Met with radiologist oncologist at Mayo yesterday

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

Gleason 6
Veteran Member


Date Joined Mar 2011
Total Posts : 876
   Posted 5/18/2011 7:55 AM (GMT -6)   
My wife and I met with Dr. Buskirk at the Mayo yesterday. He was referred by the urologist (Dr. Wehle) I saw a week and a half ago at the Mayo. We really liked him and thought Dr. Buskirk was knowledgeable, took his time with us and presented what he saw as my options clearly.

He did not suggest AS because of my age. He said that surgery or seeds would be his two top choices for me. I documented what the surgeon, Dr. Wehle, had to say in an earlier post Click here for that link .

He went on to explain that at the Mayo they do mostly IGRT, which is a nice fit for someone older than me (living in FL can make you feel young sometimes :) even at my age!). He went on to clearly explain IGRT which he said would be his third choice for me.

As far as seeds he suggested that I see Dr. Turk at the FROG (Florida Radiation Oncology Group). He said that he knows Dr. Turk and Dr. Cesaretti very well and both trained with the Mt. Sinai group (under Dr. Stock?) and do hundreds of seed procedures a year. He said that the seed procedure is highly operator dependent as is surgery. I asked about the fact that Dr. Wehle said that he sees the problems caused by radiation that can not be repaired and Dr. Buskirk said that is why you want someone performing the operation that is highly skilled and has performed many seed procedures. He also said that people come to the Mayo and Dr. Wehle (who he knows well and say is an excellent urologist and surgeon) sees case from all over the county that have had procedures done at facilities that are less than stellar and hope to have them fixed by Dr. Wehle.

He said that they had problems with seeds early on, but have refined the seed procedure over the years and now have a better template for insertion of the seeds. He said that 15 years out surgery has about an 80% "cure" rate and seeds have a 90% cure rate. If surgery fails I have radiation as a back up. If seeds fail I have HT as a back up (although there other drugs in the pipeline - please excuse my spelling but some of them were Casadax, Kedochomosole, Provenge). When I asked why seeds over IGRT he said because of my age, size of my prostate (33cc), I don't have any urinary flow problems, no flow problems after the biopsy, my PSA <10, Gleason 6 and they can put a higher dose of radiation with seeds than IGRT. He said that leakage is not a problem and does not get worse over time. He said that ED can get worse over time because the radiation constricts the blood vessels over time and is accelerated by aging, but ED drugs usually do help. He said there would be some possible burning and urgency at night for a period.

I asked about my rapidly rising PSA and he said that I could do another test, so I did. I told him I was concerned about going from 5.5 to 7.1 in a month. He asked if it was after a DRE and I said yes and he had even stimulated my prostrate to get fluid from it for a test. I'm nervous that the PSA will come back higher that the 7.1, but I would like to know what it is and if the 7.1 is an upward trend or a one time occurrence.

Bottom line is that he thought my chances were very good with either surgery or seeds. I asked him what he would do and he said it would be a tough choice and both would be good with my stats. I came away feeling good about my choices. Now my next step is to see Dr. Turk at FROG. I am leaning towards seeds at this point because: 1) less invasive (outpatient procedure similar to biopsy), 2) same (or better) "cure" rate over 15 years, 3) no incontinence problems, 4) less initial ED problems, 5) no catheter after procedure, 6) back to work quicker. I will wait to make my decision until I see Dr. Turk. Any suggestions on what I should ask Dr. Turk?
Age 61 Active. No other problems (except small hernia)
PSA 4.3 9/10
PSA 5.5 2/11
PSA 7.1 3/11
PSA 6.73 5/18/11
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
Met with Dr. Wehle @ Mayo 5/4/11
Met with RO Dr. Buskirk at Mayo 5/17/11
Will Make an appointment with Dr Terk at FROG

Post Edited (Gleason 6) : 5/18/2011 9:45:29 AM (GMT-6)


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4157
   Posted 5/18/2011 9:08 AM (GMT -6)   
Dear G6:
 
Based on what I know and have experienced, I think you got the right scoop from Dr. Buskirk.  With your stats, any of the primary treatments should be successful in curing your cancer but brachy is the one that is likely to provide you with the best overall quality of life after treatment.  Dr. Terk (note spelling) is well known and well respected in the brachy world and I understand he performs 200-300 procedures each year so he is highly experienced.
 
As for questions, the basic ones are the ones you have been asking so far, i.e. chances for cure, side effects, quality of life, etc.  You then probably want to ask specifics about the brachy process so you are well prepared should you decide on this treatment.
 
Also, feel free to copy and paste my "journey" at the end of my signature for my blow-by-blow experience in this area.
 
BTW, I am unabashedly pro-brachy based both on my research and my experience.  Some men just need the "get it out of me" approach and some men have the need to know and understand their exact pathlogy via surgery.  I understand and respect those points of view.  And, some men just are not good candidates for brachy alone (big prostates, advanced cancer, etc).  But, for those who meet both the physical and psychological criteria, it's a great choice IMHO.
 
In any case you are touching all of the right bases, doing all of the right research and becoming an educated patient who can make an informed decision...good for you!
 
Best of luck and let us know what you decide.
 
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

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 5/18/2011 9:18 AM (GMT -6)   
I agree with Tud. You got a good consultation, and some good advice. You seem like an ideal candidate for seeding, I so wished I had had the numbers to do it at the time, but I didn't. Good luck as you continue through the thinking process.

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

Gleason 6
Veteran Member


Date Joined Mar 2011
Total Posts : 876
   Posted 5/18/2011 9:35 AM (GMT -6)   
Just in (from 5:00 last night - wow that was quick!) PSA 6.73
Age 61 Active. No other problems (except small hernia)
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
Met with Dr. Wehle @ Mayo 5/4/11
Appointment scheduled with RO Dr. Buskirk at Mayo 5/17/11

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3804
   Posted 5/18/2011 9:40 AM (GMT -6)   
G6 -- if you could break that first post up into paragraphs it would be a lot easier to read cool .
 
i was also an excellent candidate for seeds except for the volume of my cancer.  so we instead did seeds and IGRT as well as lupron.  it sounds like you were well-advised.  good luck in making your decision.
 
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

overthepond
Veteran Member


Date Joined Apr 2011
Total Posts : 648
   Posted 5/18/2011 10:27 AM (GMT -6)   
The new PSA result is encouraging in that it hasn’t leapt up again.
Pleased to hear that Brachy is an option for you as I know you had previously said you were leaning towards that as a treatment.
Now time to digest all the facts, meet with Dr Terk, then make your decision.
Good luck with whatever you decide – but yes, we are unabashedly pro-brachy too. When we had digested all the information it was an easy choice for us and, so far, Brachy is doing everything it promises on the tin!

Age 62
Excellent health
First PSA test 7
Second PSA two months later 11
Biopsy results: Gleason 3+3 in two cores (right medial 30% and right apex 90%)
PSA11 with small benign-feeling prostate
10 Feb 2011 – Brachytherapy – Iodine 125
16th May 2011 - PSA 3.83

Gleason 6
Veteran Member


Date Joined Mar 2011
Total Posts : 876
   Posted 5/18/2011 10:30 AM (GMT -6)   
Purg,

With the problems you had with radiation, I'm surprised that you would be in favor of any kind of radiation.
Age 61 Active. No other problems (except small hernia)
PSA 4.3 9/10
PSA 5.5 2/11
PSA 7.1 3/11
PSA 6.73 5/18/11
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
Met with Dr. Wehle @ Mayo 5/4/11
Met with RO Dr. Buskirk at Mayo 5/17/11
Will Make an appointment with Dr Terk at FROG

JoeFL
Regular Member


Date Joined Oct 2009
Total Posts : 420
   Posted 5/18/2011 5:34 PM (GMT -6)   
G6,

Dr. Terk did my BT/IGRT treatment (along with my urologist). I responded to your recent email but haven't heard from you. The offer still stands.

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

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 5/18/2011 5:44 PM (GMT -6)   
Gleason6,

Radiation can be a very effective means of treating cancer, in both RT and Seeding. It can be effective for some in SRT situations, and it can be very useful for controlling pain from METs if they develop later.

What happened to me is rare, not the norm. It also had to do with me undertaking 2 major radiation treatments in a fairly short span of time, and having the last radiation, my SRT, not be administered correctly.

Despite my horror story, I would not discourage anyone from seeking radiation as a primary or secondary treatment.

Radiation, can and does go wrong sometimes, and some people are way more suspectible to radiation damage than others. Just like with surgical approaches to our disease, radiation has its share of risk for damage also.

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

Gleason 6
Veteran Member


Date Joined Mar 2011
Total Posts : 876
   Posted 5/19/2011 10:40 AM (GMT -6)   
Joe67,

I did get your email and appreciate the offer. I have some spare time at work to be on the forum and emails, but when I get home I'm in demand (kids, cooking, cutting grass, laundry...) and don't usually have a minute to myself until I lay down in bed to read for a bit and dose off 'till morning. My wife and I often say "We are lucky to have such full lives" LOL Man, I'm looking forward to having the kids in college and retirement...5 years and counting! I think you have reached that stage (and you're probably out golfing now), you dog!

I know from your posts that you were happy with Dr. Terk and your results. I'm looking forward to meeting him and listening to what he has to say.

Thanks.
Age 61 Active. No other problems (except small hernia)
PSA 4.3 9/10
PSA 5.5 2/11
PSA 7.1 3/11
PSA 6.73 5/18/11
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
Appointment with Dr Terk at FROG scheduled 5/26/11
New Topic Post Reply Printable Version
Forum Information
Currently it is Sunday, June 24, 2018 9:19 AM (GMT -6)
There are a total of 2,974,702 posts in 326,202 threads.
View Active Threads


Who's Online
This forum has 161301 registered members. Please welcome our newest member, Susie12.
353 Guest(s), 2 Registered Member(s) are currently online.  Details
torontolyme, Alxander