New To Board and Still Deciding on Treatment

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nscott
New Member


Date Joined Sep 2007
Total Posts : 9
   Posted 9/6/2007 7:21 PM (GMT -6)   
Hi all.  I have been wandering around the site and didn't see anything recent on chosing between surgury and radiation.  My Dr and I have been watching my PSA climb and just prior to my second biopsy it reached 9.1 but with a free PSA of 26%.  While my first biopsy came back inconclusive (1 out of 24 was not normal but not cancer either) the second one hit the jackpot (again, just in one core).  The Gleason was 6 and the stage was T1c so I consider myself very lucky ... in a relative way. 
 
In any case, I have noticed that most on this site have had surgery.  I have talked to two urologists (one of whom had the robotic assisted laproscopic procedure himself) at my medical facility and am scheduled to see a radiation oncologist next week.  I tend to be leaning that way myself but am looking for recent anecdotes from others who have gone through one or the other to help me decide.  Obviously I am interested in the recovery process and short/long term effects.
 
Thank you for your time.

biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1464
   Posted 9/6/2007 8:42 PM (GMT -6)   
Hey NS,

We are all different and chose our treatment for different reasons. As you have found, there is no magic bullet that will take care of PCa. Factors in our decision are age, PSA, Gleason and other outcomes for the biopsy. But probably most make their decision based gut feel. We collect all the information we can, ask questions of our doctors, get second opinions and go with what feels right for us. That is the most important part, that it is right for US.

I had RRP (open surgery) because I wanted the cancer out of me as soon as possible. I chose open vs robotic because I was very confident in the surgeon. My recovery was uneventful, I went back to work teaching 3 weeks after surgery. I was dry the second day after the catheter came out. It was in for 6 days after surgery. The problems I have had are the result of a low testosterone condition that I have had for years.

The two side effects of surgery are incontinence and ED. Incontinence was not a problem and I use Viagra and Trimix for sex.

You will hear from others here on the forum that have chosen different treatments. To net it all out, you have to pick the treatment that is right for you.

Good luck...

Jim
Age 73. Diagnosed 11/03/06. PSA 7.05. Stage T2C Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Pathological stage: T2C. Gleason 3+4. Cancer confined to prostate.
PSAs from  1/3/07 - 7/18/07 0.00. 
T level on 4/2/07 - 48     On 7/16/07 - 613
Started Tri-Mix on 8/7/07.  .02 ml and 50 mg Viagra.  It works!!!
Next PSA and T tests on 10/17/07
 
"Patience is essential, attitude is everything."
 


Tamu
Veteran Member


Date Joined Oct 2006
Total Posts : 626
   Posted 9/6/2007 9:03 PM (GMT -6)   
nscott,

Your are way ahead of the game with the very early diagnoses and already getting various medical opinions on types of treatment. Your knowledge is your best friend. You have time to research and decide. When I was diagnosed and once I got over the shock I began researching as you are doing. I had narrowed my choices down to robotic assisted laproscopic surgery and proton beam radiation. The proton beam radiation approach was enticing due to the reported excellent complication rates. My immediate concern was the incontinence and impotence complications of surgery. After pondering the issue for a couple of weeks it finally came down to two key points. These were, "How do I know that I am cancer free?" and "If I am not cancer free can I have another treatment that will give me the best chance to be cancer free?". The only way to know that you are cancer free is to have the prostate removed and examined pathologically. In the case of radiation types of treatments if a post treatment PSA indicates the cancer is still present then it is very unlikley that surgery can be used as a next step treatment. With surgery if the post op PSA indicates cancer cells are still present then you can followup with radiation treatment.

Prostate cancer surgery, laproscopic or open, is major surgery. While most men are only in the hospital a day or two they do take several weeks to heal enough to return to normal activity. The incontinence side effect seems to be not a big issue with most men on this forum but it can take months to become totally dry. The ED is another issue taking many months for the average guy to get a normal erection back and requiring intervention including ED drugs, vacuum pumps and penile injections until that occurs. There are the exceptions where some of the lucky ones are dry from the day the catheter is removed and get an erection within a few weeks following surgery. If you are weighing these impacts in your decision then look at the average and not the lucky guys.

The most important point for you is that your cancer is curable!!

Good luck and stay with us. If you can create a signature by going to Control Panel at the upper left of this page and filling out your information it will help the rest of us when we respond to your inquiries.

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
Began injections in April '07
Undetectable PSA on 6/25/07


spinbiscuit
Veteran Member


Date Joined Apr 2006
Total Posts : 818
   Posted 9/6/2007 9:36 PM (GMT -6)   
Hello nscott,

I chose the daVinci procedure because I wanted to know right away that the PCa was out of my body, and that the procedure would be over and done with in 1-2 days. The thought of a month or more of radiation treatments did not appeal to me even though I knew it would be just as effective. My recovery was slower than most (about 10 weeks to regain continence), but not difficult.

Some of us would rather not face surgery, and the radiation theropies offer excellent alternatives that will yield the same high cure rates. So no matter what treatment you choose; it will boil down to the experience of the doctor.

I wish you good luck with your research, and please keep asking questions.

Glen


Diagnosed at age 60
PSA went from 2.2 to 3.8 in 14 months
2 of 14 cores positive at 10%
Gleason 6(3+3), negative DRE, neg. boundaries
DaVinci surgery on 02/23/06
 

Post Edited (spinbiscuit) : 9/6/2007 8:40:44 PM (GMT-6)


puget
Regular Member


Date Joined Mar 2007
Total Posts : 237
   Posted 9/6/2007 11:19 PM (GMT -6)   
NS, I had essentially the same biopsy, and like so many others, I agonized over which treatment option to choose. With a staging of T1c I felt I was pretty safe with any of them. Like others, I finally chose surgery because I wanted the PCa out of my body -- which would give me a firm diagnosis so I could then make informed choices. My post robotic surgery assessment was that the cancer was confined to the prostate and my post surgery Gleason and staging was still 3+3 = 6, T1c. I have my first post surgery PSA this week, so wish me luck. I was lucky on the continence issue -- essentially dry after 4 weeks with only the occasional leak. After the cancer itself, this was my biggest worry. What a relief! ED has been a work in progess. I expected (unrealistically) that because both nerve bundles were saved, I would "boing" right away. That isn't the case for most men, including me. I'm now 3 months post surgery and have about a 50% response to 100 mg of Viagra (or equivalent). But I really do see gradual improvement. Dr says it can take as long as 24+ months, but he assures me I will regain almost if not all what I had prior to surgery. I continue to be hopeful. My brother had radiation. No incontinence and no ED -- at first. The issue with radiation, as I understand it, is that the scar tissue from radiation develops over time and ED does become a problem over the next 12-24 months. That was the case with my brother. After a couple of years, he now is pretty much impotent. I don't know for sure, but at this point (6 years post radiation for him) I don't think drugs are any help. I don't know if he's tried other therapies (pump, injections). Lots to consider, I know. Your age and current physical condition also play a large part in assessing how well you will do in the future, particularly as to ED. I'm sure you have more questions. There are a lot of HW threads that reflect others' experience with surgery, seeds radiation and other options. Click on Bluebird's post at the top of this thread and you'll find a listing of them. You will have lots of advice and support. Stay in touch.
Puget
60 years old
Dx March 2007
Pre-Surgery Gleason 3+3 = 6
Clinical Stage: T1c
Biopsy: 1 in 10 positive
Da Vinci: June 7, 2007 
Post-Surgery Gleason 3+3 = 6
   Clear at margins
First Post-PSA Sept 07


AEG
Regular Member


Date Joined Nov 2005
Total Posts : 154
   Posted 9/6/2007 11:46 PM (GMT -6)   
Hi NScott,

Welcome to the site, glad you found us. Choosing the course of treatment can be overwhelming. It seems that every doc you talk to has a different opinion. They all push their treatments, of course.

I found the yananow site to be very helpful initially:

http://www.yananow.net/
http://www.yananow.net/Experiences.html

Go throught the mentor experiences and it will give you a good feel for the various types of treatments that are available.

Best of luck to you and please keep us posted.

A.

IdahoSurvivor
Veteran Member


Date Joined Aug 2007
Total Posts : 1015
   Posted 9/7/2007 12:18 AM (GMT -6)   
Hi nscott,
 
Welcome to a very caring forum!  We're glad you're here, not glad that you had to share the disease.  The good news is that you'll find a lot of help here and that you have a lot of options. 
 
We invite you to make a personal signature for your posts, like of lot of us have done, by using the "Control Panel" and "Edit Profile" function above.  This will help us all know more about you as you post and such that we may respond more effectively to you.  For example, you may wish to post your age and some details about your pathology report.  See what others have done for some guidance.
 
When you go to the main "Prostate Cancer" forum link above, you'll find that our moderator, bluebird, has posted a lot of good information and helpful links in a locked post at the top of the forum.  I think this will help you as well.
 
Like has already been said, a treatment option has a lot to do with your age and current health.  In the end, you are the one who makes the final decision and no one can second-guess your decision.  Keep asking questions. 
 
My experience with robotic surgery has been terrific.  I chose it due to my "young" age of 54, my good chance at having the cancer contained solely in the prostate, and my projected life span.  The men in my family line live into their late 80s and early 90s, except for a two who smoked a lot and died of lung cancer (my uncles who were tobacco farmers in Kentucky).  So I wanted something that had a good "chance" at a cure, although, there are no guarantees.  I also wanted the deep pathology of the cancerous prostate that only surgery could provide.  I wanted to know what I was really up against since PSA doesn't tell the whole story.
 
Again, it'll be solely your choice what to do and no one here will try hard to get you to choose one treatment over another.  All the treatments have their pros and cons.  We'll just be here for support.
 
Again, welcome to the forum!
 
All the best,
 
Barry (a.k.a. Idaho)
 
 

Da Vinci Surgery July 31, 2007… 54 on surgery day
PSA 4.3  Gleason 3+3=6  T2a  Confined to Prostate

Waiting to take that first post-op PSA

My awareness web site: http://pca-info.blogspot.com

 


norskie
Regular Member


Date Joined Jan 2007
Total Posts : 376
   Posted 9/7/2007 8:43 AM (GMT -6)   
nscott

As with many who have responded here already I chose the Da Vinci for may of the same reasons. Some additional facts in my case as I looked at it was the fact that it appeared I had caught it fairly early and was a good canidate for surgery, I was young at 48 and have two young kids that I plan on being around to see grow and finish school, surgery gave me the chance to know how advanced it was and if needed could do follow up additional treatments such as radiation etc. As it turned out after the pathology report came back, it was determined my Gleason was raised from a 6 to a 7 and they found a couple real agressive cells that left untreated for another year or two could have left me with a much rougher road to travel. It has now been 8 months since my surgery and so far so good with my first two post PSA tests <.1 or undetectable, only minor incontinent issues, never used more that one pad from day one and can achieve erections with out the need of medication. While I feel very lucky it took time and things are different and will be forever but I am ok with that because my number one goal was to be cured and deal with the rest as they come. I too wondered what action to take and as the others have stated take your time and do research and the right decision for you will come, and it's what you feel is the right course of action. I had a second opinion at a University Hospital and Cancer Center and after meeting and talking to that doctor I knew what to do, it felt right and he gave me the confidence that I needed to let him preform the Da Vinci procedure, until than I was considering all options and went back and forth daily. I don't post often these days but let me say this that the folks that answer on this site are incredible and really care and help with support, suggestions and answers, I didn't find this site until I was just ready to go into surgery so you my friend are way ahead today. Good luck and our prayers are with you for great sucess in beating PCa. Remember it is your choice and decision you will know when it feels right.

Norskie
norskie
Age 49, PSA 6.22 on 9-26-06
Biopsy 11-01-06, 2 of 13 cores 10% cancer, 2 other cores abnormal Up-dated 20% prostate cancerous
Gleason score 3+3=6 After Pathology report 3+4=7 some agressive 5 cells found
Da Vinci surgery 01-09-07 UW Madison
Pathology Report- cancer 100 % capsual contained 1-18-07
Catheter removed 1-18-07 suffered bladder spasms Catheter reattached 1-18-07
Catheter removed 2nd time 1-24-07
1st Post PSA Blood Test 3-22-07 <.1 Undetectable
2nd Post PSA Blood Test 7/5/07 <.1 Undetectable
3nd Post PSA Blood Test Scheduled for 11/12/07
Incontenence-Pad free since end of May 07 4 1/2 months post surgery 
ED back to 95% prior to surgery - no medication required.


Michael's Wife
Regular Member


Date Joined Aug 2007
Total Posts : 150
   Posted 9/7/2007 3:34 PM (GMT -6)   
My husband and I are relatively new to all of this as well and have been deciding between brachytherapy (seed radiation) and DaVinci surgery for about the last month. He's also T1c with a 3+3=6 Gleason, so he's a good candidate for either. He's been leaning more towards the seeds since he's never been a very good patient and has concerns about the side effects of surgery. That said, it's really an individual choice about which is the right route for each person. I often wish there were a clear "best choice" but that's not the case here; there are pros and cons to each type of treatment. As others have said, the main advantage of surgery is that you can see the true pathology of the prostate as a whole and know (at least as much as you'll ever really "know") whether or not you are cancer-free afterward.

We had our final surgery consultation today and were hoping there'd be a clear answer in terms of which direction to take, but we're probably going to need a few more days still.

Good luck in your research and in making your decision.

Husband Age: 58
Stage: T1c
Gleason: 6 (3+3)
PSA: 4.4
Biopsy: 12 samples, Adenocarcinoma involving 3 cores, right side only (95%, 90%, 30%, discontinuously)
Still researching options

Post Edited (Mike's Wife) : 9/7/2007 3:59:39 PM (GMT-6)


nscott
New Member


Date Joined Sep 2007
Total Posts : 9
   Posted 9/7/2007 9:51 PM (GMT -6)   
Thank you all for your speedy responses. I find them extreamly informative and helpful. Also, I can now add my signature at the bottem.
Age 60 (almost)
Pre-diabetic
Biopsy 2005 - Negative on 12 cores
Biopsy Jan 2007 - Negative on 23 of 24 cores, inconclusive on 24th core
Biospy and Dx Aug 07, 1 of 24 core samples, Stage T1c, Gleason 3+3
PSA went up and down from intial 4.5 with an enlarged prostate to 9.1 prior to last biopsy
Free PSA 26%
Still deciding on treatment at Kaiser in Northern VA
 


Michael's Wife
Regular Member


Date Joined Aug 2007
Total Posts : 150
   Posted 9/8/2007 6:22 AM (GMT -6)   
nscott ... Just saw your signature. We're in the same area and my husband is with Kaiser as well. So far we've been very pleased with the doctors he's had consultations with.

Husband Age: 58
Stage: T1c
Gleason: 6 (3+3)
PSA: 4.4
Biopsy: 12 samples, Adenocarcinoma involving 3 cores, right side only (95%, 90%, 30%, discontinuously)
Still researching options


nscott
New Member


Date Joined Sep 2007
Total Posts : 9
   Posted 9/8/2007 7:32 AM (GMT -6)   
Mike's Wife,

I know the decision process drives me crazy and I imagine you to. Nevertheless, I will decide after seeing Dr. Gupta (not of CNN fame), the radiation oncologist on Tuesday. Dr. Tier is my urologist and I consulted with Dr. Michell who gave me some pretty good insight. I hope to start whichever I choose in October after I go out to Las Vegas (we have an office there so voila, a business trip) to celebrate turning 60.

Just to add to the mess, my wife and I live in separate states (VA/FL ... it is a long story but it has worked nicely for 8 years although we can't wait until we both retire, lol). She hasn't shown much worry so far but I can imagine it is getting to her as well.

Good luck on your decision.
Age 60 (almost)
Pre-diabetic
Biopsy 2005 - Negative on 12 cores
Biopsy Jan 2007 - Negative on 23 of 24 cores, inconclusive on 24th core
Biospy and Dx Aug 07, 1 of 24 core samples, Stage T1c, Gleason 3+3
PSA went up and down from intial 4.5 with an enlarged prostate to 9.1 prior to last biopsy
Free PSA 26%
Still deciding on treatment at Kaiser in Northern VA
 


Michael's Wife
Regular Member


Date Joined Aug 2007
Total Posts : 150
   Posted 9/8/2007 8:30 AM (GMT -6)   
Dr. Guarnaccia is my husband's urologist and he will be performing DaVinci surgery if my husband goes that route. The radiation oncologist he'd use would be either Dr. Tonneson or Dr. Petit. We feel we've been given very unbiased views of the options by all of the doctors, which has only added to the dilemma if you know what I mean. We still feel that either option will give the same results and it's a matter of deciding which side effects are more palatable. All of that said, I think brachytherapy will be what my husband decides on in the end. We're talking about scheduling treatment for December due to other things that are going on between now and then. Hopefully waiting that long won't be an issue. (The doctors have said that it shouldn't be, but obviously you just never know ...)

Adding to the things rambling around in my brain is the fact that we can switch him to my health plan in December, under which he'd have a wider selection of doctors. However, as I said, I know he's comfortable with those from Kaiser so far so it may make more sense to just stick with that plan for him for another year. Too many decisions ...

I'm sure it's tough for your wife and you being apart through all of this. Although the constant reminders may not be there, I know it helps with my husband and me that we can bolster each other up when needed. Last night he was the one reassuring me that everything was going to be okay and that I shouldn't worry. We take turns in that role.

Keep us posted on how the decision making goes.

Husband Age: 58
Stage: T1c
Gleason: 6 (3+3)
PSA: 4.4
Biopsy: 12 samples, Adenocarcinoma involving 3 cores, right side only (95%, 90%, 30%, discontinuously)
Still researching options


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 9/8/2007 2:50 PM (GMT -6)   

Hi ~ NSCOTT & Loved Ones,

A "Special" Warm Welcome to You!

This is truly a great forum!!! ~ "You" have joined! You are now part of our forum family ~ a group of wonderful individuals who are so willing to share their journey.

Thank you for joining all of us on this road to HealingWell…..

KNOWLEDGE IS POWER... and POWER conquers fear

* bluebird ~ Moderator for Prostate Cancer Forum <http://i206.photobucket.com/albums/bb179/mamabluebird1955/mamabluebirdWelcome.jpg>

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

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

Prostate Cancer Resources, Helpful Hints, and Topic Thread Links http://www.healingwell.com/community/default.aspx?f=35&m=52996

(Located at the top of page 1,2,3… 65,67… on the Prostate Forum : )

Invitation to New Members… Welcome to HealingWell (Special Request) <http://www.healingwell.com/community/default.aspx?f=35&m=902976>

I hope this message comes through clearly ~ I'm traveling and the settings are "funky" here!!! Stay close ~ okay... In New Friendship ~ Lee & Buddy

 


uncledan
Regular Member


Date Joined Aug 2007
Total Posts : 120
   Posted 9/8/2007 11:50 PM (GMT -6)   
I suppose it is now easy for me to say I am glad I took the da Vinci surgery since I have had very few problems. I was out of the hospital in two days on a 120 mile trip home ( wife driving ). Back to the doctor's office 7 days later for the removal of the catheter. The only real pain I had was the first night after surgery gettinig back in bed and laying down. I think the aide had her way of helping , but after that I did it my self with the help of the hospital bed ( I would move the head section all the way upright and then as I lay against it I let it down. Worked fine and didn't need the aide. I have never used more than a small ladies pad as a liner of a mens pad even on the first day I had the catheter removed. A little over three weeks later I use a ladies pad in my boxers if I go out, but around the house I don't use it. It is mostly for insurance since I am not leaking now. I am like so many more here I wanted to have the cancer out of my body. If that didn't happen I wanted to know there were other I avenues I could take later. After my biopsy was scheduled my wife bought Dr. Patrick Walsh's book on Prostate Cancer at a yard sale. So when time for me to make a decision on a procedure I read it twice. ( 6 days ). When I met with my uro after the biopsy ( he specializes in freezing and open surgery ) I told him I thought I would rather have the da Vinci method. He said that there was a doctor n Nashville who he could reccommend and he would make the appointment for me. It is a great book and has info on about every kind of procedure that is now in use. By the way he is a Dr. at Johns Hopkins. All said and done it is your decision and the more info you have the better decision you will make. Good Luck and God Bless. Uncle Dan
Age 67
No symptoms, DRE negative
10-06 PSA 5.44 01-07 PSA 6.47
CT and Bone scan negative
05-07 Biopsies, 2 of 6 positive
Gleason Score (3+4) 7 Stage T1c
08-14 Dr. Dasari - Baptist Hospital
da Vinci surgery RAP,
Surgery five hours, hospital 8-14 to 8-16
Lymph nodes 2 R & 1 L - Negative
R & L seminal vesicles - Negative
Pathology report cancer encapsulated Stage T1c
Gleason changed (4+3) 7 closer to 8 than 6
8-31 Use pad when out, Sleeping without pad.


Michael's Wife
Regular Member


Date Joined Aug 2007
Total Posts : 150
   Posted 9/9/2007 6:48 AM (GMT -6)   
Dan - We initially were thinking the same way as you in terms of "wanting the cancer out." The we realized that a surgeon could just as easily miss a few cells as a radiation oncologist could miss a few. And that would be all it would take. Essentially, the cancer is "out" and your prostate no longer exists as a prostate after brachytherapy. As far as having other options afterward, there are other options with brachytherapy as well, including going back and re-seeding if any 'cold spots' are found after the procedure.

In the end it is an individual decision, as you say. In our case, I just don't think we're able to accept the surgery risks. But that's us. I'm glad your surgery turned out so well.

Post Edited (Mike's Wife) : 9/9/2007 11:55:06 AM (GMT-6)


hawkfan75
Regular Member


Date Joined Jan 2007
Total Posts : 165
   Posted 9/9/2007 10:43 AM (GMT -6)   
Since you're still researching options, and that's a really good thing to do, I'd like to add something.  As you can see from my signature, I was in a similar situation following my diagnosis.  My radiologist's comment was that it would nice to live your life with all your parts intact.  When the pathology report came back worse than expected, my surgeon's comment was that it's good that the prostate is sitting in a jar of formaldehide somewhere!  I'm glad I did choose surgery, because now I know the extend of this beast, and am following a second round of treatments to make sure it's wiped out.  You need to weigh the possible side effects of each treatment, and your feelings on treatments versus outcomes.  Don't be afraid of side effects, since they are all better than not doing anything and giving in to the beast.  Good luck with making the decision.

PSA 4.7 (up from 3.2 one year ago)
Biopsy November 8, 2006 1 of 10 cores positive 5% LEFT Side Gleason 3+3
Robotic surgery January 19, 2007
Post Surgery Pathology
     Stage T3a, Gleason 3+4, positive margins and
     capsular penetration RIGHT Side
Post Surgery PSA:  March 5:  0.01
5 month PSA, June 13, 2007:  0.08
Adjuvant therapy began June 26 with Zoladex injection
Radiation began August 23
 


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 9/9/2007 10:55 AM (GMT -6)   
Good Morning,

When talking about ED and incontinence, the same post treatment side effects still exsist following radiation/brachy that are there following surgery. They just happen a year or two don't the road instead of now. It gets down to a treatment choice that each person (there is no we on the treatment table) feels most comfortable in having done. Most of the treatments have similar outcomes. For some men, one treatment may be his only choice. I didn't have the option of radiation for example. Cafeteria style treatment choices have to drive people a little bonkers but, at least there'a treatment for about every body type and health consideration and personality.

Good Luck Everyone who is making his decision.

Paul
 


Michael's Wife
Regular Member


Date Joined Aug 2007
Total Posts : 150
   Posted 9/9/2007 12:54 PM (GMT -6)   
Paul, I'm rather new to this, so maybe I'm missing something (quite possible). You say that the same post treatment side effects still exist following radiation/brachy as with surgery. However, isn't that somewhat relative to the individual and the particulars of the procedure performed? For instance, in my husband's case, the likelihood of nerve-sparing surgery is slim. So, we are assuming that the potential side effects of treatment are greater with surgery. Is this not a correct assumption?

Also, what I've read indicates that those having brachytherapy have a less than 1% chance of developing chronic urine leakage over the long-term. Are you aware of other information?

We're doing our best to make the most informed choice. Thanks for any info you might be able to provide.

Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 9/9/2007 1:47 PM (GMT -6)   
Erectile dysfunction is a delayed treatment reaction and urinary obstructive disorder can occur anytime with radiation and or seeds. There is no perfect choice.. There is only a right choice for the individule and every man has to decide for himself.

I agree with the majority. Takes a lot of reading to make decisions and adding our wives to that mix makes reading a whole lot easier. Two heads really are better than one. Medscape, Urology Times, PCRI, PubMed...there are a lot of places to read.

Paul
 


IdahoSurvivor
Veteran Member


Date Joined Aug 2007
Total Posts : 1015
   Posted 9/9/2007 6:22 PM (GMT -6)   
Hi Mike's Wife,
 
As Paul said, all the treatments have side-effects.  This three-page article found at WebMD may help (click on link->) Life After Prostate Cancer Treatment
 
The article contains a discussion of side-effects of Surgery, Brachytherapy, and external-beam radiation by Mark Litwin, MD, MPH, and colleagues.  Here is a part of the article:
"Brachytherapy and external-beam radiation have a much more profound and persistent effect on the bowel than patients realize," he says. "And brachytherapy tends to have more of an effect on patients' urinary voiding. Surgery, on the other hand, has a much greater effect on erections and urinary control."

Simply listing cancer treatment side effects doesn't give a full picture of a patient's quality of life. Litwin and colleagues also evaluated how much these symptoms actually bothered the men.

"After surgery, patients who have mild incontinence are somewhat bothered, but nowhere near as bothered as those with the severe urinary blockage problems sometimes caused by radiation treatments," he says. "On the other hand, even though we talk about bowel dysfunction being an issue for brachytherapy and external-beam radiation patients, at most only 20% of these patients experience severe bother from bowel symptoms."

Sexual dysfunction, however, severely bothered men in all of the treatment groups. Sixty percent of the surgery patients reported severe bother from sexual dysfunction -- but that tended to diminish over time.

Among men who had no sexual dysfunction before surgery and who underwent nerve-sparing surgery, sexual function improved over the first two years after treatment.

"At the 24-month time point, they are right up there with the brachytherapy and external-beam radiation patients," Litwin says.

All in all, the side-effects are personal and are a product of the patient's health before treatment, the response of the patient to treatment, and the on-going skill and judgment of the healthcare professional.
 
Hope this helps.
 
Keep asking those good questions!
 
Kind regards,
 
Idaho

Da Vinci Surgery July 31, 2007… 54 on surgery day
PSA 4.3  Gleason 3+3=6  T2a  Confined to Prostate

Waiting to take that first post-op PSA

My awareness web site: http://pca-info.blogspot.com

 


Michael's Wife
Regular Member


Date Joined Aug 2007
Total Posts : 150
   Posted 9/9/2007 7:25 PM (GMT -6)   
Thanks, Idaho. We much appreciate the info.

I guess all in all it's kind of a Catch-22. We're grateful to have the choice, but it's a tough one. Either one risks unwanted side effects. Guess we choose our poison, so to speak ...

jetguy
Veteran Member


Date Joined Sep 2006
Total Posts : 741
   Posted 9/9/2007 8:01 PM (GMT -6)   

I had Image Guided IMRT (radiation - not seeds).  The following is what I learned and know.  Please understand that each of us learned and know different things.  Since I am not a medical person, I do not recommend a particular treatment.  I'm not qualified to do so.  But I am happy with my treatment and its results to date.

Urinary problems are more likely with surgery.

ED problems are possible with both.  Perhaps worse with radiation if the surgeon is really good.

Bowel problems are more likely with radiation.

Complications due to surgery do not happen with radiation.

Most of the stats re: radiation are out of date.  Most of them reflect the results of plain old EBRT and not IMRT, or IGRT. 

You pays your money and takes your chances.  Sorry to say that, but I think you know that by now.  There is no perfect choice.  Good luck on your choice.

Regards,

Bill


August of 2006, PSA up to 4.2 from 2.7 one year ago. 
October free and total PSA 12% free and 5.0 total.
A month, or so later, 4.7.
Late in the year decide on Image Guided IMRT.
Begin 43 treatments on January 23, 2007 and finish on March 23.
Four month post treatment PSA is 1.9.  (This is a very good result.)
No side, or after effects.  None.
I have aged a year and am now 63.  How did that happen?


Michael's Wife
Regular Member


Date Joined Aug 2007
Total Posts : 150
   Posted 9/10/2007 3:46 AM (GMT -6)   
Good summary, Bill. And you're right ... There is no perfect choice.

Ellen

JustJulie
Regular Member


Date Joined Mar 2006
Total Posts : 355
   Posted 9/10/2007 2:23 PM (GMT -6)   
nscott:
 
Glad you found us!
 
My husband chose Brachytherapy and has been pleased with the results.  For a full report of the journey, please feel free to take a look at JustJulie's Brachytherapy Journey in this forum.  It's everything we've been through from diagnosis to date and might give you some additional information.
 
If you should have ANY further questions, please ask away.  I can only speak to Brachytherapy and each treatment is a personal choice but I'd be happy to provide any information I can.
 
JustJulie
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