Need information on PostateCancer treatments

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Motelmat
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Date Joined Nov 2006
Total Posts : 50
   Posted 11/26/2006 7:26 PM (GMT -7)   
Hello, my name is Mat and I found out about 2 weeks ago that I have prostate cancer.  I am just starting to investigate what treatment I should take, but from what I have read and the men I have talked to who have had both surgery and the seeds, I am strongly leaning toward the seeds and maybe follow up with external radiatiion.  I would appreciate any input from others who have been through this.  My stats and facts are as follows:
 

Age-66, very good health, walk 5 miles each day at a good pace, use a rowing machine and lift weights 5 days a week, 6’ 3”, 195 lbs.  Never had a major illness
Family History of prostate or breast cancer-Both grandfathers had prostate cancer and one cousin so far.
PSA history was around 3 t 3.5 for many years then to 4.95, back to 4.8 and then this fall up to 6.6
Stage ???
Gleason 3+3
Findings of the DRE  - soft and no hard spots, not enlarged, ultra sound showed size at 19 cm
Number of needles in the biopsy - 8
Number of positive needles - 5
Percent cancer or volume in the needles. – less than 1/3 on any of them
City and Country of patient – Discovery Bay CA,
Any scans (Bone, CT, Etc.) none yet, I am under VA care from Palo Alto and San Francisco which has a prostate clinic and going for those test in the next couple of weeks.


bluebird
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Date Joined May 2006
Total Posts : 2542
   Posted 11/26/2006 7:47 PM (GMT -7)   

Hi Mat *MotelMat ~

 

Welcome New Friend…  I’m glad you joined us!

 

You’ve come to the right place!!!!!!!  There’s lots of different journeys here.  Find the one that helps you and pull from them.  We’ve traveled the path so ~ let us help you and thank you for sharing your journey with us.

 

Jetguy is considering radiation and he is under the Thread: Jetguy’s Page….  Please hook up with him…… too…..   I know he’d like to talk with someone who’s considering these options too!!!

 

JustJulie’s husband is having the seed therapy, known as Brachytherapy, they chose this over surgery and external beam radiation.

 

What ever decision you make…. It will be the right decision for you!!

 

Take care and know we will keep you close…in thoughts and prayers.

 

In New Friendship ~ Lee & Buddy

 

 

(direct link ~ just click on the title!  Reminder to click on the REFRESH icon once there)

Helpful Hints for New Members... Hope this helps you! :) Updated 02-05-2007

 

PS….

You did perfect with starting your Own Thread….  Perfect timing…. I was thrilled when it popped up!

 

I’m glad you didn’t mind me asking you to move on to your own thread…. It will really make a difference for you….

 

I’m heading over to Whisper’s Thread and will delete my posting  (top right button)  you can do the same…..


mama bluebird - Lee & Buddy… from North Carolina

Link to our personal journey…>>>     Our Journey ~ Sharing is Caring 

April 3, 2006  53 on surgery day

RRP / Radical Retropubic Prostatectomy with "wide excision"

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

June 29th ~ PSA Less than 0.1 Non-detectable

Post Edited (bluebird) : 2/6/2007 11:48:58 AM (GMT-7)


Motelmat
Regular Member


Date Joined Nov 2006
Total Posts : 50
   Posted 11/26/2006 7:50 PM (GMT -7)   
me to...

Motelmat
Regular Member


Date Joined Nov 2006
Total Posts : 50
   Posted 11/26/2006 7:56 PM (GMT -7)   

Hello again,

I have read a lot about various treatments on the net and spoken with many people that have had early treatment and from what I have gathered it seems like the success rate for brachytherapy is about the same as surgery and if that is true why would someone want togo through all of the pain and problems of the surgery if the success rate is just as good from the seeds and has a much better quality of life?  What am I missing?

 

Mat


Tamu
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Date Joined Oct 2006
Total Posts : 626
   Posted 11/26/2006 8:30 PM (GMT -7)   
Mat,

You are struggling with the same decision making process all of us that have travel this path have followed. Your questions are right to the point. In general, the answers that I came up with is that at 10 years out the reocurrence of PC is the same for surgery and radiation. Therefore, if you feel that at your age you will live 10 years or less then it does not matter which treatment you choose. Once you get beyond 10 years then the statistics indicate that reoccurence is higher for radiation treatment then surgery. The other general fact is that once you choose radiation then backing that up with surgery in case the radiation does not work is not practical because of the damage that the radiation does to the tissue around the prostate. Whereas with surgery if there is need for further treatment then you can use radiation. With all that being said, age and quality of life are the big items for consideration given that getting rid of the cancer is the prime outcome. I was 56 when diagnosed. If I had been 66 like you I would have given more consideration to a form of radiation. I opted for the Da Vinci surgery because of my specific situation. By the way, I had no pain associated with my surgery and feel I made the right decision but i sit here at the moment being almost four weeks since surgery still leaking and without an erection. I am confident that I will become continent and potent. I am also sitting here with a sense of relief since I know that the post op pathology analysis confirmed that my cancer was confined to the prostate. Good luck on your quest and continue to question.

Tamu
Diagnosed 7/6/06
1 of 10 core samples, 40%
Stage T1c, Gleason 3+3
Da Vinci on 11/01/06
56 Years Old
Post Op Path
Gleason 3+3
Prostate Confined


Motelmat
Regular Member


Date Joined Nov 2006
Total Posts : 50
   Posted 11/26/2006 8:45 PM (GMT -7)   

Thanks Tamu,

Although I older than most I am healthier than most my age and according to all of the longivity tables I am going to live into my late 80's so I am looking at things different than most my age.  I recently went to a test at VA where they injected me with a dye and I was put on a treadmill and they said my condition was what they would have expected from someone 40 years old.

Another question, on the 10 years out for comparison of surgery or seeds, from what I have read it is that they do not have results for the seeds for more than 10 years where they do for surgery.  You have mentioned other facts I have not read about so I will check it some more.  We are going to talk to a surgeon on 12/12 and then a radiation person sometime before than so I will knowmore then.

Mat

 


jackcc
Regular Member


Date Joined May 2006
Total Posts : 80
   Posted 11/26/2006 9:16 PM (GMT -7)   
Mat.  If you haven't checked it out yet, you might find WWW.yananow.net  helpful.  It has information  from a lot of experienced men who have been through this.  Look in the mentor experiences section.  You'll find people who have tried the different procedures.  You're in  good physical condition and thats a big plus for you. 

Motelmat
Regular Member


Date Joined Nov 2006
Total Posts : 50
   Posted 11/26/2006 9:20 PM (GMT -7)   

Thanks, I had that site info, but could not find it and now I see it is .net instead of.com

Also, I see reference to DaVinci, is that the same as Laproscopic (sp)?

MotelMat


M. Kat
Veteran Member


Date Joined Jul 2006
Total Posts : 715
   Posted 11/27/2006 5:31 AM (GMT -7)   
hi Mat, you are going through the same thing my husband and I did. we had initially decided on seed implants until we actually spoke with the urologist, who said surgery after seeds is very difficult. my brother-in-law who is in his early 60s opted for seed implants and said you can find doctors who will operate if needed years down the road. Jeff made his decision to have surgery (radical retropubic) because he wanted the cancer out and he wanted to stay with his doctor, who only performed the open surgery. DaVinci is a type of laproscopic surgery, but done with the DaVinci robot machine. keep reading and asking..you'll come up with a decision you are comfortable with. take care, kat
Husband Jeff 56 years old
diagnosed July 27, 2006
PSA 6.5
2 positive areas in biopsy, Gleason 3+3=6
Radical Retropubic Prostatectomy August 30, 2006
pathology report - all clear - cancer gone
1st post-surgery PSA test 0.1
no more pads Oct 12, 2006


GreenAcres
Regular Member


Date Joined Jul 2006
Total Posts : 474
   Posted 11/27/2006 7:06 AM (GMT -7)   
Hi, Motelmat. Looks like you're in the same age/health category as my husband. We, too, debated all the options and did three months of research before making a decision. It is not an easy one and the doctors are not much help - each wants you to choose his/her specialty, or they simply expect you to make in informed decision based on what you can find on your own.

Regarding radiation, note all of the above. Plus, we discovered that while we stood the chance of temporary incontinence/impotence with surgery, that radiation can affect you the same way 6 months or 6 years down the road and it could be permanent. Plus the bowels can sometimes be involved and even destroyed, leading to colostomy. Those are extremes, of course, but we wanted to enjoy a full life as you do (well into the 80s and longer) with as many faculties intact as possible. If we need radiation at some future point, at least it's still an option following surgery. Plus, we also know what we're dealing with pathology-wise. If they had not inspected the gland post-surgery, we would not know of additional involvement until perhaps a year down the road. With radiation, it takes that long for everything to settle down inside before receiving an accurate PSA test.

To me, a healthy 66 year old (or even older in good health and based on clean scans, etc.) is an excellent candidate for surgery. Age has nothing to do with the type of decisions available; health, emotional outlook and expectations, and cancer staging do.

With surgery, you stand every chance of no repeat treatments. With radiation, if something is needed in 10 years, you're facing that at 76, instead.

Just wanted to add to the confusion. ;-)
Husband age 65
PSA on 5/1/06: 4.2 (had doubled in 13 mos. and rising monthly)
DaVinci Surgery 8/2/06
T2a (at biopsy)
T4c (at pathology) w/cancer cell leakage into fatty tissue
Post-Surgical PSA on 10/3/06 - undetectable!
Update: 11/1/06 - perhaps bladder neck involvement; 30%-50% chance of recurrence
Future: PSA tests twice-yearly for now
 


lawink
Veteran Member


Date Joined Oct 2006
Total Posts : 621
   Posted 11/27/2006 7:26 AM (GMT -7)   
We so agree with GreenAcres, above. There's so much comfort after surgery (robotic in our case) in hearing that "clean" pathology report. We were told all of the same things as GreenAcres about surgery vs radiation.

My own two cents . . is that often a person is hesitant to choose surgery because of their own fears surrounding being put out, being cut, pain, etc. After the fact we see that it really wasn't all that bad, the pain was manageable and almost non existant. So, my thoughts are to not let that part enter into your decision.

Sometimes a person needs to choose radiation due to other health concerns, and then that's the choice for them, but otherwise, in my opinion surgery is definitely the way to go.

Take care and please keep us posted.  This site has been a godsend and we are all so glad that you too have found us and joined in with your own journey.

;o) Linda & Bob


Bob (60) had laproscopic prostate surgery on Sept 27, 2006 - 2/12 malignant biopsy samples - gleason 3 + 3 = 6.  Follow up PSA results and pathology results received Nov 14th are NO MORE CANCER!  Gleason changed to a 3 + 4; cancer completely confined to prostate; (even a second more agressive, previously undetected cancer)      PSA UNDETECTABLE.
 
Bob also takes Hydroxyurea to control Polycythemia (elevated red & white cells & platelets) has secondary condition . . Myelofibrosis) -- If anyone has experience or knowledge of these, please post us.


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 11/27/2006 8:47 AM (GMT -7)   
Mat,

Good Luck as you seek information and make your decision.

Mat, you are making a decision based on a PSA of 6.6 with prostate volume estimated to be 19gms (cc). More than 50% of the biopsy cores came up positive. You have a lot of questions to ask about all available procedures and how they relate to size and such. A 6.6 PSA is on the lower side...a very good thing....that's a positive. You're healthy. Another good thing! Now find out how size relates to treatment. A 40 gm prostate is not the same as a 20gm prostate in other words. Cancer treatment is so individulaized. Just ask all the questions you can think of then ask one more! You'll make the right decision.

Take care, Swim

JustJulie
Regular Member


Date Joined Mar 2006
Total Posts : 355
   Posted 11/27/2006 10:02 AM (GMT -7)   
Hey Mat:
 
I thought I would check in here regarding seed implants (or Brachytherapy).
 
My husband just finished his 6-month treatment and he's doing great.  His PSA dropped from 3.74 to 0.95 (3-months) to 0.61 (six-months).  Doctor says everything looks great!
 
He had 91 seeds implanted.  There is a new technique available here in Canada called "stranded seeding" whereby the seeds are actually stranded together so there is less chance of "migration" and the seeds stay where implanted.
 
With respect to long-term results, we were told that the 15 year results for both surgery and Brachytherapy are the same. 
 
One thing to consider is the location of the tumour.  It's all well and good for someone to suggest "just remove the prostate" but sometimes it's not that easy.  My husband's tumour bordered other organs and there was increased risk of splitting a tumour and leaving some in on the one hand and cutting too deep and leaving him incontinent.
 
He chose Brachytherapy and except for expected fatigue, he did very well with this treatment.  Let me know if you need any other information, I'm glad to provide it.
 

Motelmat
Regular Member


Date Joined Nov 2006
Total Posts : 50
   Posted 11/27/2006 10:31 AM (GMT -7)   

Thanks to all of you for your information.  My urologist at VA is 75 years old and does not seem to think sex after 60 is important and has said as  much to my wife and me (we have ben married almost 45 years and I have good support from her) and he is adament about surgery, but I think he looks at it differently and since he only works 2 days a week I am not sure how much he keeps up on modern medicine.  I was pretty set on the brachy therapy, but now thanks to all of your comments, I am giving surgery another look.  I am going to do more research and then talk to both the surgery department and the radiation people so I will get more up to date information.

Motelmat


Motelmat
Regular Member


Date Joined Nov 2006
Total Posts : 50
   Posted 11/27/2006 11:12 AM (GMT -7)   

JustJulie,

Thanks, I will asked about the stranded.  What was the size of your husbands prostate? I understand that makes a difference on how many seeds they have to use which can have an affect on how much chance of the radiation getting into other areas where you don't want it to get.

I understand brachytherapy has only had reults for 10 or 15 years, do they have any idea of what happens after that period?  I alos hear that one can have all of the unwanted problems and side effects after 5 to 10 years so I am not sure what the long term affects are.

I am told in some places that you can not have surgery after the seeds, but now I am hearing that you can have surgery after seeds, do yo know which is correct?

MotelMat

 


lawink
Veteran Member


Date Joined Oct 2006
Total Posts : 621
   Posted 11/27/2006 11:24 AM (GMT -7)   
Hi again!
Interesting viewpoint from your doctor about sex after 60. Bob's doctor has said that as far as ED goes, in the long term he should be able to get back to where he was before surgery (as in if there were ED problems before surgery it wouldn't be better than that). So we are currently using Cialis for a type of physio to keep the blood flowing and some firming. Down the road if necessary are the other types of meds along with injections. In our case, only one nerve was spared and the doctor is still saying the outcome will be good but patience and time are the answers to that.
;o)
Bob (60) had laproscopic prostate surgery on Sept 27, 2006 - 2/12 malignant biopsy samples - gleason 3 + 3 = 6.  Follow up PSA results and pathology results received Nov 14th are NO MORE CANCER!  Gleason changed to a 3 + 4; cancer completely confined to prostate; (even a second more agressive, previously undetected cancer)      PSA UNDETECTABLE.
 
Bob also takes Hydroxyurea to control Polycythemia (elevated red & white cells & platelets) has secondary condition . . Myelofibrosis) -- If anyone has experience or knowledge of these, please post us.


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 11/27/2006 11:35 AM (GMT -7)   
Surgery after radiation/seeds is possible Mat. The complication rate is pretty high but the surgery itself is being practiced by quite a few high volume surgeons across the country.

Boy... a man who thinks sex isn't imprtant to a couple after age 60 is not a Doc I'd want working on my behalf! Please consider a more outcome friendly Physician. He sounds like he's long past actually caring about the man inside the suit if ya get my meaning.


swim

JustJulie
Regular Member


Date Joined Mar 2006
Total Posts : 355
   Posted 11/27/2006 11:43 AM (GMT -7)   

Hi again Mat:

I'd have to go back and check my journal to see if I have the prostate size written in there.  He had 91 seeds, the patient beside him had 102 unstranded seeds.

Other than fatigue and some food restrictions (which we handled with the trial and error approach) he didn't have any of the severe side effects like the absolute urgency and burning - he uses Flomax to prevent burning if he gets that "twinge".  His bladder was not really irritated but, one word of caution, if you have hemmoroids before seeding, they will be aggravated.  There is a new over the counter product called Nupricanal that is very good and comes recommended from the doctor.

It is my understanding that surgery is not an option post Brachytherapy but that HIFU (high intensity focused ultrasound) can be used post seeding but new studies may be proving that surgery may be viable depending on your case.  Brachytherapy is gaining in popularity and we're blessed to live near one of the best cancer hospitals in Toronto where we received treatment.

Good luck to you, I know the information can be overwhelming and everyone promotes their own experience.  We were initially told we had all three choices open to us but once they started investigating tumours and locations, there were not really three choices ...

 


JustJulie
Regular Member


Date Joined Mar 2006
Total Posts : 355
   Posted 11/27/2006 11:45 AM (GMT -7)   

Thanks Swim for the post-seeding update.  I too had heard that it was becoming possible.  Although I hope we never need it, I'm glad to know the option exists!

 

JustJulie
Husband's PSA dropping from 3.74 to 0.95 to 0.61


jetguy
Veteran Member


Date Joined Sep 2006
Total Posts : 741
   Posted 11/27/2006 4:54 PM (GMT -7)   

Hi Mat, Greetings from the Republic of Texas,

Bluebird mentioned to you that I am considering radiation instead of surgery and she is correct.  My wife and I are meeting with my urologist this Thursday and unless he says some magic words, I am going with IGRT (also Google IMRT).  I'm 62 and healthy and exercise and etc.

Winston Churchill said that sailors, soldiers, and airmen are the sum of their fears.  I expect that those of use deciding on our cancer treatment are the same.  We make our decisions based on our worst fears rather than our best hope.  That's what I'm doing and I'm doing it intentionally and with good understanding of what and why.

My urologist is a surgeon and wants me to have surgery.  He also said that the latest and greatest radiation results are as good (or as bad) as surgery.  No matter what your decision, you can depend on support here.  I expect you already know that.

Keep Your Mach Up,

Bill


Gleason 3+3=6, T1c, one core in twelve, another pre-cancerous.
62 years old and good health.  Married 37 years.  To same woman!


Motelmat
Regular Member


Date Joined Nov 2006
Total Posts : 50
   Posted 11/27/2006 6:42 PM (GMT -7)   
Jetguy, Thanks, I googled IMRT and IGRT and I can not figure out what it stands for, what do the initials mean?

Motelmat
Regular Member


Date Joined Nov 2006
Total Posts : 50
   Posted 11/27/2006 6:50 PM (GMT -7)   

Hi again,

I spoke with VA and it looks like I can not get in to see the radiation doctor until the end of Dec and I am supposed to be gone on a trip to MX for the month of Jan (I can change that if I need to) but the practioner at VA said my numbers were slow growth and having it done (whatever it is going to be) in Feb would be fine and gives them time to schedule.  She said that the VA in San francisco has a prostate clinic and works with the UC Berkeley medical center and they have laproscopic, but their success rate with brachytherapy is about 98% becaue they only do it on very select patience and she said from my numbers she feels I would qualify.

I am going to the book store tomorrow and buy a couple of books on it to read and I also have an appointment with another urologist (not VA) and I am making an appointment with a non VA oncologist.  The VA people said I did not need a cat scan or MRI or bone scan because the chance of it spreading beyond the prostate were like 1/10 of 1%.  Any comments on that?


Motelmat
Regular Member


Date Joined Nov 2006
Total Posts : 50
   Posted 11/27/2006 6:58 PM (GMT -7)   

I found IMRT definition and downloaded some articles on it to read.

thanks,

Motelmat


slls
Regular Member


Date Joined Dec 2005
Total Posts : 38
   Posted 11/28/2006 2:03 PM (GMT -7)   
I have had Pca for 8 years, had RP and radiation. I never had a scan, they told me the cancer cells, if any, would be microscopic and would not be pick up on a scan. After 8 years I agree with them.

JayMan56
Regular Member


Date Joined Oct 2006
Total Posts : 61
   Posted 12/2/2006 1:22 PM (GMT -7)   
Mat, welcome to the fraternity nobody wants to join voluntarily..... I am 56, was diagnosed this past Oct 12th with 2 positive malignant fields out of 12. I had a recent PSA of 2.3. I interviewed one doc after another, plus spoke to quite a few good people and I reached one conclusion.... for me, at this age, the best therapy is a radical prostatectomy. At first, I couldn't fathom the relationship between age, life expectancy and the therapy option. I intitially wanted the seed therapy, but was disuaded from that because of my age. The word I got was that the longer you live, the longer period of time for the cancer to return. The likelyhood that if the cancer returned, the prostate would not be operable, or at very least post-radiation prostatecftomy was not an attractive option with current technology. I countered that even if the cancer returned 20 years from now, new advances in treatment would be able to deal with the problem. But, after thinking long and hard, I concluded that my personality would not allow for me to take that chance. Conclusion: I am having my DaVinci robotic procedure a week from Tuesday. I want to be done with it.... but that's me.

I want to say this about the doctor who poo-pooed the sexual aspect of your recovery. I beg you to not use this surgeon. I interviewed with one surgeon who failed to at least give me the impression he was interested in my future sexual health. The other surgeons, while never guaranteeing me anything, told me that they would make every effort to spare the nerve bundles and had a post-surgical plan for my recovery which they took the time to explain to me. That made me feel a whole lot better. Any surgeon who couldn't give me that little bit of assurance was disregarded immediately.

I'll have a whole new topic coming up this week where I can start a thread as I approach the surgery and the effects post-surgery.

Mat, God Bless you buddy.... we are all with you.

Jay


  • 56 year old male, divorced
  • Diagnosed: 10/12/06
  • Two of twelve samples contained malignent cells, Gleasons: 3+3=6, 3+4=7
  • Last PSA as of 11/5/06: 2.3
  • Scheduled a DaVinci Robotic procedure for Feb 6th
  • In control, but partially terrified about the future
  • Click (or paste) this link to watch the DaVinci Procedure: http://www.or-live.com/ShawneeMission/1664/event/webcast.cfm?

Post Edited (JayMan56) : 12/2/2006 1:27:20 PM (GMT-7)

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