health and surgery looks like a nobrainer to me. if i have cancer, why would i wait?
Welcome to the site.
Newcomers here often are surprised by everybody telling them to take their time to do their research. It seems counter-intuitive, doesn't it, when you've got cancer in you? However there are good reasons in taking your time to figure out what to do next. The reasons for this are:
1. Prostate cancer is the slowest growing cancer by far - decisions are therefore not urgent, especially in the case of low volume low grade cancer that you seem to have.
2. You are making your decisions on biopsy results that may or may not be correct. Ideally you would organise an expert review of your biopsy slides. We have learnt that all pathologists are not equal and the person you want to rely on should have looked at thousand of prostate slides rather than 1000s of run of the mill diseases. Examples of expert pathologists include Bostwick and Epstein.
3. For someone with low volume, low grade cancer there are many treatment options. Surgery is the option that your urologist is likely to recommend as he/she is likely to be biased towards surgery. Surgery can be curative but a proportion of people come out the other side with incontinance issues and most with erectile issues. However there are other attractive options that you could explore, brachytherapy (seed therapy) is one of them. Less side effects but a similar likelihood of a cure. Or in suitable people even active survellience - carefully monitoring your cancer is an option because some low volume cancer does not progress.
4. If after reviewing your options you decide on surgery then you need to consider, which surgeon? The incidence of post-op issues is much lower in some surgeons than others - incontinance rates range from 2-40% depending on the surgeon. You need to research who has the best results and even if it means flying across the country it is worth going to them. You have your entire life to live with the consequences so finding a good surgeon is a decision that is not to be taken lightly. A similar story would be the case with brachytherapy - you would want the best you can get.
5. Read Read Read Read and Read ..... the internet, books, this forum.
The reason why people would tell you to slow down is that we have all been through that horrible feeling when we or our significant others got diagnosed. We remember how urgent it felt to get the cancer out. But you have time, a couple of months won't change the outcome of what happens to you. If you do 1.-5. you will need a couple of months but you will be making a treatment decision from a position of strength and knowledge and based on a clear understanding of your situation.
Hope this helps,
Husband's age: 52. Sydney Australia.
Family history: Mat. grandfather died of PC at 72. Mat. uncle died of PC at 60. He has hereditary PC.
PSA: Aug07 - 2.5|Feb08 - 1.7|Oct09 - 3.67 (free PSA 27%)|Feb10 - 4.03 (free PSA 31%) |Jun10 - 2.69. DRE normal.
Biopsy 28Apr10: negative for a diagnosis of PC however 3 focal ASAPs “atypical, suspicious but not diagnostic” for PC. Review of biopsy by experienced pathologist, 1/12 core: 10% 3+3 (left transitional), 1/12 core: ASAP (left apex)
Nerve sparing RP, 20Aug10 with Dr Stricker. Post-op path: 3+4 (ISUP 2005). Neg (margins, seminal vesicles, extraprostatic extension). Multifocal, with main involvement in the fibro-muscular zone. T2C.
Post RP PSA,
Lab 1: Sep10 – 0.02|Nov10 – 0.03|Dec10 – 0.03
Lab 2: Nov 10 - 0.01|Dec10 – 0.01
Post Edited (An38) : 2/6/2011 6:17:13 AM (GMT-7)