2nd opinion at the Mayo yesterday

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Gleason 6
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Date Joined Mar 2011
Total Posts : 876
   Posted 5/5/2011 10:20 AM (GMT -6)   
I saw Dr. Wehle, a Urologist, at the Mayo yesterday. He was recommended by another doctor at the Mayo that we know. He has done over 500 Robotic prostate operations. On the ride down with my wife, I told her that my preference right now is seeds. Less time out of work, less evasive, less side effects and about the same cure rate.

First his PA came in looked at the biopsy and said that surgery would be the best choice for me and they probably would not be able to have to spare the nerves on the left side because that is where most of my cancer is. He also said that he wanted me to know that at the Mayo, they are not paid by how many operations they do and they want what is best for the patient. I have a tendency to think some PA's are doctor want to be without the education, so I take them with a grain of salt.

Then Dr. Wehle came in. He said that AS is not an option for me with a G6 and that surgery is the best option for me. Most important is 1) take care of the cancer 2) incontinence 3) ED; in that order. He said that radiation never bests surgery and there are less problems with surgery. Radiation may have as good a survival rate, but never is better. He said that he can fix problems caused by surgery, but not problems caused radiation. He said once the radiation is complete, the radiation oncologist's job is complete and they do not have to deal with the problems. The urologist is the one the patient sees if there are problems (and that makes sense to me) and he sees a lot of problems from radiation ( 3 patients a week - is what I think he said). If things go wrong with radiation such as radiation burning through the rectum, I'll be peeing out my butt or if radiation hitting the bladder and there is nothing he can do to fix it. If surgery fails, I would have radiation as a backup. With radiation only have HT as a backup. They have my slides from the biopsy, but have not read them yet and he will call me when they do.

Surgery: Hospital stay 1-2 days. Catheter out after 7 days. 2% need transfusion. Can save nerves 80% of the time and said that probably can save nerves on both sides with a G6 (contrary to what the PA said). 90% of patients are continent within 6 weeks. Spontaneous erections could take up to 1 - 2 years (and I did not write down the % of total ED if nerves are spared). I asked about ejaculating urine and he said that can be the case, but not in most cases. I asked about penis shrinkage and he said that can be true, but that comes from lack of use and the sooner you use it (PT) the less that would be a factor.

Radiation: They do IMR and not seeds (usually) anymore. I'm not sure I could go 5 days a week for 8-10 weeks. I have an appointment for May 20th to see Dr. Buskirk (radiation oncologist) at the Mayo.
Age 61
PSA 4.3 9/10
PSA 5.5 2/11
PSA 7.1 3/11
Template Biopsy 6 pos out of 40 3/25/11 GS 6 (3+3)
CT bone scan neg
6/18 areas positive - 2 in left base, 4 left apex. 6/40 cores pos. 33cc.
Stage T1C
Meeting with Dr. Wehle @ Mayo 5/4/11

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4183
   Posted 5/5/2011 11:09 AM (GMT -6)   
G6...sounds like the urologist was a pretty good salesman for surgery.  That should be no surprise since he is a surgeon...sounds like some of the same hype I got from one of the uro-surgeon-salesmen that I saw.  Glad you are going to see the radiation oncologist as well so you should have a balanced perspective by the time you have to make an educated decision.
 
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

Julietinthewoods
Regular Member


Date Joined Sep 2010
Total Posts : 309
   Posted 5/5/2011 11:19 AM (GMT -6)   
Wow. That was kind of a hatchet job on radiation. I am glad you plan to see a radiation oncologist, and I think you will hear a different story. I would never presume to tell you what to do, and only know as much as everyone else does from reading, but that strikes me as an unbalanced viewpoint.

Incidentally, did this urologist/surgeon specify exactly what problems he treats in radiation survivors? Problems resulting specifically from brachytherapy, or from the older external beam therapy used in the past? Be sure and ask the radiation oncologist what your options would be from failed seed treatment as well. HT is not the only option.

Good luck in your decision-making. It can all be so confusing and seems a shame to me that the patient is left with so much of the burden of sorting through the conflicting reports/accounts/expert opinions and making any kind of confident choice.

Juliet

JNF
Veteran Member


Date Joined Dec 2010
Total Posts : 3794
   Posted 5/5/2011 11:25 AM (GMT -6)   
Sounds like clear surgeon bias. If he doesn't spare the nerves how is he going to fix the damage to incontinence and ED he claims he can do?

Please talk to a good radiology oncologist about IMRT, low dose brachytherapy, and high dose brachytherapy. Log on to www.cetmc.com and see what HDR brachytherapy can do and how you may qualify for monotherapy. Just as effective as surgery with less side effects.

The argument that if surgery fails they can radiate but if radiation fails they can only do HT just does not hold water. If radiation fails it is usually because the PCa is systemic and in that case neither surgery or radiation would have been successful.

If he says he can't spare nerves I interpret that he is essentially predicting positive mnargins that will require radiation and the very risks he wants you to avoid. So why is radiation so bad as a primary treatment but so good as salvage? Why would a person want to go through the risks and damage of surgery when they have a good chance of also having to undergo the risks and damage of radiation? Start with radiation and limit yourself to one set of risks.
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.
PSA <.1 on 4-7-2011

Fairwind
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Date Joined Jul 2010
Total Posts : 3783
   Posted 5/5/2011 11:33 AM (GMT -6)   
"I asked about penis shrinkage and he said that can be true, but that comes from lack of use and the sooner you use it (PT) the less that would be a factor."

MANY men on this forum will testify that THAT statement is BS...My penis was an inch shorter when I woke up after surgery and it still is.....

I love it when the Urologists, Radiation Oncologists and Medical Oncologists start fighting over who gets a bigger slice of the PC pie....I DO know they all enjoy badmouthing each other...
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

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 5/5/2011 11:46 AM (GMT -6)   
You guys amaze me sometimes. Gleasson6 goes to the Mayo (who would doubt their credibility?) and all I see is folks here trashing the opinion he was given. How do you know that surgery isn't the best choice for him? You aren't the doctor, you don't know all the facts. I find this amazing considering that most of the men here at HW are surgery patients. A lot of what the doctor told him is true a lot of the time. And he is going to get a Radiation opinion next.

This doctor was 100% right on one point, when the RO finishes messing you up (as happened to me in a drastic way), I litteraly got dumped by the RO and Radiation clinic back on my Uro's doorstep. They didn't ( and still haven't) given a rat's hair about all the pain and damage that they directly caused. It was my Uro's compassion and care that kept me going after SRT, and even now. And the radiation made the most money out of all my treatments and operations. My uro has spent part of his long career fixing the damaged patients from radiation, which can be a very difficult task.

The penis shrinkage issue is an urban myth in my opinion. The way it was explained to me, that after prostate removal, the bladder's angle is changed where the bladder neck joins the urethra, and the bladder has one less "mounting point". The weight of the bladder pulls back in a small amount in the flacid state of the penis. So it appears shorter. Since I have never experienced any ED, I will attest, that in the errect state, my penis length is 100% pre-surgery, but in the flacid state, it is a tiny bit shorter. My uro/surgeon drew me a picture after surgery to explain how this worked.

Some of the posts to this thread, shows me that people have their own built-in bias, and they can't see past them to look at the bigger picture. That's not helpful too someone that is trying to make an informed and intelligent and tough primary treatment decision.

The surgery vs. radiation debate will go on forever. This doctor has the priorities right: cancer first, incontinence second, and ED third. The best treatment is the one that has the highest means of eradicating the cancer. Who can disagree with this?

Was real disapointed with the bulk of the answers on this thread.

Gleason6: I feel you are doing your due dilligence, and should continue to do so. When you decide in the end, I am sure that you will make the best choice for your self and your particular circumstances.

People should stop playing "doctor" and let the doctors be the doctors. We are here for support and encouragement, or at least I thougth that was the original game plan.

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 margin
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, 4/11 3.81
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

Julietinthewoods
Regular Member


Date Joined Sep 2010
Total Posts : 309
   Posted 5/5/2011 12:29 PM (GMT -6)   
David, I went back and reread my post to see if I had been 'playing doctor'. While I do see validity in what you say, I also want to point out that, in our case, this website helped us with information seeking and opinions that pointed my husband and me to sources on which to base our decision. The support and encouragement was equally important, but not all we wanted. If I went back now and reread my first post here asking for opinions, I have a feeling that I would find the majority telling of good experiences with surgery. I wasn't offended at all, just grateful...and that isn't the decision we made!

But the things you said made me feel uncomfortable enough to decide not to respond to this type of post anymore, like I already decided not to respond to the Tony/Bob posts. I think I should just stick to the 'congrats' threads. :)

Gleason 6, I apologize and hope I didn't confuse issues for you. Things are just all around hard enough.

Juliet

JoeFL
Regular Member


Date Joined Oct 2009
Total Posts : 420
   Posted 5/5/2011 12:37 PM (GMT -6)   
G6,

I started out thinking surgery and switched to a combo of seeds/IGRT. I have admitted in prior posts a bias for this type of treatment for G6 guys based on my personal experience and what I have learned here on HW over the last year and a half as far as cure rates and SEs are concerned.

Mayo has an excellent reputation. As it turns out, I live between two doctors on the staff at Mayo. One of them told me that if he were a G6, he would do BT. The other said the cure rates were comparable and he wasn't sure what he would do. (My treatment was not done at Mayo)

In the end, there are no guarantees regardless of the treatment you choose. After doing all the due diligence, it comes down to what feels right to you. Best wishes with the choice.

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. 25 IGRT sessions ending 3/22/10 - some fatigue until 30 days after last treatment. PSA as of 4/14/11 - 0.1

JNF
Veteran Member


Date Joined Dec 2010
Total Posts : 3794
   Posted 5/5/2011 12:49 PM (GMT -6)   
My rad-onc has me on the same schedule as my uro and med-onc.   I am not being dropped by anyone.
 
My rad-onc is not done as he needs to monitor me for long term effectiveness and side effects.   Plus if I have a recurrance in the prostate area I may need another round of HDR brachytherapy.   If my PCa spreads I may need radiation to lymph nodes, bone, etc.
 
No way he is dropping me and I think any urologist that would claim that is simply dead wrong.   After all, isn't the urologist's job done after the surgery?    Shouldn't the urologist dump the patient then?   He isn't going to operate again.   If salvage RT is needed then the rad-onc comes in.  If it metastizes then the med-onc comes in.   Not the uro.
 
I stand by my original statement that the uro is biased and handing out misinformation.
 
In my case I reserved judgement and decisions about treatment until I had seen two urologists, two rad-oncs, and two med-oncs.   I wasn't smart enough to think that one through by myself.   It was the requirement of my urologist in order for him to take me as a patient. 
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.
PSA <.1 on 4-7-2011

Gleason 6
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Date Joined Mar 2011
Total Posts : 876
   Posted 5/5/2011 1:32 PM (GMT -6)   
Funny. I really wanted to do the seeds and will reserve my decision until after I talk to the radiologist. After talking to the urologist I was disappointed with what he had to say about radiation and I do feel like he has credibility with the recommendations we got for him and the fact that he is a Mayo doctor. Maybe I'm just looking for the "easy" way out of this mess and seeds seem to fill that bill for me. I believe that both radiation or surgery if done correctly with no complications during the procedure have about the same "cure" rate. Purg, you seem to be one of the few who had problems with radiation (here at HW), but who knows how many more are out there and it scared me when I thought about the "what if something does go wrong" possibility. I also thought it was a good point about the urologist being the one who sees the problems. However, I should have pressed him further (hindsight is 20/20) about what the complications are (although I did mention a few in my original post) and he led me to believe that he sees 3 or so new cases a week. Now, 3 cases a week that are referred to him from "radiation gone wrong" (sounds like a scary movie) from around the country sounds like a lot, but he works at the Mayo and may see more than the average urologist. It will be interesting to see how I feel after talking to the radiation oncologist.

I do appreciate all of the comments and views and opinions from you survivors that have been through all of this. I know that the opinions here may not be the same for all people, but at least it's something to go on. I don't like it so much when the arguments turn to who makes the most money kind of thing (although that may be a factor in what is recommended) because that strays from helpful opinions and insight. If someone feels strongly that radiation or surgery is good or bad and states why or what their experiences were, I think it is helpful (at least to me).
Age 61
PSA 4.3 9/10
PSA 5.5 2/11
PSA 7.1 3/11
Template Biopsy 6 pos out of 40 3/25/11 GS 6 (3+3)
CT bone scan neg
6/18 areas positive - 2 in left base, 4 left apex. 6/40 cores pos. 33cc.
Stage T1C
Meeting with Dr. Wehle @ Mayo 5/4/11

clocknut
Veteran Member


Date Joined Sep 2010
Total Posts : 2670
   Posted 5/5/2011 1:32 PM (GMT -6)   
JNF, you said, "If he says he can't spare nerves I interpret that he is essentially predicting positive margins that will require radiation and the very risks he wants you to avoid."
 
I don't think that's true.  For one thing, it was the PA who told Gleason 6 that the surgeon would probably not be able to spare the nerves on one side.  I take PA's statements with a grain of salt.  This past winter, the PA at the orthopedic surgeon's office told me that my problem was certainly a rotator cuff injury.  Then the orthopedist himself came in and said, no, the injury I had suffered mimiced a rotator cuff injury, but that my symptoms were actually being caused by two herniated discs in my neck.  The surgeon actually told Gleason the nerves can be saved 80 percent of the time, and especially in the case of a G6.
 
In my own case, the surgeon told me in advance he would likely not be able to save the nerves on my left side, because of the obvious tumor there.  It wasn't a question of a positive margin, but a question of taking a safe approach when the nerves were essentially lying right on top of the tumor area.
 
I've begun to feel concerned when we second guess newcomer's doctors.  I'm not talking now about anyone in particular at all.  But, none of has even seen the one-page medical history we all have to fill out before we see the doc.  We haven't laid eyes on the patient.  We don't know what other physical conditions the patient may present with.  We don't know what medications they are on.  We don't know their blood sugar levels, their cardiac condition, their blood pressure, their weight, or anything about them.  In fact, what we know is about like peeking thru the keyhole of the doctor's office.  And then we sometimes suggest that the doctors are just trying to pad their own wallets and buy a new Porsche, or call them "salesmen" and so forth.  I think we often go way too far in advocating for our own particular points of view rather than just making suggestions that they look into other treatment options. 
 
I don't mean to say this site isn't the best around.  I think it is, and it provides a tremendous amount of support.  But we're not M.D.s, and we sometimes get beyond our depth.  IMHO
 
 
 
 

Gleason 6
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Date Joined Mar 2011
Total Posts : 876
   Posted 5/5/2011 1:59 PM (GMT -6)   
Joe67 did you get your treatment in FL? If so where, if you don't mind and why not Mayo?
Age 61
PSA 4.3 9/10
PSA 5.5 2/11
PSA 7.1 3/11
Template Biopsy 6 pos out of 40 3/25/11 GS 6 (3+3)
CT bone scan neg
6/18 areas positive - 2 in left base, 4 left apex. 6/40 cores pos. 33cc.
Stage T1C
Meeting with Dr. Wehle @ Mayo 5/4/11

Gleason 6
Veteran Member


Date Joined Mar 2011
Total Posts : 876
   Posted 5/5/2011 2:29 PM (GMT -6)   
Gosh, it seems like there has got to be a better way to make this critical decision. Maybe a database on the web that compiles all statistics from all doctors and radiologists who perform procedures and give accurate counts of success, side effects, mistakes, complications, etc. Maybe one of us could invent something.
Age 61
PSA 4.3 9/10
PSA 5.5 2/11
PSA 7.1 3/11
Template Biopsy 6 pos out of 40 3/25/11 GS 6 (3+3)
CT bone scan neg
6/18 areas positive - 2 in left base, 4 left apex. 6/40 cores pos. 33cc.
Stage T1C
Meeting with Dr. Wehle @ Mayo 5/4/11

reachout
Veteran Member


Date Joined May 2009
Total Posts : 725
   Posted 5/5/2011 2:30 PM (GMT -6)   
For what it's worth (not much) the radiation guy I saw thought I would do better with surgery. I think sometimes we get too paranoid at thinking the doctors are completely biased towards what they do best. I think in most cases they give us the straight scoop as they best know it.
Age: 66
PSA: 7 tests over 2 years bounced around from 2.6 to 5.6
Biopsy 8 of 12 positive, Gleason 3+4, T2a
DaVinci August 2009, pathology Gleason 4+3, neg margins, T2c
Continent right away, ED
Viagra, Cialis did't work, Trimix works well
Post-surgery PSA:
3, month: undetectable <.1; 6 month: undetectable <.014 (ultrasensitive); 9, 12, 15 month: undetectable <.1; 18 month detectable .05

medved
Veteran Member


Date Joined Nov 2009
Total Posts : 1096
   Posted 5/5/2011 2:40 PM (GMT -6)   
One of the good things about a place like Mayo is that the docs are all on salary, so they don't have an economic incentive to recommend one kind of treatment over another. Of course, they may have other "biases" (such as a belief in their own specialty) but at least the "financial bias" is eliminated. Perhaps because of this, Mayo docs are well-known for working collaboratively among specialties. If the Mayo RO recommends radiation to you, it would be interesting for you to request (1) an appointment at which both docs are present, with you, or (2) that the two Mayo docs confer with one another and provide a consensus recommendation.

Architect
Regular Member


Date Joined Apr 2011
Total Posts : 43
   Posted 5/5/2011 3:05 PM (GMT -6)   
My urologist is a surgeon, and recommended me for robotic prostatectomy. HOWEVER, she refused to perform the surgery (or to refer me to someone local). Instead, she referred me to a more specialized location with great experience.

This made my decision easier, because she clearly wasn't trying to benefit from the operation and will have to deal with the consequences of someone else's work after the fact.

My decision has been based upon these factors:

1) I want to have the cancer REMOVED from my body.
2) Robot assisted surgery (performed by good surgeons) has really high rates of potency and low rates of incontinence. (I keep hearing 80%+ potent, and 2-10% with incontinence issues from three separate locations: IU, Vanderbilt, and Barnes-Jewish).
3) I have the option of radiation as "salvage therapy" later.

I hope to a nerve sparing RALP in late June.

142
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Date Joined Jan 2010
Total Posts : 6982
   Posted 5/5/2011 3:11 PM (GMT -6)   
Have to agree to a point with reachout - the RO I consulted first with gave me less than good prospects. She pushed RT above surgery, but admitted the numbers were not as good.
 
A very major (has to remain unnamed) high-profile cancer center turned me down when I did a consult for Proton or seeds - said I should do surgery.
 
I think that doctors suggest what they know. That is the reason we go see multiple doctors for each treatment path.
 
But I also agree with David - support means, in my mind, that we help each other understand what our doctors are saying, not offer a new diagnosis.
 
And yes, G6 is right, this is one of the few diseases where there is no clear path to follow. Reminds me of the drawing of the castle where all steps going up or down connect back to themselves. I am still as confused as I was the first day about what the "right" treatment was. I picked one, then another picked me, so what's done is done, but I doubt I'll ever know if I made the "right" choices.

reachout
Veteran Member


Date Joined May 2009
Total Posts : 725
   Posted 5/5/2011 3:11 PM (GMT -6)   
OhioState, you didn't see my radiologist
Age: 66
PSA: 7 tests over 2 years bounced around from 2.6 to 5.6
Biopsy 8 of 12 positive, Gleason 3+4, T2a
DaVinci August 2009, pathology Gleason 4+3, neg margins, T2c
Continent right away, ED
Viagra, Cialis did't work, Trimix works well
Post-surgery PSA:
3, month: undetectable <.1; 6 month: undetectable <.014 (ultrasensitive); 9, 12, 15 month: undetectable <.1; 18 month detectable .05

Architect
Regular Member


Date Joined Apr 2011
Total Posts : 43
   Posted 5/5/2011 3:11 PM (GMT -6)   
I don't know why my signature doesn't always show up here, but since it didn't attach to my post above....

DX 4/26/11 (Age 36)

6/15/09 PSA 2.1
3/17/11 Lost Father to Complications of PC and Bone Cancer (Age 59)
3/30/11 PSA 2.5 & Abnormal DRE (Nodules felt) found during post-op for extracorporeal lithotripsy procedure
4/18/11 Biopsy
4/26/11 Biopsy Results = 3 of 12 Cores Positive (both lobes) with Gleason 6 (3+3)
5/5/11 CT & MRI = Negative for metastatic cancer

reachout
Veteran Member


Date Joined May 2009
Total Posts : 725
   Posted 5/5/2011 3:37 PM (GMT -6)   
Ohio State, didn't mean for my post to be personal. Just pointing out that not all radiologists recommend radiation etc. But I agree with you that the vast majority do, just as the vast majority of surgeons recommend surgery. In my opinion, though, I think they do this because that's what they know. You know the old saying if you're a hammer everything looks like a nail. But I do think they recognize thise cases where they would do more harm than good and send them to the other guy. In my case I had high volume cancer and the seeds guy didn't think he could get it all. He did say that I could still have radiation if I wanted it but should have seeds + IMRT + HT. Or I could choose surgery then go SRT if that failed which is what I did.

Peace.
Age: 66
PSA: 7 tests over 2 years bounced around from 2.6 to 5.6
Biopsy 8 of 12 positive, Gleason 3+4, T2a
DaVinci August 2009, pathology Gleason 4+3, neg margins, T2c
Continent right away, ED
Viagra, Cialis did't work, Trimix works well
Post-surgery PSA:
3, month: undetectable <.1; 6 month: undetectable <.014 (ultrasensitive); 9, 12, 15 month: undetectable <.1; 18 month detectable .05

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 5873
   Posted 5/5/2011 3:47 PM (GMT -6)   
dont see where sparing the nerves have anything to do with continence/incontinesnce, only effect ed outcome, check it out ! Its another part of the operation, less you mean accedetly cutting urethra in surgery
Diagnosed 8/14/09 psa 8.1 66,now 67
2cores 70%, rest 6-7 < 5%
gleason 3+ 3, up to 3+4 @ the dub
RPP U of Wash, Bruce Dalkin,
pathology 4+3, tertiary5, 2 foci
extensive pni, prostate confined,27 nodes removed -, svi - margins -
99%continent@ cath removal. 1% incont@gaspass,sneeze,cough 18 mos, squirt @ running. psa std test reported on paper as 0.0 as of 12/14/10 ed improving

F8
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Date Joined Feb 2010
Total Posts : 3836
   Posted 5/5/2011 4:02 PM (GMT -6)   
G6 -- did they tell you your penis would be 1-2" shorter after surgery cool ?  seriously if you are truly a G6 either surgery or radiation would work for you.
 
ed
 
 
age: 56
PSA on 12/09: 6.8
gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10
2/8/11 PSA <.1, T= 6 ng/dl

John T
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Date Joined Nov 2008
Total Posts : 4237
   Posted 5/5/2011 4:03 PM (GMT -6)   
I'm with Tud on this one; sounds like a strong doctor's bias towards surgery along with a lot of misinformation. My radiologist hasn't dropped me; I see him once a year and email him any questions I have and he always responds the same day. If any problems would arise I would go to him 1st then my oncologist. The things he told you just are not supported by facts; of course there are always issues in any treatment. The Brachy patients on this and other forums have had very few issues. Nerve involvement is one of the reasons I had Brachy. ED was a foregone conclusion with surgery and was never an issue with Brachy.
JohnT
66 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, 4 weeks of urinary frequency and urgency; no side affects since then. 2 years of psa's all at 0.1.

compiler
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Date Joined Nov 2009
Total Posts : 7213
   Posted 5/5/2011 5:22 PM (GMT -6)   
Well, when I had my last meeting with the RO, he did say I could call him with any post-SRT problems but most likely he would be referring me to the proper medico.
 
For example, if I have rectal bleeding in 3 months, he would send me to a GI expert.
 
Really, the RO's job is done once radiation is over.
 
Mel

davidg
Veteran Member


Date Joined Feb 2011
Total Posts : 4093
   Posted 5/5/2011 5:48 PM (GMT -6)   
Gleason 6 - sounds like great advice to me. You must feel comfortable with your choice above all and find someone who is great at what they do. I can confirm that I'm doing even better than what this doc says will be probable outcome. Good luck with your choice.
40 years old - Diagnosed at 40
Robotic Surgery Mount Sinai with Dr. Samadi Jan, 2011
complete urinary control and good erections with and without meds
Prostate was small, 34 grams.
Final Gleason score 7 (3+4)
Less than 5% of slides involved tumor
Tumor measured 5 mm in greatest dimension and was located in the right lobe near the apex.
Tumor was confined to prostate.
The apical, basal, pseudocapsular and soft tissue resection margins were free of tumor.
Seminal vesicles were free of tumor.
Right pelvic node - benign fibroadiopse tissue. no lymph node is identified.
Left pelvic node - one small lymph node, negative for tumor (0/1)

AJCC stage: pT2 NO MX
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