Posted 6/14/2007 11:40 PM (GMT -6)
Tamu and Vet have both given you great advice and if I was in your shoes, I would follow it.
I had a psa of around 4.5 - 5.5 for 5-6 years before I saw a urologist. I had a negative DRE (digital rectal exam), and a free PSA running from 21-24% which points to if a problem, chances are it was benign. I had a twelve core biopsy, just for screening. 6 on each side. Left side all negative. Right side, 1 core of the 6 on the LAST 1mm of a 120mm core showed some cancer cells... Rated at a Gleason 3+3 or 6. They only caught it by a distance of a hair...
I researched the alternatives, also thinking in the back of my mind that the cancer must be very small and insignificant... And I would easily be well within the negative margin group where all the cancer was totally contained within the prostate. After research, for me, my current health, and my future life, I decided to go with the nerve sparing DaVinci robotic procedure. These decisions must be made by every individual themselves... That is why it is important to be as informed as you can get and ask as many questions as you want... I would write them down before a visit to the doctor(s) so I would not forget anything.
I had surgery 4/24 and catheter out 5/2... I am feeling very well and healthy... I am also on the "normal" side of recovering my continance and seem to be faster on the ED side. Yes at times I get frustrated about the time it takes to recover total continance and ED factors, but that is just because I am impatient. I would not change my decision at all. It was the best decision I made for ME.
And, by the way, the reason I gave you so much background about my minimal screen biopsy, as I interpreted it and I think the doctor was a little suprised also, was that the pathology of my prostate after it was removed was that it was 20% involved! and I had two areas where a couple of the cancer cells were touching the outside portion of the prostate. I am so glad I caught the cancer when I did... The Gleason stayed at 6 for the final pathology and did not get upgraded higher which sometimes happens to many patients. The doctor feels it all got removed and my final pathology "numbers" reflect on a nomogram that the "odds" are 95% that I will not have a recurrence of cancer for 7 years.... Nothing is ever 100% with cancer (and many other diseases) ... especially the longer time frame you look out. For me, these are GREAT numbers for cancer... I I fully expect to eventually die from something other than cancer.
Walt, take good care of yourself, research, inquire, ask many questions, get second opinions from doctors, keep on visiting this board (no question is dumb or too intimate!), follow the advice from the previous posters, and make the best decision for yourself and your particular circumstances.
Age 59 y/o - Last 3-4 years of annual general health checkups - PSA 5-6 but Free PSA Ratio 21-24%, suggesting "benign"
3/7/2007 - Went to urologist -Neg DRE, but scheduled screening biopsy
3/13/2007 - 12 point biopsy - Left 6 OK Right 1 of 6 had small hit.
Gleason 3+3 Diagnosed as T1c
4/24/2007 - DaVinci performed at Virginia Mason hospital in Seattle
5/2/2007 - Catheter Out! Got copy of pathology report:
Gleason 6 T2c Nx Mx approx 20% of prostate involved
Positive margin, but 2 places where a focal point of only 2 cells were touching edge, the right apex and right posterior. Perineural Invasion present. Seminal Vesicle and Lymphatic/Vascular not identified. Final Diognosis of T2c "suggests" organ confined. Stats for no re-occurance are 95% for 7 years. No further treatment other than PSA watch.