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Aloha Wilbert Wilson,
Actually my starting conditions were beyond what is normally recommended for surgery. The chances were too great that the PCa had left the prostate (12 of 12 cores, 4 to 70% PCa), although nothing beyond the prostate was detected by testing. My urologist recommended EBRT/IMRT and 3 years of ADT. After one year of ADT I asked to stop because of pain at the injection sites (still have that pain 2 yrs later). The EBRT/IMRT ultra-sound guided, damaged my colon, rectum, anus, urethra, the two sphincters, and the bladder. These problems are difficult to live with. I was just one of those 10% who got more than their fair share of side affects. At present, the penis is very functional, and I am alive. There is a very good chance that the PSA test and PCa treatment saved my life.
Keep in touch, let us know how you are doing. If you have doubts about treatment, get help, talk it out.
Hamakua Coast, I love it,
I just noticed your comment about the injection site pain. I've been getting Zoladex shots monthly and all the injections caused no problem except the last one when the Doctor seemed to hit something which caused extensive bruising and soreness. You might try a different area for the injection, a different LHRH drug or a different amount of the drug (one month instead of three).
Aloha Wilbert Wilson,
I think that you are rushing into a surgery and I agree that you have plenty of time (many months) to make your decision.
Take a copy of this abstract to your urologist to ask questions and discuss.
Also, please look up/find your local chapter of "US TOO" at cancer.org. Go to a meeting and talk to other men who have had surgery. Life after prostate cancer treatment is never the same. PCa treatment is a life changing decision. Take the time now to understand what you are getting into with treatment.
Getting control of your emotions is a first step toward understanding what is going on in your body. The more you understand what is happening to you the less emotional fright you will have and the better decision you will eventually make. It is your decision. As Terry says, take your time, understand your decision, and with understanding, go for it.
Hamakua Coast, love it,
Aloha Wilbert Wilson,
Please understand that PSA test results are only an indication of many possibilities that are different for each man. My PSA started at 8 and rose to 14 over several months, this with 12/12 cores showing cancer was not good. Your PSA seems to be steady, and as Terry points out this is very good news for you. I have friends with PSA's that are very high, but no cancer. If you read more on this site, you will find that even low PSA's (like 3 to 4)for men with bad cancer. You need to look at and evaluate all the available data that applies to you. Test, Test, Test, then get second & third consults. If you consult a urologist, surgery will be recommended. If you consult a radiologist, radiation will be recommended. In the long run, if you choose surgery, the type of surgery, open or robot, makes no difference in the outcome. It is only the skill of the surgeon that makes the difference. I'm referring to the quality of life after surgery.
I did consult the radiation oniclogist and I was suprized the she did not reccomend radiation theatment in my case. She stated my age for not recommending radiation. From what I here that is unusual as most Doctors will steer you towards there specialty as the best solution.
I have a friend that was diagnosed one month before me. He choose Cryosurgery. He had the cryo 3 days ago have not talked with him since the treatment.
I was never one for Wishful Waiting as I would know that these cells could take off at anytime then it could be too late.
There seems to be no correct answer its what you as a Pc paitent can tollerate or live with.
Slow down. I had all twelve cores like Joe positive, but I got a second opinion with my biopsy. I then used all the nomograms to position myself in regards to what my chances were with different treatments. I also thought all this through myself, and discussed it with my wife, family and friends. And then I thought about the consequences of surgery. ED is no joke, believe me, and there are stories on this web site about ED and incontinence that would put you off surgery completely. Read them and understand that your decision is irreversible!
There are other factors to consider in regards to your biopsy. You have not mentioned any type of carcinoma. I had cribriform sheeting, which can show a more aggressive form of cancer.
Interesting discussion. I was diagnosed Feb. 16 with a normal PSA and a Gleason of 6. My father died of prostate cancer in 1998 after having surgery, radiation and finally hormones. His quality of life was greatly diminished after the surgery. I am a firm believer that PCa is genetic. Also, from everything I have read and everyone I have talked to, the disease moves very slowly and if the cells are going to spread, it really does matter which treatment you select.
The standard responce to the diagnosis is if you are under 60 surgery is the only way to go. If you look at the numbers it doesn't matter what treatment you choose at your stage, the survival rate is about the same. It is pretty much better than a 90% of greater than a 10 years. What you have to ask yourself is, how do I want to live out the rest of my life. I asked a doctor once why surgery is the perferred treatment (he was a surgeon) and why it is the most common treatment and he said "people just want the cancer out". In reality all of the tissue can never be removed. That is a fact supported by literature.
Go to the Internet and watch a video of the surgery, both open and D'Vinci. I wasn't thrilled by what I saw.
I have been to the urologist and the radiologist and they both gave the standard answer. When I asked what the survival rate was they said it is the same no matter which procedure you pick. The only issue was the order. If you did the radiation first you can't go back and do the surgery, but you can go forward and do hormones or any other treatment available.
I have one more consult coming up on May 4 at Loma Linda to discuss Proton treatment, which is a targeted form of radiation. This is also available to you since you live in southern CA.
You have to do what is right for you, but look at all the info available on this site before being pushed into something just bacause it is the "standard of care"
I am scheduled for a consultation with LL on May 4 with Dr. Rossi. My insurance has turned down proton therapy, but they have approved the consultation. I assume they want justification for pursuing this therapy, which I will give them after my visit with Dr. Rossi. As long as he can do this, they should approve. I will let you know what he has to say.
I just finished reading Bob Marckini's book and I would highly suggest you do that before your surgery. I would be happy to borrow you mine if you can not get one that quickly. The main symptom he had was a rising PSA. He puts together a very non-bias description of the process he went through to evaluate his diagnosis.
In the end you still need to make your own dscision. I wish you well.
I have just read Bob Marckini's book as you recommended and I have previoulsly also read Dr. Patrick Walsh's from John Hopkins.
Each book says that there treatment is the best(?). My main symptom is also a high PSA.
I have an appointment on May 4th with my Urologist for the pre surgical workup and examine. As I mentioned the surgery is scheduled for May 8th. My urlogist Dr. Tamaddon has done around a 1000 of the Di Vinci procedures at Kasiser in in West L.A. so I am not concerned about his experence with the procedure. I know it will be an uphill fight with Kaisier HMO to get them to pay for the Prothon treatment. In the mean time the PCa could be spreading.
Before I comment ot surgery I will discuss this Prothon treatment otption at my appointment on May 4th.
Yes, you are moving too fast. Yes, your PC may be spreading, but likely not so fast that you cannot take the time to understand the outcomes.
On April 18 I got the results of my PSA. On May 14 I had my biopsy. On July 7 I had my surgery. I moved too fast.
I now believe that you should not be hoping that or counting on the experience of your doctor to somehow beat the numbers. Already now, even before surgery, you should be planning on how you will deal with ED. It is easy and reasonable to say, "get the cancer out, we'll deal with the rest as it comes." It is wonderful that you have a supportive spouse. So do I. But I will tell you, ED hits you harder than you even now can fathom. I'm cancer free since the surgery--and there are days that I want my prostate back, even diseased, I want it back. The absolute frustration of ED is a daily thing. The depression that comes with ED is real.
You're running on fear. We hear "Cancer" and it ramps us up like few things can. I know, I had a front seat on fear's roller coaster ride.
My doctor was great, one of the most experienced in the area, working out of one of the best facilities in the area. Both nerve bundles were spared. Surgery was uneventful, recovery was uneventful. I am no longer in diapers, pads are still a once and awhile safety net. While mostly continent, I think about, plan, and leave allowance for peeing every day. I can't drink a glass of water without taking into account when or where I will be when I have to pay the price.
Wilbert, it is not if you will be incontinent, but for how long and to what degree you will get something back that you can count as control? There will be a new "normal"--what can you live with. It is not if you will have ED, but what is your, and your doctor's plan to deal with ED?
Wilbert, you ask if you're moving to fast, guys have been giving you great answers, but it doesn't sound like you are listening when they say "yes, you are." I understand. I didn't want to hear either. I wanted guys to say, "no, run and get your operation," and when they didn't agree with me, I didn't listen either.
Read my entry on the experience page. I am more like your experience than not. Had I to do it all over again, I would rather deal with the diet and testing regimen of active surveillance than what I am dealing with now.