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You are asking some very technical questions now which some of us are trying to help you with, but in reality you should be asking the doctors who you are consulting.
Having said that, let me try to help you with the current crop:
1. You mention four sizes for your prostate gland: 40 gm/cc; 30 gm/cc; 64.82 gm/cc and "5.0cm x 4.2cm x 4.0cm". Now just pause and consider the last item of information along with a PICTURE OF A PROSTATE GLAND
Just what do those measurements mean? Which is the 5 cm dimension; which is the 4.2 cm dimension; which is the 4 cm dimension? Is your prostate gland even the same shape as a 'normal' gland. The shape of a prostate gland is not a uniform cube or cylinder - it canvary in shape considerably and calculating the volume of an irregularly shaped object is notoriusly difficult.
As to the doctors 'estimates', bear in mind that the estimated sizes of your doctors are based on the small part of your gland that they can feel through their rubber gloves, your rectum and your lower bowel. A doctor with small hands might not feel as much as a doctor with long fingers. Then they have to convert what they feel into the size of a gland remembered from their estimates of glands they have removed.
My (very pleasant) main urologist in South Africa was absoltely surprised when we finally tried to get a more accurate estimate of the volume of my gland. He prided himself on the accuracy of his estimates, saying that he used to win the sweeps on size even when he was a student. But he had no idea that my gland had expanded almost vertically - and well away from his probing finger, giving me a total estimated volume after scan of 160 gm/cc. No wonder I had some urinary problems as the expansion certainly indented the base of the bladder.
2. You say I know they will chemically shrink the gland prior to starting... Well, yes and no. The ADT will usually reduce the size of the gland, but not always - and no one can tell you precisely how much it will shrink, if it does. The studies relative to this show quite a wide range of estimates.
3. You ask Is there a prostate size that would eliminate one from being a candidate from radiation? To the best of my knowledge there is not a specific size, if only because if the gland is enlarged it may depend on the direction of the enlargement. In some cases, when brachytherapy is being considered for example, it is said that portion of the gland may be in a position behind the bones of the pelvic girdle which would make it very difficult to insert the seeds. The radiologist who has all the information rearding size and situation of the gland is in the best position to answer this question.
4. You say With my stats, if I elect surgery that issue will be eliminated but I most likely will need radiation anyway, so I'm doubling the risk from both treatments... IF what you say is correct, then what option do you have? If you are certain that surgery will fail, then there is the same likelihood that EBRT will fail. There are no good independent long term studies that show that one has superior results over the other.
5. You ask .... due to the BPH related symptoms I had been having, which started this whole excursion, ...... If my prostate is not enlarged why these problems? I don't recall any specific reference to BPH in any of your biopsy reports (but must confess that due to time constraints I have not been back to read through the various threads - it would have been more simple if you had posted your story on the Yana site). So have you been diagnosed with BPH. That is not the only reason, although it is a common one, for urinery problems which couild result from prostatitis, which is a short term inflammation of the prostate cells or a bladder infection.
Peet, I am not sure there is much more we laypeople can do for you. You're still searching for certainty. I think you should write down all the questions you have before your next appointment and ensure that you get answers that you understand to these questions. If the doctor is agreeable, take a small tape recordr with you to reduce any misunderstanding of what you are told.
Just part of my education process before I leap into the fire.
I was never diagnosed with BPH cause my uro told me my prostate was unusually small and when I declined having the first biopsy back in May 2011, he had nothing else to offer, as in advice or meds for the symptoms I was having.
anyway low flowing water under the bridge at this point.
I am looking for a new Urologist and will discuss this with my current RO, as I move in that direction, EBRT,Brachy and a short term HT for good measure
Really do appreciate your advice through this process, hey what's the worst that can happen? Everything is impermanent...
