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Sorry to hear your news, Carlos, but welcome to the club you never wanted to join. I am using Google translate to make this into a Portuguese reply below. Hope that helps you.
1. The increase in your PSA may not have anything to do with prostate cancer. The very small amount of prostate cancer found in your biopsy may not have anything to do with your PSA. The fact that you seem to have some prostate or bladder problem may well be the cause of the higher PSA.
2. It is very difficult to establish just what an IPSS of 22 means because this method of diagnosis is not used outside Europe. But it seems clear that you have problems with obstruction.
3. I have seen, particularly in Europe, men having a TURP (Transurethral Resection of the Prostate) or RTU before therapy, but always before the main therapy to allow healing. I have never seen brachytherapy done at the same time as a RTU.
4. It seems from what you have said that brachytherapy may not be your best option. There is no ‘right’ or ‘wrong’ in the prostate cancer world, but some treatments may be better than others, depending on the man and his diagnosis.
5. Your diagnosis indicates that it may be in your interests to consider AS (Active Surveillance), which is to say that you might consider delaying any treatment. Many men with a similar diagnosis to yours have found that the disease does not progress.
Finally, can I suggest you read my booklet. If you go to A STRANGE PLACE. and get the URL address and then go to Google Translate and enter the URL. Choose from English to Portuguese and the page will be translated.
Good Luck.
Terry in Australia
Triste de ouvir as notícias, Carlos, mas bem-vindo ao clube, você nunca quis participar. Eu estou usando o Google Translate para fazer isso em uma resposta Português abaixo. Espero que ajude você.
1. O aumento em seu PSA pode não ter nada a ver com o câncer de próstata. A pequena quantidade de câncer de próstata encontrado em sua biópsia pode não ter nada a ver com o seu PSA. O fato de que parece que você tem algum problema de próstata ou bexiga pode muito bem ser a causa da PSA superior.
2. É muito difícil estabelecer o que apenas um dos 22 meios IPSS porque este método de diagnóstico não é usado fora da Europa. Mas parece claro que você tem problemas com a obstrução.
3. Eu tenho visto, principalmente na Europa, os homens que têm uma RTU (ressecção transuretral da próstata) ou RTU antes da terapia, mas sempre antes da principal terapia para permitir a cicatrização. Eu nunca vi braquiterapia feito ao mesmo tempo como uma RTU.
4. Parece com o que você disse que a braquiterapia pode não ser a melhor opção. Não há "certo" ou "errado" no mundo do câncer de próstata, mas alguns tratamentos podem ser melhores do que outros, dependendo do homem e seu diagnóstico.
5. Seu diagnóstico indica que ele pode estar em seus interesses a considerar como (vigilância ativa), o que quer dizer que você pode considerar adiar qualquer tratamento. Muitos homens com um diagnóstico semelhante à sua descobriram que a doença não progride.
Finalmente, pode sugiro que leia o meu livro. Se você vai para : Um lugar estranho.
Um guia de informação To Câncer De Próstata e obter o endereço URL e, em seguida, ir para o Google Translate e digite a URL. Escolha de Inglês para Português e da página será traduzido.
Thanks for your comments, and also for STRANGE PLACE information. Very clear.
I really have afraid of RP side effects. I am still very active professional and phisical (sexual, sports...) and I can not see myself with ED or incontinent. That was the reason to look for brachyterapy, once side effects seems to be lower. However, I have this obstruction problem which is not caused by HBP (my prostate has 37cc). So I had two different opinions of doctors. The first one told me to make the RTU first and 2 months later after healing, do the brachy. The second one told me that the intervention is so small, that there is no problem . The first one seems to me more conservative and reliable.
I would like to follow AS, but I do not want to pass through more biopsies. I saw 1 colleague with a very strong infection.
So, I fear that, I could have a underevaluation of my Gleason score (6), and could not control effectivelly the progress, whithout further biopsies, only with PSA tests. I am on the desert of decision!
First, get a second opinion on the pathology report.
I am getting Brachy, but I may be having a procedure first. My prostate measured 39cc from a recent ultra sound, so slightly enlarged, but the enlargement is in the median lobe and it was described as a nub or knuckle, just at the bladder neck...so two options, shrink the prostate with meds, to see if that also reduces that minor restriction(which could become a not so minor problem after seeding) or submit to a minor procedure to reduce the "nub",with a TUNA or TUIP not a TURP, the TURP is for very enlarged prostates and is much more involved, with much more risk.
You need to investigate what exactly is causing the problem and what your options are in dealing with that prior to any treatment
Either way, my RO's and others I've talked to have advised me that any urinary issues need to be dealt with prior to treatment, with approximately 3 months to heal. I think radiation treatment at the same time as a procedure that will physically damage tissue is counterintuitive, or simply a bad idea.
Thanks for your input. My situation is similar, my prostate was 37 cc in a recent(2 months) ultra sound, I took some meds, but the symptoms are not improving, even last RM (magnetic ressonance), it seems that yhe prostate has shrinked (even I don´t believe so much because, now is reporting 23 cc).
I have serious doughts that the flow restriction will improve only with meds.
The first RM showed that I have a lymph node with volume incresed and doctor before send me to brachy want to clarify this. So, This January second I will have a second RM after been taking 3 weeks of antibiotics.
I´ve been passing bad times with anxiety, and I still have no firm decision about brachy or radical cirurgy. I fear that here in Portugal , doctors are no yet so much experienced.
