Let me address your questions if I can;Who are Bostwick or Epstein and how do I do that?
Read the sticky for the newly diagnosed - you'll see links to their websites there. They are two expert prostate pathologists who run pathology labs that specialize in reading prostate biopsy specimens (other labs don't). Just tell the Uro who did your biopsy to send the slides to Epstein or Bostwick (pick one). It might run you about
$250 out of pocket if your insurance refuses."My dr didn't even say anything about bone scan and I also already had a ct scan."
You should have one to rule out that it has already spread to distant
locations. If it has, it is futile to put you through radiation therapy (hormone therapy + chemo would be a better option if there are known metastases.) It wouldn't hurt to get a second opinion on the CT scan of the pelvic lymph nodes.Wouldn't surgery be an option? Is radiation the better treatment? ...I just want this out and the sooner the better.
Based on the numbers, surgery is vastly inferior to radiation in cases like yours. Surgery can only cut out what's in the capsule and nothing outside -- only radiation can reach it there. Your reaction "I just want it out now" is very typical, but it is not the best route for you. With your Gleason 5s, I'd also worry about
spreading the cancer with the surgical equipment - probably not, but why take the risk?"My dr talked about radiation and seed radiation."
Right. They combine external beam radiation and brachytherapy. One kind of brachytherapy is commonly called seeds. There's another kind called high dose rate (HDR) brachytherapy. They can use either kind. Seattle is known as a world center for seeds - a lot of area brachytherapists were part of a group at UW Seattle/Hutchinson that developed the techniques widely used today....Walla walla and they scheduled me for a face to face on July 14th. That seems like a long way out. Shouldn't things be moving faster than that?
A couple of months probably won't make a difference. But, after you've had a bone scan (it has to be after), I think it would be good for your own peace of mind to get started with Casodex and/or a Lupron shot. That should arrest any further development for now, and you'll need it anyway in preparation for the radiation therapy.
The big name brachytherapist at UW Seattle is Kent Wallner
- (I think he's still there). You can call his office on Monday to check. Celestia Higano
is a big name in medical oncology there, and can help with the chemo. If you decide to go for the combo therapy, you can probably get the time-consuming external beam part of the treatment done locally, but I think you'll want to hear what some of the top doctors at UWSeattle have to say first. I don't know the doctors at Virginia Mason. I know a couple at Swedish.