radiation, robotic or open surgery,

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mgl
Regular Member


Date Joined Feb 2007
Total Posts : 122
   Posted 2/9/2007 6:09 AM (GMT -6)   
I'm 50 and am still debating which way to go PSA 5.4 gleason 3=4=7
 sexually active  , Leaning toward the surgery, but scared
pros /cons

JayMan56
Regular Member


Date Joined Oct 2006
Total Posts : 61
   Posted 2/9/2007 7:31 AM (GMT -6)   

MGL,

You've got a lot of research to do. Read through these threads carefully because they are as real as it gets. Nobody here has an ax to grind with any one treatment method. You need to consult with doctors, family, friends, on the internet.... the works. In the end, only YOU have to feel good about your decision.

I can only speak for myself. And I emphasize that no two people are exactly the same. I was diagnosed at 56 and I too am sexually active, or I should I say was (temporarily). As I mulled over my treatment options I kept one thing foremost in my mind.... getting the cancer out of my body with the highest success rate possible that it would not come back. When I concluded that both radical prostatectomy (surgery) and radiation (either seed or regular) had equal success rates over 20 years I looked into things more closely. Every, and I mean EVERY physician I consulted told me, at the relatively young age of 56, to have the surgery to remove the prostate. The reasoning is that in our 50's, our estimated life-span is longer and with radiation, there is always a chance the cancer can come back over time and if it does, the treatment options available then are far more limited. For instance, after undergoing radiation, if the cancer comes back, I was told removal of the prostate is not a good, viable option. However, I was also told that once the prostate is removed, assuming the cancer has not escaped the organ, that's it, finito, sionara, adios............... there is simply no prostate for a cancer to take hold again.

Now, as for the sexually active part... that's another story. I was fairly to heavily active prior to the surgery. Both physically and psychologically, I am currently inactive. While I can get a partial erection using Viagra my sex drive is currently down. I have no permanent partner, so this makes it worse. Mind you, I am less than two months from the surgery, but I miss the good ole' days. Part of my problem is that while I was recovering from surgery, one of my best friends died, and I am left feeling down most of the time....  depression. For that, I will continue to seek counseling and take Prozac. But I miss the sexual urge and a good stiff erection. My doctor told me that will come back with time and he counseled me to be patient.

MGL, good luck. You have this board to help you do your research. I had the surgery done with the robotic DaVinci. If you decide to go that route it will cut down considerably on your down-time and you'll be back to a relatively normal life again in 30 days. If you go the open surgical route, the recovery time, as I understand it, will be closer to 60 days.

As for me, I chose the surgical route because my Gleason's were 3+3=6 and 3+4=7, and I was not going to be looking over my shoulder the rest of my life faced with any chance that the cancer could come back. Prostate cancer, while very slow-growing and curable in its early stages, is not a pretty way to go out if it spreads outside of the gland. 

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 1/25/07: 0.1
  • 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?
  • Davinci surgery took place on 12/12/06
  • Post-op report shows zero malignancies in surrounding tissue, zero malignancies in lymph nodes and the prostate had one malignancy at 3+3=6.
  • Regained continence 3 days post-surgery.
  • Regained a full erection 8 days post-surgery!! Yippee!!!


naimnut
Regular Member


Date Joined Jan 2007
Total Posts : 93
   Posted 2/9/2007 8:18 AM (GMT -6)   

mgl,

When I was first diagnosed I had the opportunity to speak with another survivor over the phone. He had previously been a spokesman for the american cancer society for a region of the country. This guy knew his stuff--knew the disease from firsthand experience, knew the treatment options, knew the side effects. He advised me--"you've got to basically get yourself a masters degree in biology and medicine, on your own. You've got to study the disease, the treatment options and risks until YOU are confident about your choice of treatment. And once you make your decision, you've got to never look back. So get to the point where you can make your decision with confidence..."

Jayman's counsel is right on. Read, read, read. Books, (the one by Scardino is excellent, also the one published by the american cancer society, and I also really liked the one "what your doctor may not tell you about prostate cancer". Regarding books, I looked for books which were published in the last year or two. Even now, treatment options have evolved to where I have found NO book to be completely up to date. That's what the internet and this board are for. Even Scardino, who is one of the foremost cancer doctors in the world, did not write extensively about the da vinci robotic surgery option. At the time he was putting pen to paper (2004) to get his book published in 2005, there had not been a lot of widespread experience with the da vinci. That situation has now changed and there are a lot of centers around the country where experienced doctors are doing good work. I'm tending to lean towards the da vinci, personally, and I agree with Jay's reasons for doing so.

Any of the treatment options will produce fairly excellent results, if practiced by a top doctor. And any will produce discouraging side effects, if performed by dr. joe average, from smalltown USA, who doesn't see much prostate cancer or have very many opportunities to do a surgery or other treatment. My guess is that you will want to find a doctor who is doing at least 3-4 procedures a week, 50 weeks a year. and some of the very top guys are doing many, many more than that. IMHO this ability to do a procedure quickly does not imply carelessness, it suggests great skill and experience, so there is minimal waste of time and motion. When you hear that a surgery took, say, four hours, well that is either an unusually complicated case or a comparitively inexperienced doctor. And, all doctors started out as inexperienced. But you want to look at yourself as the most important patient in the world, not someones 8th or 30th or 60th patient for their "practice". You want somebody who has AT LEAST 200 procedures under their belt but probably more like 1000+.

I could ramble, but I think the main thing is to: A) read all the links, especially yananow. B) take your time and look through many of the old threads on this board. They are excellent and this board is the best place I know where people ask ANY question and get STRAIGHT answers, as graphic as it needs to be.

Best wishes, my friend.

Markus 


Age, 53
PSA 3.76, Gleason 6, T1c, scans negative
psa doubling time 35 months
Still researching and deciding treatment options.  Leaning towards da vinci robotic.


JayMan56
Regular Member


Date Joined Oct 2006
Total Posts : 61
   Posted 2/9/2007 10:02 AM (GMT -6)   

Markus is right on, but I forgot to mention something in my initial post.

Surgeons will recommend surgery... because that's what they do. There are Surgeons that do an "open" procedure will recommend an "open" procedure... because that's what they do. There are sugeons who do laporascopic surgery because that's what they do..... There are radiation specialists and guess what they recommend? You get my drift. Every one of them will swear their way is the best way and has the greatest chance of success. Sigh.

MGL, above all else, talk to people, go to survivor groups, get the word out there. There's nothing wrong with that. I found that almost EVERY person I spoke to personally knew of someone who has had prostate cancer. It was scary. One contact led to another contact, which led to an article on the internet, which led to a phone call to a surgeon, which led to an appointment...... and so on and so on. And, of course, you have this blessed bulletin board which has been a savior to me even though I don't post much. Every week or so, I come in, look and get more info.

As Markus wrote, the DaVinci has only been around for the past 4-5 years or so. At the bottom of my posts I give a link to a site where they will show at least part of the actual procedure. With a skilled surgeon at the controls and a top notch assistant, this, in my own personal opinion is the only way to go if one elects the surgical option. Nothing against open procedure, this is what I concluded. I have seen and read much about the DaVinci since my surgery and the more I know about it, and considering my own rapid recovery, I could do nothing less than recommend it to anyone asking my advice. Follow what Markus wrote you about selecting a surgeon if that's the route you choose.

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 1/25/07: 0.1
  • 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?
  • Davinci surgery took place on 12/12/06
  • Post-op report shows zero malignancies in surrounding tissue, zero malignancies in lymph nodes and the prostate had one malignancy at 3+3=6.
  • Regained continence 3 days post-surgery.
  • Regained a full erection 8 days post-surgery!! Yippee!!!

Post Edited (JayMan56) : 2/9/2007 9:09:10 AM (GMT-7)


Tamu
Veteran Member


Date Joined Oct 2006
Total Posts : 626
   Posted 2/9/2007 1:10 PM (GMT -6)   

mgl,

Doing a lot of research is the right thing to do.  If you have not been there go to this site,

 
 
Once you enter this site go to mentor experiences and scroll down.  You will find the stories of men that have chosen treatments for PC listed by those treatments.  I read everyone of them before I made my decision.  I had worked the treatment choices down to two.  These were Da Vinci surgery and Proton Beam radiation.  The Proton Beam radiation looked good to me because I had talked to an old high school classmate that Had it done and was very pleased.  If you read the stories under the Proton Beam radiation treatment on Yananow you will see everyone of them are very pleased.  I also felt that with the Proton Beam the incontinence and impotence complications were very small.  The Da Vinci provided a minimal invasive surgery and the removal of the prostate where it would be pathologically analyzed and I would know definitively if the cancer was confined.  I knew that temporary incontinence was part of the complications with a Da Vinci and that impotence could be months to come back or not at all.  The point of decision making came down to one thing.  If I considered that with my family history I could expect perhaps 30 more years of life and the chance to see my grandkids grow up this surpassed my immediate desire to maintain my potency.  That does not mean that the Proton Beam treatment would not have had the same outcome it just meant that my comfort level was higher with the removal of the prostate then leaving it in and wondering if cancer cells have already gotten out or the radiation would not get them all.  That constant worry with the radiation approach just was not what I wanted.
 
We all have to take control here.
 
Good luck!!
 
Tamu
Diagnosed 7/6/06
1 of 10 core samples, 40%
Stage T1c, Gleason 3+3
Da Vinci on 11/01/06
Catheter out on 11/13/06
56 Years Old
Post Op Path
Gleason 3+3
Approx. 5% of prostate involved
Prostate Confined, margins clear
Undetectable PSA on 12/18/06
No more pads as of 1/13/07


JayMan56
Regular Member


Date Joined Oct 2006
Total Posts : 61
   Posted 2/9/2007 1:59 PM (GMT -6)   
Tamu,

Excellent advice, couldn't have said it any better myself....

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 1/25/07: 0.1
  • 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?
  • Davinci surgery took place on 12/12/06
  • Post-op report shows zero malignancies in surrounding tissue, zero malignancies in lymph nodes and the prostate had one malignancy at 3+3=6.
  • Regained continence 3 days post-surgery.
  • Regained a full erection 8 days post-surgery!! Yippee!!!


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 2/9/2007 2:56 PM (GMT -6)   

Hi ~ mgl,

 

We chose… Radical Retropubic Prostatectomy

 

We invite you to visit our link: Our Journey ~ Sharing is Caring by Buddy & Lee

 

Below are excerpts from “OUR JOURNEY”.

 

We decided to share Our Journey” in hopes of helping at least 1 person! 

If it helps more….  If it helps you!!!!      That will truly be a blessing 

At no time are we writing to tell you what you must do, or what you should do….

 

                                     Your Decision is Your Decision!!

 

Just giving you a view of what decisions we made, what the process was for us, and the outcome as of this date. 

 

Read as much as you can on the forum… there are so many different scenarios.  You will gain much knowledge from all of them.  There will be so much coming at you in the next little while… I would suggest the following for any new member:  When you read a posting that you think you might want to re-visit….copy and paste it in a word document.  There are so many postings coming in ~ you may not find it again….  This way you can re-visit it as many times as you like or delete it. 

I hope our journal entries will help you.

 

 

mgl,

 

As your search for answers continue…. I hope you take time to look at many of the Threads here on this forum.  You can gain so much from each one and each one may offer a little something that you can pull into Your Journey to make it smoother.

 

That’s why we are here….. To help you stabilize any rocky stepping-stones.  That’s what Helping Hands are for.  Thank you for reaching out to all of us!

 

In Friendship ~ Lee & Buddy

 

 

Other Threads by:  mgl

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

50 with prostate ca  Started by: mgl


mama bluebird - Lee & Buddy… from North Carolina

J  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 with "wide excision"

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

2nd PSA 02-06-2007 Less than 0.1 Non-Detectable :)

 

 « bluebird ~ Moderator for Prostate Cancer Forum

Post Edited (bluebird) : 6/26/2007 8:45:12 PM (GMT-6)

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