which is the most selected method

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siberian
Regular Member


Date Joined Oct 2007
Total Posts : 94
   Posted 11/15/2007 6:34 PM (GMT -7)   
open prostate surgery, IMRT, Brachytherapy, Davinci---gentlemen  a poll is in order  please give your pathology situation  and what guided your decisions.  I was diagonosed 0ct 2007,having had a psa rise from 2.9 to 4.7  in 12 months,---had T1c, gleason 3+3=6 and 66cc size.  Since I was on testosterone replacement,  they immediately sugested I stop replacement.  After much research  I find that it is inconclusive whether testosterone  deprivation is necessary, but that it is possible that estrogen deprivation, and increasing progesterone  would work better.  I have even found out that the PSA is also important in that it is the body's method to attack the cancer in the prostate--it appear to be anti-angiogenesis.Their are many studiesout there with many condridicting each other.---How then do you make a  clearn decision.
 
Siberian
T1c
3+3=6 gleason
66cc
age 68

ldoun
New Member


Date Joined Jun 2007
Total Posts : 19
   Posted 11/15/2007 7:37 PM (GMT -7)   
Siberian,

I would suggest you check out http://www.yananow.net/ which is a site with experiences and treatment choices of hundreds of men with prostate cancer. That will give you an idea of who chooses which treatment and the reasons they give.

You can get answers to questions and specific advise on this site (healingwell) and a lot of support in dealing with the decisions you are dealing with. There is a wealth of information on the internet and with continued effort put into research you will become very knowledgeable on the subject in a short time.

It is generally accepted that testosterone will promote the growth of prostate cancer and is a standard treatment in most advanced cases.
Age 64
5'8" 145#
PSA pre-op 5.2 (12% free)
Gleason 3+4=7
Robotic RP 4/24/07 Dr. Albala, Duke
Post-op- Organ confined Gleason 7
6/18/07 PSA <0.1
10 wk: 0-1 mini pad per day
ED Cialis and VED prescribed


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 11/15/2007 10:01 PM (GMT -7)   
Siberian,

You are doing some good reading..keep it up! After a while things do start to click and we understand more and more. Like anything else I suppose, need to know leads us where we need to go.

I would like to comment on testosterone replacement therapy and untreated cancer.......

It is fuel for the exsisting cells as long as the cancer is present and/or untreated. It isn't the same as a man's natural production. While it isn't necessary to stop "production" in low grade, organ confined cancers, it is necessary to halt that which feeds cancer cells in more advanced cases no matter how a man gets his testosterone. Some scientists even believe long term hypogonadism puts a man at higher risk for developing PCa. Anyway, what we do know for certain is, adding testosterone to an exsisting cancer, promotes growth. That is why it is suggested you stop replacement therapy, for now at least. It's ultimately your decision.

The wait time for resuming replacement therapy following successful cancer treatment is a highly debated subject. Most Physicians say absolutley never again while others hold a different view. Several of our forum members have resumed using testosteorne after successful surgery, a reasonable wait time and after multiple, negative PSA tests. My DH (Paul) is one such man. I wish all men who need therapy were able. Saddly, this is not the case. Someday we'll outsmart and beat this disease! In the mean time, find a good Doc you can communicate with and one whom you trust to help giude you in finding the right treatment. Wishing you all the best and welcome to the forum.

Swim
 


41diagnosed
Regular Member


Date Joined Jun 2007
Total Posts : 176
   Posted 11/15/2007 10:23 PM (GMT -7)   
There is also Proton Therapy which has proven to be very effective, if not more so than some of the other methods.  I struggled between Proton Therapy and Surgery.  As you can see below, I chose surgery, but it was a difficult decision.  There are many factors that go into making your decision, even beyond your favorable gleason and PSA scores.  Keep us posted on your process and keep the questions coming.  All of here have been through the decision process and will offer whatever support we can.
 
Bluebird, the moderator, might be able to advise how to link to the post I wrote on my decison process.
 
tongue   Post edited to add information per members request

Started by: 41diagnosed

10-16-07  So here's how the games have been going...

09-28-07  On the road to recovery...

07-11-07    Just getting started

 

 

42 yo.

PSA 4.65

Gleason scores from 4 pathologies of the same biopsy with 2 of 12 cores positive for cancer (if this isn't confusing to the patient...):

 

1) both cores 3+4 (Weiss Memorial)

2) one 3+4 and one 3+3 (Univ. of Chicago Hosp.)

3) both cores 3+3 (Mass General Hosp.)

4) both cores 3+4 (Northwestern Memorial Hosp.)

 

9/17/07 - Radical Retropubic Prostatectomy Surgery at Northwestern Memorial in Chicago by Dr. William Catalona.

 

and the winner is...post op Gleason score of 3+4.

 

Good pathology report with negative margins, no seminal vesicale involvement, no lymphatic or vascular invasion, bladder and urethral free and tumor volume was 5% of 27.3g.  Amazing how something so small can cause such problems!

 

9/27/07 - Catheter removal...let the games begin...

Post Edited By Moderator (bluebird) : 11/15/2007 10:50:34 PM (GMT-7)


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 11/15/2007 10:37 PM (GMT -7)   

Hey ~ Glad to see your personal thread...

tongue  HiSiberian & Loved Ones…

 

Welcome   to…   ~ HealingWell ~

 

and

 

A   Special   Warm Welcome  to  You !

 

Knowledge gives us POWER….  POWER takes away the fear.

 

~     ~     ~     ~     ~     ~     ~     ~     ~     ~     ~     ~     ~

 

 Click  on  link  below for important information that will help you ~ help us!!

 

Welcome New Members ~ to HealingWell

 

 

The information (link) listed above is to help you get started on your journey. 

     It is a journey best traveled with friends. 

          Welcome ~ New Friend from all the members here... on HealingWell.com

 

v      IdahoSurvivor ~  Moderator for Prostate Cancer Forum

http://farm2.static.flickr.com/1160/1313099593_9f819e3ff8.jpg

 

v      bluebird ~  Moderator for Prostate Cancer Forum

http://i206.photobucket.com/albums/bb179/mamabluebird1955/mamabluebirdWelcome.jpg


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 11/15/2007 11:12 PM (GMT -7)   

Hey ~ Siberian,

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

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

Here's one link not in the direct links yet...to help get you started in your research

 open, Laproscopic, DaVinci, Oh My; open ... started by nscott

There are quite a few in the link below....

Excerpt from your direct links in your Welcome message above... click on link 

v      Prostate Cancer Resources, Helpful Hints, and Topic Thread Links

This link is also located at the top of the HealingWell’s Prostate Forum where topics (threads) are viewed.

*Articles recommended by members, *Biopsy, *Decision Time, *Depression, *ED, *HealingWell Information

* "Our Journey", *Other Topic Threads, *Radiation Threads, *Support, *Urinary

*Woo-Hoo's  A small sample of PSA's being undetectable or coming down!!!

 

Post Edited (bluebird) : 11/16/2007 8:38:50 AM (GMT-7)


JustJulie
Regular Member


Date Joined Mar 2006
Total Posts : 355
   Posted 11/16/2007 7:11 AM (GMT -7)   

Siberian:

If you have any questions of Brachytherapy let me know, that was my husband's treatment choice.

My only advice to you is to choose whatever you're comfortable with and don't look back.  Good luck in your decision.


spinbiscuit
Veteran Member


Date Joined Apr 2006
Total Posts : 818
   Posted 11/16/2007 8:21 AM (GMT -7)   
Hello Siberian,

Just as Julie said what ever your choice is, and for what ever reason; don't second guess. All procedures show the same excellent results. It's fortunate you have an early diagnosis because every option is open to you. What ever the choice is make sure the doctor has your total confidence; he/she has to be the best.
Be prepared with questions for the doctor's interview. You'll need to get a good feel for what the doctor's capabilities are, and if you trust in him/her.

Good luck to you on your search, and 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. margins
DaVinci surgery on 02/23/06
Last PSA 08/26/07 @ 18 months "0"


biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1463
   Posted 11/16/2007 11:30 AM (GMT -7)   
Hey Siberian,

I too was on testosterone replacement therapy for 10 years before cancer. When diagnosed, my urologist told me I could never use TRT again. I stopped taking shots and had a radical prostatectomy. I was fine for a couple of months then started having hot flashes, muscle weakness, confusion and finally a deep, dark depression that resulted in near suicide. My uro still would not let me use TRT so I found another doctor that put me back on shots. Within a few days I was back to normal. My testosterone level at that time was 48. Currently it is about 600.

As Swim has said, it is controversial. My PSA tests had been 0.00 for 4 months and I chose to use TRT rather than face the terrible effects of hypogonadism. That was in April 2007 and my PSA tests have all been 0.00 since then. Surgery was the only choice for me because any other treatment would have made it impossible for me to go back on TRT.

Its risky and if I still have cancer cells I will have to face the consequences. My choices were to live like a zombie on Prozac with the possiblility of having a recurrent cancer anyway or to chance it and live a happy life for as long as I can. I chose life. It seems to be one of the quandries of this disease that testosterone can kill us and the lack of testoserone can also kill us.

We have many choices to make while fighting PCa. We have to take control of our lives, research the options, get second opinions then make decisions and not look back. Until a cure is discovered this is the best we can do. There is life after cancer but we have to make it happen...

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 - 10/17/07 0.00. 
Started Tri-Mix on 8/7/07.  .05 ml and 50 mg Viagra.  It works!!!
Next PSA test on 1/15/08
 
"Patience is essential, attitude is everything."
 


jetguy
Veteran Member


Date Joined Sep 2006
Total Posts : 741
   Posted 11/16/2007 6:12 PM (GMT -7)   

Hi Siberian,

My numbers were the same as yours except that my prostate was much smaller and I'm five years younger than you.  I did Image Guided IMRT and have been happy with the results.  My first post treatment PSA was a 1.9 and my most recent was 0.8.  My only long lasting side effect is the occasional loose bowel.

I also agree with JustJulie.  Do your research, make your decision, and don't look back.  Best to you.

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.
Seven month PSA is 0.8.


siberian
Regular Member


Date Joined Oct 2007
Total Posts : 94
   Posted 11/17/2007 12:34 AM (GMT -7)   
thanks biker 90

Your posts was very informative.. I too dont like testosterone deprivation therapy. I have read several articles that dont agree with testosterone deprivation. In fact 50% of the articles dont agree. Many articles promote balancing the hormones--In most instances gents with pc have lower testosterone and higher estrogen. They contend that it is the higher estrogen and lower progesterone that is the real culprit. Indeed some articles even say that lowering psa may not be that good while yu still have your prostate because psa is a natural enzyme that is itself anti-angiogenesis, which means psa acts to cut down the blood supply to a tumor The point is, that even the doctors cant agree.
I have been recommended to stop the testosterone replacement until after the operation. I have agreed to that, but will talk to my doctor about balancing my testosteron/estrogen/progesterone,---before surgery. If this shrinks the size of the prostate, I am on the right tract,--and will let board know.

siberan
age68 psa 4.7 was 2.9 a year ago
t1c and prostate size 66cc
gleason 3+3=6
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