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This forum is for the discussion of anything to do with Prostate Cancer.
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Re: Surgery vs other options

I had surgery 4 years ago at UCLA. My Biopsy was similar to yours. Unfortunately some cancer had spread to fatty area outside capsule. A year later I had to go for salvage radiation and ADT therapy. To answer your question, I would have been thrilled with surgery if I would have caught the cancer while it was still contained. The side effects from surgery were minimal and getting better every day. The side effects from 6 months on Lubron have been harder to deal with and after 2 years since stopping treatment I still have lingering side effect. If you go with surgery make sure you get a great surgeon.

Re: Surgery vs other options

Yes, surgery is probably still the gold standard but other options are catching up apparently. I agree that the quality of the surgeon is the key if you choose to go that route. My hospital stay was one and a half days.

Re: Surgery vs other options

Another agreement here. I live far from you but I came for robotic surgery in Waukesha Wisconsin in 2007. Northwestern was an option I considered. My stats were similar, PSA 7.1, Gleason 4+3, all cancer on left side. The surgeon indicated that my chances of capsule contained were roughly 50%, prior to the operation. All went very well but a single small positive margin remained after the surgical results were analyzed. So I went into adjuvant radiation 3 months after the surgery. It was not difficult. Since then I've been in great health and have no sign of PSA in my blood tests. I'm fortunate. Don't delay, but do check other options, make yourself knowledgeable if you can, before deciding on surgery and a specific surgeon.

My original urologist told me that I'd probably come out cured, and would feel like I just dodged a bullet. But I needed to act and that he'd support me in whatever choice of treatment I chose. He was an impersonal guy but did very well by me. Said the whole experience might make me more appreciative of life.
I think so.

Re: Surgery vs other options

My local urologist was very personable and for months told me what I wanted to hear. He was leading me down a dark hole. My new urologist at UCLA was not as personable but laid out the facts. He was great. An excellent surgeon. He was more like a mechanic. My point in responding is to let others know that picking a urologist (surgeon) should not be based on personality.

Re: Surgery vs other options


I am 68 years old and have recently been diagnosed with Gleason 7a (3+4), PSA = 9.1. A more detailed description complete with an abstract of the biopsy report is available on Yananow under the category "uncommon, experimental", and the name "RICK E E".
I have been offered the opportunity to be involved in a clinical trial . If I am able to "pass" the various tests listed below and can show that I indeed have "unifocal" prostate cancer, I will then have just the tumor removed leaving the balance (maybe 2/3? of the prostate) intact and functional. I feel that if I don't avail myself of this opportuninty now it may have passed me by forever.
I also feel that I should treat this cancer NOW especially since there is a relatively small component that is grade 4. This newer therapy is a much less radical approach than we have seen in the past. If this cancer was Gleason 6 (3+3) I might take the watch and wait route.
Tests that I would be scheduled to have include : "a pelvic phased array coil and injection of contrast dye to perform : Dynamic Contrast Enhanced MRI (DCE-MRI)" and an "MR Elastography" + an "11C-choline PET/CT" + an "Ultrasound Elastography" + a "Three-dimentional transperineal mapping saturation biopsy", NONE of which would be available under standard protocol for any prostate procedure in Canada that I'm aware of. The ONLY diagnosis available in standard protocol are DRE, PSA and a possible CAT scan along with a bone scan and this leads to the ONLY therapy procedures available that I'm aware of on the standard protocol are RP, EBRT, or Brachytherapy which will all be whole gland therapies. It is my understanding that any so-called "focal" therapy is considered "experimental" in Canada and may also be in some other countries as well . If these tests were to confirm "unifocal", intraprostatic cancer in less than half of one "lobe", I would be implanted with the prescribed amount of LDR seeds required to ablate the focal tumor only (plus a "surgical margin") while leaving the balance of the gland intact and functional with hopefully decreased morbidity/side effects. There are numerous follow-ups involved such as future PSA tests every three months, MRI's once a year for the next two years, and one further saturation biopsy two years down the road.

My question is simply this : Does this regimen sound like a sound approach or am I leaving too much to chance in regards to a possible recurrence later on? Any input would be valued.

Re: Surgery vs other options

Rick,

Go for it. Nothing you describe prevents further curative or palliative measures being taken later on if necessary and you may advance the science no end in taking part in this process.

Good Luck

OC in England

Re: Surgery vs other options

Thanks for the reply Old Codger! I think I will go for it! Couldn't do much better me thinks. Again, thanks - Rick PS I will update my postings when I have any other info.

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