What questions should we ask?

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mariateresa
Regular Member


Date Joined Jun 2007
Total Posts : 95
   Posted 8/24/2007 11:07 AM (GMT -7)   
What questions should we ask Dr. Menon? I already printed off all the pre-op, post-op, catheter care, Kegel exercises info from the Henry Ford website so I have all that information. And the only question I have so far for Dr. Menon is to ask if sparing the nerves will leave cancer behind. Are there other questions we should ask? Thanks!

Maria Teresa
Husband Rod, Age 55 Maria Teresa age 44

Total PSA 8 on 05/21/07

DRE: prostate bumpy

Biopsy on 07/16/07: 5 out of 8 cores positive, Gleason Score 8 (3+4+5)**
A. Infiltrating, poorly differentiated adenocarcinoma, Glesason Score 8 (3+4+5). The tumor involves approx 70% of the submitted tissue.
No perineural or capsular invasion is identified.

B. Infiltrating, poorly differentiated adenocarcinoam, Gleason Score 8 (3+4+5). The tumor involves approx 50-55% of the submitted tissue.
Perineural invasion identified. Capsular invasion is not seen.

C. Infiltrating, poorly differentiated adenocarcinoam, Gleason Score 8 (3+4+5). The tumor involves approx 70% of the submitted tissue.
No perineural or capsular invasion is identified.

D. Infiltrating, poorly differentiated adenocarcinoam, Gleason Score 8 (3+4+5). The tumor involves approx 60% of the submitted tissue.
No perineural or capsular invasion is identified.

E. Infiltrating, poorly differentiated adenocarcinoam, Gleason Score 8 (3+4+5). The tumor involves approx 20% of the submitted tissue.
No perineural or capsular invasion is identified.

CT of the abd/pelvis; Bone Scan; Xrays done on 08/13/07: Normal


**"Report to the Nation on Prostate Cancer" published by the Prostate Cancer Foundation, page 11: "In some cases, the pathologist might identify a third pattern, which is less common but that has a higher grade than either of the first two patterns that comprised the Gleason score. The presence of this third pattern might indicate that the tumor is more aggressive than the Gleason score would otherwise imply. For example, if a Gleason 4+3 tumor also has some grade 5 cells, the cancer would be considered as being of higher grade disease overall."


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8122
   Posted 8/24/2007 11:27 AM (GMT -7)   
Hi Maria Teresa,
You might ask the following as well...
1> If you perform the procedure, will you be removing lymph nodes and testing them for cancer?
2> If the LN appear positive would you still remove the prostate?
3> Given your husbands Gleason, what additional therapies would you suggest after surgery?

Dr. Menon is one of the top surgeons in the world and I would guess the first two are yes and he may suggest HT and radiation on the last one.

Tony
Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology was poor: Gleason 4+3=7, 4 positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
 
My PSA did drop out after surgery to undetectable.  It has not returned and I will continue HT until January '08.
 
My Life is supported very well by family and friends like you all.
 
STAY POSITIVE!


AEG
Regular Member


Date Joined Nov 2005
Total Posts : 154
   Posted 8/24/2007 12:33 PM (GMT -7)   
Hi Mariateresa,

Glad to see you're doing better. Here is a link with questions to ask:

http://malecare.com/new_page_44.htm

Best of luck.

A.

IdahoSurvivor
Veteran Member


Date Joined Aug 2007
Total Posts : 1015
   Posted 8/24/2007 2:07 PM (GMT -7)   

Hi Maria Terese,

The "malecare" link that AEG gave you has very good information.

Here is a list of questions that I found and used when I visited my doctor:

  • Based on your experience, why is this the right approach for me?
  • Do you plan to employ a nerve-sparing technique with the aim of conserving my ability to get an erection following surgery?
  • What level of success have you had in preserving potency (ability to get an erection) in your patients following surgery?
  • What about preserving urinary continence (bladder control)?
  • What will you do if you find cancer outside of my prostate during the surgery?
  • Will that change my prognosis and future treatment?
  • Do I need to be concerned about blood loss during the surgery? Should I store my blood or get my family and friends to donate blood in case it is needed?
  • What can I expect following the surgery in terms of recovery time? How long will it be before I can return to my normal activities?
  • What are the likely or possible side effects of the surgery, both short-term and long-term?
  • What will we do to monitor my prostate cancer following the surgery?
'Hope that helps!
 
Idaho

Age: 54
PSA: 4.3
Biopsy: T1c, 3+3=6, 2 pos. samples in one side of prostate
Da Vinci 31 Jul 2007: saved nerve bundle on side of non-cancerous side
Final pathology: Confined to prostate, T2a, 3+3=6
Working to get back into good shape
Waiting to take that first post-op PSA

mariateresa
Regular Member


Date Joined Jun 2007
Total Posts : 95
   Posted 8/24/2007 2:58 PM (GMT -7)   
Oooh, those are all excellent questions! Thank you so much!

Maria Teresa
Husband Rod, Age 55 Maria Teresa age 44

Total PSA 8 on 05/21/07

DRE: prostate bumpy

Biopsy on 07/16/07: 5 out of 8 cores positive, Gleason Score 8 (3+4+5)**
A. Infiltrating, poorly differentiated adenocarcinoma, Glesason Score 8 (3+4+5). The tumor involves approx 70% of the submitted tissue.
No perineural or capsular invasion is identified.

B. Infiltrating, poorly differentiated adenocarcinoam, Gleason Score 8 (3+4+5). The tumor involves approx 50-55% of the submitted tissue.
Perineural invasion identified. Capsular invasion is not seen.

C. Infiltrating, poorly differentiated adenocarcinoam, Gleason Score 8 (3+4+5). The tumor involves approx 70% of the submitted tissue.
No perineural or capsular invasion is identified.

D. Infiltrating, poorly differentiated adenocarcinoam, Gleason Score 8 (3+4+5). The tumor involves approx 60% of the submitted tissue.
No perineural or capsular invasion is identified.

E. Infiltrating, poorly differentiated adenocarcinoam, Gleason Score 8 (3+4+5). The tumor involves approx 20% of the submitted tissue.
No perineural or capsular invasion is identified.

CT of the abd/pelvis; Bone Scan; Xrays done on 08/13/07: Normal


**"Report to the Nation on Prostate Cancer" published by the Prostate Cancer Foundation, page 11: "In some cases, the pathologist might identify a third pattern, which is less common but that has a higher grade than either of the first two patterns that comprised the Gleason score. The presence of this third pattern might indicate that the tumor is more aggressive than the Gleason score would otherwise imply. For example, if a Gleason 4+3 tumor also has some grade 5 cells, the cancer would be considered as being of higher grade disease overall."


aus
Regular Member


Date Joined Sep 2006
Total Posts : 211
   Posted 8/24/2007 4:53 PM (GMT -7)   
Regarding your question on nerve sparing and leaving cancer behind:
 
Surgeon's priority is to remove all cancer. He would not leave a nerve if that would also involve leaving cancer.
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