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swu
New Member


Date Joined Oct 2006
Total Posts : 2
   Posted 10/23/2006 10:54 AM (GMT -7)   
I'm so glad to have found a forum with so much great advice and encouragement!  
 
My father recently was diagnosed with PC.  He's 65 and his latest PSA was 5.6 and he has a Gleason score of 3+3 and 4+3.  CAT and bone scan all negative.  Another kicker to this whole issue is that my father has Type II Diabetes. 
 
I want to find out as much info and get as much advice from people so that I can help ask his physicians all the right questions so that we can make the best decision.  But the more research i'm doing the more confused things seem to get.
 
It seems that most everyone participating in this forum has opted for the Da Vinci procedure.  Is there a certain reason that so few have done radiation therapy?  Because of the diabetes, healing after surgery is a real concern for my dad.  I would have thought just getting the prostate out would be ther best option, but now i'm not so sure.
 
help....
 
any advice or thought would be really appreciated by my family.

Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 10/23/2006 12:03 PM (GMT -7)   
Your Dad has a 4+3 Gleason score and diabetes. Radiation is a very good option for him is it not? Makes great sense to me. Surgery is still an option for him though it may be complicated by a slower healing time. It''s more up to his past history and his Doctors opinion about how well or poorly he might heal. Radiation just sounds like a less invasive procedure for a man with diabetes such as your Dad's. There are a few diabetics in here who chose radiation and or seeds. They just don't hang around all the time! Julie's husband had his done recently for reasons other than DM. She could probably give you some idea about side effects of treatment.
Good Luck, Swim

flippin out
Regular Member


Date Joined Mar 2006
Total Posts : 137
   Posted 10/23/2006 2:00 PM (GMT -7)   
55 Da Vinci procedure April 25th 06' ending with 3+3 =6 Lazt PSA >.0 {thats the Good}
Type II Diabetes since 2000'
     Radiation might be a good second choice for me if the cancer shows up again.
 However once radiation has been given sugery may not be available. Might wana think on that .
 I did have a bought with low Blood pressure in the hospital but figured it was caused by the glucose drip I was on
recovery has been  remarkable.   
      

spinbiscuit
Veteran Member


Date Joined Apr 2006
Total Posts : 818
   Posted 10/23/2006 5:11 PM (GMT -7)   
Hi swu,

One thing for sure you need to seek a second professional opinion, and ask as many questions as you can. Your dad's circumstance is different from most so maybe start with his primary care physician, and get his/her input afterall who would be more familiar with you dad's condition? and who better to advise than he/she? I wish you and your dad the very best of luck.

Glen

EB02
Regular Member


Date Joined Dec 2005
Total Posts : 48
   Posted 10/24/2006 12:09 AM (GMT -7)   
You certainly need to consider the diabetes in exploring all of the options. There is a lot less to heal in the DaVinci surgery than traditional open surgery, so I'm guessing that would be the better surgical option if you take that route.

jeb187chs
Regular Member


Date Joined Aug 2006
Total Posts : 62
   Posted 10/24/2006 5:28 PM (GMT -7)   
EB02,

I had conventional Lap. surgery (without the robot) because that was the specialty of my "expert" I chose. One of my best friends had the robot surgery the week before and we both have done equally well. I cannot repeat this enough.... find an "expert" that has done literaly hundreds or thousands of the procedures he specializes in. Lay out all the cards such as the Diabetes to him and then ask questions. If you have any questions you feel uncorfortable with the answers for get a second or even third opinion. I believe this is the key. Your expert may be local or across the country but surgery leaves you a lot more options afterwords. I am about to start radiation post-surgical because my PSA hasn't fallen all the way to zero. The problem with radiation is that surgery after radiation becomes tricky (I am told) if it can be done at all. My gleason of 8 was reduced to a seven after the pathology report, so don't be real upset about your 7 gleason, it may go down (or up) after they get to actually look at the prostate and surrounding tissue they remove in surgery. I personally wanted to get it out of there.

Good luck, we will keep your father in our prayers, keep us posted.

John
Diagnosed Aug. 7, 2006
Age 55
Biopsy 8 of 10 positive
Gleason 8
PSA 16.2
Negative CTscan, bone scan and lung x-ray
Lapro Prostatectomy 9/7/2006


swu
New Member


Date Joined Oct 2006
Total Posts : 2
   Posted 10/24/2006 9:47 PM (GMT -7)   
Thanks all for all your advice.
 
Many have mentioned that surgery after radiation may not be possible at all or it can be very tricky.  Do you know why?
 
Thanks again,
 
swu

lawink
Veteran Member


Date Joined Oct 2006
Total Posts : 621
   Posted 10/24/2006 9:54 PM (GMT -7)   
Hi swu!
My understanding of it is that radiation affects so much of the area surrounding the target, and in fact damages them, that those organs/tissues wouldn't heal properly if surgery were done after the fact. I know our doctor initally told us same thing -- surgery first then radiation if necessary but NOT in reverse.
Linda
Husband (Bob) had laproscopic prostate surgery on Sept 27, 2006 - 2/12 malignant biopsy samples - gleason 3 + 3 = 6.  Follow up PSA results and pathology results due Nov 14, 2006.


JustJulie
Regular Member


Date Joined Mar 2006
Total Posts : 355
   Posted 10/25/2006 9:08 AM (GMT -7)   

Hi Swu:

As mentioned above, my husband chose Brachytherapy as his treatment and it's been going very well.  At his last checkup they gave him a 97/100 for seed coverage and his PSA had dropped to a 0.95 - great news for us.

With respect to side effects, fatigue was the biggest complaint for the first little while.  Bear in mind my husband is VERY active and can't sit still but his body shut him down when it needed to - he did have a nap a day for the first couple of months.

Certain foods can aggrevate the bladder so he was given a list of "in moderation" foods but nothing really bothered him to the point where he would avoid it entirely.

Please know that there are other options out there and you shouldn't feel "doomed" if surgery is not an option for your dad.  My husband's surgery was a day surgery and he was out that night and on the road to recovery.

If you have any questions, feel free to post them and I'd be happy to share our experience.

justjulie


floridarobert
New Member


Date Joined Dec 2006
Total Posts : 11
   Posted 12/26/2006 1:56 PM (GMT -7)   

What your doctor does not tell you.

 

In December 2005 I was diagnosed with prostate cancer. The urologist game me a pamphlet which spelled out the choices for treatment.   After reading the pamphlet I started to read via the Internet and found more treatment option than the pamphlet recommended.

 

In the U.S. the treatments are typically 1. watchful waiting; 2. radiation (several kinds) and 3. surgery to remove the prostate.  

 

  1. Watchful waiting capitalizes on the usual slow growing nature of prostate cancer.  If one is over age 70 or 75 one might die of something else before prostate cancer kills.  The operative word is “might” as the available information is statistcaly based. If  a high percentage of people with prostate cancer will experience slow growth of the cancer, that does not rule out the small percentage that might have cancer that is spreading to other parts of the body.  It is not easy to distinguish slow growing from fast growing cancer.  In addition men are living longer these days; waiting is risky.               

 

 

  1. Radiation either by beam or by wire of one source or another tend to kill the cancer but also carry some unwanted side effects: impotence and incontinence (fecal and/or urinary).

 

  1. Radical prostatectomy carries similar side effects as radiation.

 

After reading about the above options I was not happy with any.    I  kept reading and found hormonal treatment, freezing,  and ultrasound. Hormonal treatment and freezing (cryo surgery) which  both carry significant levels of unwanted side effects.  High intensity focused ultrasound(HIFU) appeared most promising.

 

HIFU

 

Hifu has been used in Europe and Asia more than a decade to treat benignly enlarged prostate.  More than a half dozen years ago this method has been used for treating prostate cancer. This is the least invasive treatment for prostate cancer that carries the possibility of a cure.  There is no incision and side effects appear to be less than other methods.  Since this is experimental one is engaging in a degree of risk since large numbers of patients over many years have not yet been studied. 

 

From my amateurish reading of literature on the internet, it appeared to me that HIFU offered similar survival rates to someone in my situation (T1C; psa 4.6; Gleason score of 6) with less likelihood of  such side effects as impotence, incontinence, and  fistula.  Perhaps radical prostatectomy has a slightly better cure rate.

 

 

Among HIFU machines, I chose Sonablate over Ablatherm largely because Sonablate gives the physician a live image.

 

I emailed a number of different practitioners and researchers  who use Sonablate in Italy, England, Germany, U.S.A. and Japan. Most responded quickly and were willing to answer my questions.

 

I asked each physician about price and how much experience they had.   The American physicians were the most expensive($20,000 for treatment in Dominican Republic or Mexico), followed by the English, Japanese and finally two  Italians.   Dr. Durso in Torino, Italy was willing to do the procedure for about $7800. With my love for Italy and a good price, I nearly chose him. I then learned there was an “upgrade” to the machine; when I asked him about the upgrade, he did not respond.  I finally chose Dr. Uchida who not only has the most up to date equipment, but he has more experience than any other person working with Sonablate.  For $10,000 I could employ the services of one of the most respected researchers and practitioners in the field.  

 

We arranged for the procedure and I flew to Tokyo on my spring break.  I took my wife and daughter so we could have a little tour of Tokyo, a welcome distraction.  Dr. Uchida met me in the lobby of his hospital, Tokai University Hachioji Hospital.  Hachioji is a suburb of the sprawling city of Tokyo.  I felt as though I was taking the subway to Queens from Manhattan. 

 

Dr. Uchida gave me a room in which my wife and daughter could spend the night.  He spend two hours working on me with the Sonablate from approximately 5- 7 p.m.    I felt very little except the insertion of the catheter through the abdominal wall into by bladder. That felt like someone was trying to jam a screwdriver through my belly.  The next day I was ready to leave the hospital and continue my tour of nearby parks, museums, and temples.  Unfortunately the tube of the catheter prevented me from closing my pants! I was walking around Tokyo with my pants unbuttoned and my shirt tails out covering my front. 

 

The catheter was the most uncomfortable part of this experience, though I never doubted that it was a worthwhile trade off.  I complained to Dr. Uchida who gave me a more flexible tube. It was still irritating but tolerable.  Over the next 3 weeks, increasingly more urine was coming out of my penis than the plastic tube. 

 

I returned to Florida after about 10 days in Tokyo and sought a way to remove the catheter. I had made an appointment with the local urologist who had called for a biopsy.  When I showed up for my appointment to remove the catheter, he refused to see me since I had gone to another doctor.  However annoying that was I called a number of other doctors and found two urologists willing to work with me. 

 

I had my psa tested every 3 months, and it went from 4.6 biopsy, to 5.2 at time of treatment to 1.2  two months after.  Two more tests a few months later yielded 1.3.  I had a biopsy 12 months after the first and 9 months after the HIFU, and all 12 samples were benign.  Such a biopsy does not guarantee that I am cancer free, but I am in pretty good shape to face the future.  Erections have been weaker than prior to the treatment, but I can attain and maintain an erection. There is no ejaculate, but I can climax. Climaxes are slightly weaker than before. I tried the three drugs for erectile dysfunction: Cialis, Levitra, and Viagra each for daily dosage for several weeks.  Levitra worked best for me. I have no other side effects. 

 

I would be happy to talk to anyone interested in HIFU. I am not an expert but I have acquired valuable experience. 


flyshigh007
New Member


Date Joined Oct 2007
Total Posts : 1
   Posted 10/23/2007 7:08 PM (GMT -7)   
Hi,
 
Floridarobert or anyone, can you give me any info on Dr. Uchida in Japan(i.e phone number).  My friend is 57 and recently diagnosed with prostate cancer.  His PSA is 4.2 and Gleason score of 3+3=6. We have decided to go with the HIFU procedure and looking at doing it in Japan.  It seems to be less there.  How do we go about scheduling an appointment or being able to speak with him first?  Do you have an email?
 
Thank you

Jayadub
Regular Member


Date Joined May 2007
Total Posts : 89
   Posted 10/23/2007 7:28 PM (GMT -7)   
swu said...
 
It seems that most everyone participating in this forum has opted for the Da Vinci procedure.  Is there a certain reason that so few have done radiation therapy?  Because of the diabetes, healing after surgery is a real concern for my dad.  I would have thought just getting the prostate out would be ther best option, but now i'm not so sure.
 
help....
 
any advice or thought would be really appreciated by my family.
Well not all of us here have had surgery, just the majority. I found the side effects and aftermath as described by many here to be undesirable to the point where I chose Proton Therapy at Loma Linda in So. Ca. If you have any interest in as non-invasive a procedure as can be found currently in the US, please visit www.protons.com. This is the new LLUMC web site. If you wish to talk firsthand, my email is active and I can be contacted through it.
 
flyshigh007 you may wish to check out Proton Therapy as well. The cost of going to Japan and Loma Linda are probably about the same. You can see my numbers in my signature.
 
John

54 years old

PSA 5.6 on 3/20/07

DRE: Negative

Biopsy on 4/20/07 

Results 4/25/07:

3 out of 12 cores positive, 2 on the right lobe with 5% adenocarcinoma Gleason 3+3, 1 on the left lobe 10% adenocarcinoma Gleason 3+4, overall Gleason graded 7 Cancer T1C.  After web research discovered Proton Beam Therapy and called Loma Linda. Completed consultation with Dr. Luu on 7/5/2007 and started treatment at Loma Linda on 7/26/07. Completed treatment 44 on 9/28/07. 0 treatments remain. Side Effects remain minimal. 1st PSA scheduled for end of Jan. 08.


justtom
New Member


Date Joined Sep 2007
Total Posts : 11
   Posted 10/24/2007 8:01 AM (GMT -7)   
 Dr. Patrick Walsh's Book, Guide To Surviving Prostate Cancer is a very informative book to read.  If you could get it I think you can find many answers you need.  At the least make decisions that are well thought out.  You can type Dr.Patrick Walsh/John Hopkins in search on Google for example and see a long list of his accomplishments.  As I mentioned in an earlier post on this site, I wish I'd have taken a little more time to make wiser decisions and this book I mentioned would have helped.  I would have maybe gotten a second opnion from Dr.Walsh himself if possible.  From reading this site on a daily basis I can tell you we all have simular but different reslts from whatever we choose to do.  Keep the faith and a Positive outlook and you will see,  There is life after Prostate Cancer...The scores and results you posted are simular to mine..Although I don't have diabetes, I have had Myasthenia Gravis for 24 years.  I have been on Prednisone for 20 years, small dose, 10mg every other day..  Had I have read the book I'd not have taken the Hormone shot because it emphatically mentions long term Prednisone and Hormone therapy both being bone killers, Osteoperosis..  Anyway good luck with your PC and your not alone..  Kind Regards,

AGE 54, DIAGNOSED PROSTATE CANCER 3-13-07
11 OF 12 BIOPSIES POSITIVE, PSA 7.2 GLEASON 4+3=7
RADICAL 4-27-07, NERVES SPARED ON THE LEFT, REMOVED FROM RIGHT SIDE..
PSA 1 MONTH AFTER 0.05
ELIGARD 45 GIVEN 6-05-07
NEXT PSA DEC.07
JUSTTOM


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 11/9/2007 9:53 AM (GMT -7)   

tongue   Hi ~  SWU  & Loved Ones…

 

Welcome   to…   ~ HealingWell ~

 

and

 

A   Special   Warm Welcome  to  You !

 

Knowledge gives us POWER….  POWER takes away the fear.

 

~     ~     ~     ~     ~     ~     ~     ~     ~     ~     ~     ~     ~

 

 Click  on  link  below for important information that will help you ~ help us!!

 

Welcome New Members ~ to HealingWell

 

 

The information (link) listed above is to help you get started on your journey. 

     It is a journey best traveled with friends. 

          Welcome ~ New Friend from all the members here... on HealingWell.com

 

v      IdahoSurvivor ~  Moderator for Prostate Cancer Forum

http://farm2.static.flickr.com/1160/1313099593_9f819e3ff8.jpg

 

v      bluebird ~  Moderator for Prostate Cancer Forum

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bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 11/9/2007 9:57 AM (GMT -7)   

Hey ~ SWU,

I hope you’re staying close!!! yeah    You and your family are in our thoughts and prayers as you help your dad move forward ~ researching the path he needs to take.

In Friendship ~ Lee & Buddy


mama bluebird - Lee & Buddy… from North Carolina

 

v          We invite you to visit our personal thread:  Click Here:  “Our Journey” ~ Sharing is Caring 

April 3, 2006  53 on surgery day

RRP / Radical Retropubic Prostatectomy

PSA 4.6   Gleason  3+3=6    T2a   Confined to Prostate

3rd PSA 08-07-2007 Less than 0.1 Non-Detectable :)

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