prostate cancer treatment

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ratman
New Member


Date Joined Mar 2011
Total Posts : 1
   Posted 3/14/2011 9:39 AM (GMT -6)   
I have prostrate cancer and am in the process of determining the treatment I want to take care of the problem. I have narrowed it down to brackotherphy and removal by robot. My Gleason score is 6 my cancer was found in only 1 biopsy out of 12 and my PSA is 8.9. I am leaning toward Brackotherphy. I would like to hear hear pros and cons on either treatment on anyone that has had either of these treatments.
 
Ratman

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 3/14/2011 10:30 AM (GMT -6)   
welcome aboard, ratman.

sorry you need to be here, but glad you found us.

In the one core that had cancer, do you recall what % of cancer was found?

Both methods would be suitable for a primary treatment. There are several men here that are very happy with their seeding treatments, and it is way less invasive than either type of surgery. I had open surgery myself

The good thing, with your numbers, you got plenty of time to research and think your way through the maze of optons.

Please keep us 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 2/11 1.24
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10,

GTOdave
Regular Member


Date Joined Oct 2010
Total Posts : 175
   Posted 3/14/2011 12:22 PM (GMT -6)   
If you want help here, please allow me to suggest that there is much more info you can post that will help us help you.

Your age is a huge component in any decision criteria. Overall health, etc.

BTW, I have a pet peeve. We have/had PROSTATE cancer, not prostrate cancer. Drives me nuts when it gets misspelled.
52 yr old, PSA 3.5, Gleason 6 with 3 of 4 top nodes (0%;1%;10%;1%) cancerous. Bottom 2 floors are clean.

DaVinci surgery at Yale 3/4/11.

45 gram gland weight
Gl 3+3
T2C
margins clear
no metastis
5% of gland aedenocarcinoma

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3887
   Posted 3/14/2011 12:49 PM (GMT -6)   
At the top of this forum are 4 permanent threads..One of them lists some VERY helpful resources including BOOKS..Some of these books will provide you with a much better background you will need when making treatment choices.. Dr. Walsh and Dr. Chodak will lead you out of the PC wilderness and the people on this forum will be happy to answer any detailed questions you may have, especially in regards to how these treatments worked on them.....Welcome to the forum and good luck to you...
Age 68.
PSA age 55: 3.5, DRE normal.
age 58: 4.5
61: 5.2
64: 7.5, DRE "Abnormal"
65: 8.5, " normal", biopsy, 12 core, negative...
66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
67 4.5 DRE "normal"
68 7.0 3rd biopsy positive, 4 out of 12, G-6,7, 9
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT. 2-15-'11 PSA 0.0

Highwayman
Regular Member


Date Joined Sep 2010
Total Posts : 148
   Posted 3/14/2011 1:31 PM (GMT -6)   
Ratman,
In my own personal journey my doctors told me that my prostate was too large for Brachytherapy in their opinions. I went with a laproscopic surgury. I wish I had been able to do the seeds. Each treatment has its issues.
I have to use a pump before my wife and I can have sex.
Age 48 w/diagnosed
10/06 PSA 3.0
11/06 PSA FREE %13.2
10/07 PSA 3.4
12/07 Biopsy-neg
1/09 PSA 4.6
6/09 psa 5.8
2/10 psa 8.7
7/10 PSA 10.8
8/2010 3rd biopsy GG 3+3=6, one of eight cores -2%
Lap 10/22/10 Dr. Troxel
Path- Neg Margins, Gleason 6, Nerves spared, 85 gm
Jan 20, 1 pad/day psa < 0.1, ed an issue

JNF
Veteran Member


Date Joined Dec 2010
Total Posts : 3880
   Posted 3/14/2011 1:41 PM (GMT -6)   
In your research I sugest you also look at High Dose Radiation brachytherapy. This is the version that does not leave the seeds in the body. They can use it even with large prostates and pubic arch problems that are more difficult with the permanent seeds.

It shares the effectiveness of permanent seeds and surgery, but with fewer and less severe sifde effects as it is more accurate. The best information can be found at www.cetmc.com, the website of Dr. Jeffrey Demanes, a pioneer in HDR.
PSA 59 on 8-26-2010 age 60. Biopsy 9-8-2010 12/12 positive, 20-80% involved, PNI in 3 cores, G 3+3,3+4,and 4+3=G7, T2b.
Eligard shot and daily Jalyn started on 10-7-2010.
IMRT to prostate and lymph nodes 25 fractions started on 11-8-2010, HDR Brachytherapy 12-6 and 13-2010.
PSA <.1 and T 23 on 2-3-2011.

JoeFL
Regular Member


Date Joined Oct 2009
Total Posts : 420
   Posted 3/14/2011 1:52 PM (GMT -6)   
Ratman,
 
I had a combo of BT and IGRT...see my signature below. I have been very happy with this choice. Side effects were minimal and went away after several months for both the seeding and the 25 rad treatments. You have a lot of options....take your time and learn as much as you can before you decide. Regards,
 
Joe
Age 68 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 as of 12/9/10 - 0.1

tigre
Regular Member


Date Joined Sep 2010
Total Posts : 69
   Posted 3/14/2011 6:09 PM (GMT -6)   
ratman,
sorry you have this bridge to cross. i can only speak to the robotic prostatectomy. had mine in late 2009 and i can honestly say that the worst of it was getting over the anesthesia and the dreaded catheter. my gleason pre and post op was 3/3 (6). due to my age (45 at dx) i opted for the surgery and unfortunately had to follow that with rt. erections were starting to make progress before radiation. not so much afterward. staging was upgraded from t1 to t3a due to positive margin. if i had it to do all over i would not change anything however, each of our cases are different. you'll find tons of good information and support here by others much more knowledgeable than i. good luck whatever tx path you choose.

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4271
   Posted 3/14/2011 6:11 PM (GMT -6)   
Hi Ratman:
 
First of all, welcome to HW...glad you found us and however you spell it we are sorry you have our cancer.  I have a couple of thoughts along with answering your question:
 
1.  You might consider getting a second opinion on your biopsy slides just to make sure that your are staged correctly.  PCa pathology takes real expertise and it pays to make sure it is done correctly.  A couple of experts who do a lot of second opinions are Dr. Epstein at Johns Hopkins and Dr. Bostwick at Bostwick Labs.
 
2.  Assuming your pathology is correct you have plenty of time to make an educated decision and it is likely most any treatment will provide a cure.  I can recommend 3 books, by Walsh, Strum and Blum/Scholz that will give you a broad perspective of your disease.  Of course there are others but these are three good ones in my opinon.
 
3.  If you psych can handle it, you may want to consider Active Surveillance of your cancer.  You may just want to carefully watch it.
 
4.  Re brachytherapy, that was my choice.  The stats you provided indicate that you might be a poster boy for this.  Brachy may provide you with equal cure rates to surgery with much less onerous side effects.  Feel free to cut and paste my "journey" shown at the bottom of my signature if you would like to do so.
 
In any case, please feel free to ask any question you want and please let us know how you progress.
 
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 12/8/10. PSA: 6 mo 1.4, 1 yr. 1.0, 2 yr. .8. My docs are "delighted"! My journey:
http://www.healingwell.com/community/default.aspx?f=35&m=1305643&g=1305643#m1305643

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4268
   Posted 3/14/2011 7:36 PM (GMT -6)   
I have very little to add to Tud's post. Quality of life surveys indicate that those patients that have had Brachy are more pleased with their quality of life then those undergoing other treatments. With low risk prostate cancer, since it is not life threatening, side affects and quality of life should play a prime portion of all decision making. Active survelience has the least quality of life issues.
JT
65 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, no side affects and psa .1 at 1.5 years.

RCS
Veteran Member


Date Joined Dec 2009
Total Posts : 1268
   Posted 3/14/2011 9:11 PM (GMT -6)   
I've talked to a few guys who apparently did very well with Cyberknife. If you decide you must be treated (i.e. that you do not chose Active Survellince) you might want to look at CK. From what these guys tell me, it appears to have less side effects than brachy.

For a lot of reasons I chose Davinci, but woiuld agree that QOL side effects from surgery can be significant.
PSA 2007 - 2.8; 11/24/2008 - 7.6; PCa Dx 2/11/09; age at Dx 62; RLP 4/20/09
Biopsy - Invasive moderately differentiated prostatic andenocarconoma; G 3+3=6; PT2C; No evidence of Seminal Vesicle or Extraprostatic Involvement; Margins clear; Tumor identified in sections from prostatic apex. 70 gram prostate. Continent after removal of cath.
ED - Trimix works well; levitra @ 90%
PSA - <0.1, 1/17/11
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