Help with recommended treatment

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Mower Man
New Member

Date Joined Apr 2007
Total Posts : 3
   Posted 4/26/2007 9:43 PM (GMT -6)   
I have just been diagnosised with Prostate Cancer and am having trouble with the treatmement decision.  Can anyone help with this?  I want the outcome to leave me the most normal.

Regular Member

Date Joined Oct 2006
Total Posts : 411
   Posted 4/26/2007 9:59 PM (GMT -6)   
hi mowerman,

There are two branches to go out: Surgery or Radiation.

From there are several branches


open or Robotic


Proton beam, a couple image guided radiation techniques or Brachytherapy.

With so many treatment decisions, I would ask around, look around, get second opinions, do own research.

Fortunately there are tons of treatment choices, tons of situations, and tons of options. (although sometimes when we were researching, i just wanted to say "Someone TELL us what to do.")

Search, look, read all over and find the best decision for YOU!

In the meantime, what are your stats (PSA, biopsy results, etc.)

Best Wishes to you, you have found a great forum!

Age: 63
Diagnosed: 10/30/06
PSA: 3.7 (up from 3.4 previous year)
Biopsy: 1/10 cancerous, 5% of one core, right apex.
Gleason: 3+3=6
Da Vinci: April 10, 2007
Path results: 1% of prostate involved. Very small tumors on both right and left apex. Negative margins. Gleason 3+4=7.

Regular Member

Date Joined May 2006
Total Posts : 80
   Posted 4/26/2007 11:16 PM (GMT -6)   
You should start doing kegel exercises immediately.  Strengthen your pelvic muscles.  Do this up until you have your treatment, whatever you choose.  This will help you later.

Mower Man
New Member

Date Joined Apr 2007
Total Posts : 3
   Posted 4/27/2007 6:45 AM (GMT -6)   
PSA 4.1 (up from 2.5)
Biopsy 5/12  -- cancerous in both sides w/3 pre-cancerous
Gleason 3+3+6

Cedar Chopper
Regular Member

Date Joined Mar 2007
Total Posts : 432
   Posted 4/27/2007 8:50 AM (GMT -6)   


Your age and other health issues (and sometimes relational issues / lifestyle expectations  - Don't put the "cart before the horse!") will be the keys for your decision of which treatment path to choose.  Tanya did an excellent decision tree for you.  You will need to weight the information personally for each decision.

If you mention what part of the country you are in, others nearby can give you some feedback on facilities and physicians they liked.

Some will say that with a "6" that you have time to decide.  I personally would not wait very long.

I had a "6" (age 54) and was told by some physicians there was no rush.  My personal physician said not to wait.  The tumor was touching the edge of the capsule.  Biopsies aren't that informative.

Keeping you in my thoughts and prayers.


2 Years of PSA between 4 and 5.5
Biopsy 23DEC06 
Only 5 percent cancer in one of 8 samples.
Gleeson 3+3=6
Radical Prostatectomy 16FEB07 at age 54.
1+" tumor - touching inside edge of gland.
Texas Hill Country
FRESH Produce Department Manager
Have you had your 5 colors today?

Regular Member

Date Joined Mar 2006
Total Posts : 355
   Posted 4/27/2007 9:59 AM (GMT -6)   

Mower Man:

You've come to the right place.  While the ultimate decision must be yours, we're here to provide you with our personal experiences - the good, the bad and the ugly.  Take them for what they're worth, do some research and be confident in your decision.

My husband was 44 when diagnosed, 3.74 PSA, Gleason 6.  He opted for Brachytherapy.  If you want the scoop in it, see the thread entitled "JustJulie's Brachytherapy Journey".  If you have ANY questions not answered in there, ask away, I'd be happy to help.

Until then, Bless You,


New Member

Date Joined Apr 2007
Total Posts : 7
   Posted 4/27/2007 10:30 AM (GMT -6)   
Good luck Mower Man. I would be very interested in your decision and the rationale. I went with the Davinci robotic laproscopic surgery thinking that if I removed the prostate, I wouldn't have future problems. Unfortunately, post surgery biopsy showed postive margins on the left side. I am waiting for post op PSA on 10 May and followup on 16th to determine what is the next steps. This is certainly a journey
DIAGNOSIS: . Age 59. PSA 4.6. PSA free 2%. Clinical pathology: Gleason 10. Stage T2a.           
SURGERY: 23 March 2007. RP at Hackensack Medical Center. Surgical pathology Gleason 7. Stage T3a (positive margin left lateral.)  seminal vesicles invasion absent, regional lymph nodes pNX, extraprostatic extention present on left lateral side.
POST OP: 10 May 2007: First post op PSA was TBD. 

Veteran Member

Date Joined May 2006
Total Posts : 2542
   Posted 4/27/2007 11:11 AM (GMT -6)   

Hi ~ Mower Man &  Loved Ones,


  A   “Special”  Warm Welcome  to  You!   yeah  


We know ~ we can “all” make “Your Journey” smoother just by being here for you! 

This is truly a great forum!!! ~ You have joined!  You are now part our forum family ~ a group of wonderful individuals who are so willing to share...  It helps “all of us” ~ to help you ~ if we know where you are on your path. So ~ Please stay with us and take our hand when you need it! 

Keep posting.... OKAY!!


KNOWLEDGE    IS    POWER  ...  and  POWER conquers  fear



~ and ~

Your decision will be the right decision for you!!!


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


Our thoughts and prayers will be with you as you continue to move forward with your decision. 

In Friendship ~ Lee & Buddy


“God Bless You”

It's a little prayer  ~  "God Bless You" ...but it means so much each day,

It means may angels guard you and guide you on your  way.


(Direct Link ~ just click on the title below and a new window will open!  

Reminder … click on the REFRESH icon once you get there)

Helpful Hints ~ & ~ Direct Links to Important Topic Threads ~ Hope this helps you!! :)

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 :)

Post Edited (bluebird) : 4/27/2007 10:24:38 AM (GMT-6)

Veteran Member

Date Joined May 2006
Total Posts : 2542
   Posted 4/27/2007 11:37 AM (GMT -6)   

Hi Mower Man,


I hope the links above will help you ~

You will read and research and then all of a sudden ~ you will know which route is best for you.


                                                        Knowledge is Power ~ and Power takes away the fear…


What is your age??  Take everything in…. and know that the more you learn and understand…. A lot of the fear will be set aside.  And for the times that it sneaks back in….  We will be here for you!


Thank you for reaching out to all of us!!!  This journey is definitely best traveled with friends who know where you’ve been and where you are headed.  We know the roller coaster feelings that come with this path.  And that’s why “All of Our” Helping Hands are there to help shore up any wobbly stones you may find yourself on.  And there will be some ~ expect it! 


Keeping you close in thoughts and prayers as you move forward.

In Friendship ~ Lee & Buddy

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 :)

Veteran Member

Date Joined Nov 2006
Total Posts : 1464
   Posted 4/27/2007 1:08 PM (GMT -6)   
Hey Mower,

Making the decision on treatment was the hardest part of the whole journey for me and my wife. It makes you prioritize the important things in your life and think about what kinds of after effects you are willing to endure. Once the decision was made, we relaxed and the rest was not that bad. Surgery and recovery went better than I ever expected. Continence came back in about 2 months. Potency is still an issue.

Please stay with us...


Age 72. Diagnosed 11/03/06. PSA 7.05. Stage T2B Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Pathological stage: T2B. Gleason 3+4. Cancer confined to prostate.
PSA on 1/3/07 - 0.04. 
PSA on 4/4/07 - 0.00  T level - 48  Restarted T therapy.
Next PSA on 7/11/07.
 "Cancer feeds on fear - starve it to death."

Veteran Member

Date Joined Oct 2006
Total Posts : 626
   Posted 4/27/2007 1:53 PM (GMT -6)   

The treatment decision process is the most frustrating part of dealing with PC. You will have to decide what your personal considerations will be in making that decision. It is only right for those of us that have come through that process not to tell you what you should do but just share what we did and hope that it helps you some. In my case my personal approach was that I was fairly young (56) at the time of diagnosis, in good health and overall shape, my family history indicated that I could expect to live into my 80's and I wanted freedom of mind. I took a look at the proton beam method of radiation because of good experiences I received from old high school friends and others. I liked the idea of retaining my continence and potency and not having to go through the period of dealing with the return of those items. My decision not to go with proton beam or any other form of radiation was the freedom of mind that I wanted. With radiation there is no way of knowing whether or not the cancer was killed other then the continued monitoring of your PSA. Also, with radiation it is extrremely difficult and unusual to have surgery as a secondary treatment if the cancer is not killed. I just did not want to live with that hanging over me so I opted for surgery. I had already researched the two forms of surgery and having never had surgery before or even been in a hospital the Da Vinci just seemed to offer less pain, quicker recovery and perhaps a better chance of a good nerve sparing outcome due to the good field of vision of the surgeon. Most importantly, the prostate would be out and the post pathology would tell you whether or not it was all contained. If I had been 70 years old I would have probably gone proton beam as at that point I would be more likley to die with prostate cancer if it was not successful then because of it due to the slow growing characteristic that my Gleason score indicated.

Good luck and feel free to ask any question.

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
Began injections in April '07

Veteran Member

Date Joined Apr 2007
Total Posts : 823
   Posted 4/27/2007 7:55 PM (GMT -6)   
Mower.  Your life has changed forever since you recieved that bad news.  Take some time to reflect on your situation and gather your support system around you (Family, friends and co-workers), so you can decide that there are other things in life beside cancer.   When you gather you thoughts, seek out opinions from the people on this site and get Dr. Walsh's book and look up everthing you can find on treatments.  Seek out several opinions on what treatments are out there and seek out Medical centers that have a multi-diciplinary approach to treating it.  When you make your decision with God's help don't look back. Set a date to get started and move forward with you life.  I am waiting to have my surgery (June 4th) so I can get on with my life with all my friends, family and co-workers with me.  Good luck to you and please read the posts on this site, there are some very special people and good information here.

Regular Member

Date Joined Oct 2006
Total Posts : 444
   Posted 4/28/2007 2:02 AM (GMT -6)   
Hi Mowerman

The decision making process is the most agonizing. I want to direct you to my thread relating to my proton radiation therapy treatment, in which I discuss my reasons for electing this treatment and rejecting the various other types of treatment.
You are still in an early stage of prostate cancer; at your age you should seriously consider proton radiation therapy as a possible treatment choice.
I did seriously consider robotic surgery at first, but finally rejected it in favor of the proton therapy. Best of luck.

68, Biopsy 9/27/06, Stage T1c, PSA 7.1, Gleason 6 [less than 5% in two areas], Gleason 7 (3+4) [less than 20% in third area], negative DRE, bone scan and MRI. Starting proton radiation therapy 2/22/07. Treatments completed 4/18/07.

Post Edited (pcdave) : 4/28/2007 1:08:51 AM (GMT-6)

Mower Man
New Member

Date Joined Apr 2007
Total Posts : 3
   Posted 4/28/2007 6:51 AM (GMT -6)   
Thanks for all the good information.

I am 67 years old, Live close to Kansas City, Good Health, Active life style, Great relationship with wife.

Two things are my main concern with choosing a method for treatment. Which method of treatment will leave with me with a lessor problem with incontinence and impotence? Both radiation and surgery appears to have a high risk factor in both these areas. Please give me your personal knowledge and experience on these.

Veteran Member

Date Joined Oct 2006
Total Posts : 621
   Posted 4/28/2007 8:18 AM (GMT -6)   
Hi Mower Man!

Tamu's advice has always struck me as being right on and parallel with how we felt and made our decision. . . . get that cancer OUT! We too wouldn't have been able to deal with never quite knowing it was gone.

As it turned out in our case, post operative pathology report showed a second cancer present in the prostate which was far more aggressive than originally thought. Luckily, both cancers were completely confined to the prostate and the first two PSA tests have been undetectible!

We're not sure what the outcome would have been had we chose another method of treatment, not knowing about this second cancer.

We agree that everyone's choice is their own, and once made is the right decision for them. Health and age often dictate the appropriate direction to follow. We do not agree, however, with opting for a non surgical approach only based on a persons fear of surgery.

Good luck to you.

;o) Bob & Linda
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 aggressive, previously undetected cancer) PSA UNDETECTABLE November 2006 AND February 2007.

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

Regular Member

Date Joined Oct 2006
Total Posts : 444
   Posted 4/28/2007 10:42 AM (GMT -6)   
Hi Mower Man

I assume when you posted your last response you had not read my thread on proton therapy. we are both about the same age and our PC stats are similar. at our age, there is a good chance that we would have to deal with total or significant impotence after surgery. we would also have to deal with incontinence and who knows to what degree. you can read all of the stories here and make your own decision--many of the stories are very discouraging to say the least. i decided at age 68 that i didn't want to deal with surgery. my side effects from proton therapy thus far have been insignificant. i did not feel compelled to have my prostate out so that i would know immediately the true pathology and stage of my prostate cancer. it seems that the majority of PC patients, even older ones, feel compelled to remove their prostate and feel that it gives them a piece of mind and a greater chance of cure their cancer. Even those that have surgery are sometimes confronted with positive margins in the area surrounding the prostate, in which case they will likely need subsequent radiation treatment to hopefully eradicate the remaining cancer. One of the gentlemen who had recent proton radiation therapy at the same time as I did, told me that he decided on radiation treatment because of a fear of cancer being found in the margins outside of his prostate. when the prostate is treated with radiation, it includes radiating an area extending into the margins.

i am not anti-surgery by any means, but i think older men have other options which can produce similar or better results than surgery, especially not having to deal with the potential nasty side effects of surgery. i have tremendous respect for the members here, the majority of whom elect surgery. after reading their stories it has further reinforced my decision to have proton therapy which is considered the safest form of radiation therapy today. incontinence after proton therapy would be considered rare. impotence can occur very slowly after radiation therapy (months and years). however, unlike surgery, medications like viagra have been known to overcome such impotence. i think that radiation gets a bum rap and many patients just have a fear of it. in part, this results from the stories they have heard about the sometimes horrible side effects from radiation treatment years ago which was somewhat primitive. radiation therapy today is very sophisticated and relatively safe with more minimal side effects.

there are at least three members here who have had proton radiation treatment and at least two who have had x-ray (IMRT or IMGT) radiation without any major side effects during treatment. one member here had proton therapy several years ago and is doing very well (i.e., low PSA for several years). i think you have concluded too quickly that surgery and radiation are equal in terms of having a high risk for both incontinence and impotence. the key here my friend is to be very objective and do your homework. don't let anyone, including me, unduly influence your treatment decision until you have carefully weighed the pros and cons of the various treatment options. All the best to you!

68, Biopsy 9/27/06, Stage T1c, PSA 7.1, Gleason 6 [less than 5% in two areas], Gleason 7 (3+4) [less than 20% in third area], negative DRE, bone scan and MRI. Starting proton radiation therapy 2/22/07. Treatments completed 4/18/07.

Post Edited (pcdave) : 4/28/2007 10:02:44 AM (GMT-6)

Regular Member

Date Joined Feb 2007
Total Posts : 60
   Posted 4/30/2007 7:41 AM (GMT -6)   

The responses you are getting are excellent. What a wonderful group that is willing to share their ideas/thoughts/concerns. Research, research, research is what I had to do. We are all wired differently so YOU must make the critical decisions. I have mentioned on other threads that I had the highest comfort level in major medical centers like Hopkins, Cleveland Clinic, Mayo. They have seen it all. Once I made the decision, I felt great. Also remember that it will take time to got a "good" doctor since their schedule fills up quickly.  Ed

Age: 63
PSA 2.62, Negative DRE
Biopsy: Gleason 3,3
Stage T1c
Prostate 71 grams 
Biopsy: Cancer 5% in one of twelve modules
DaVinci April 16, 2007, Cathter Removed Day 8
Tumor Confined To Prostate,  Gleason 3,3
Surgical Margins and Seminal Vesicles Are Negative for Tumor

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