[Re: too many unknowns with this disease]

[Guest guest]

Mick - My guess is the blood in your semen was related to your PCa (for how long did you notice it - or dark colored ejaculate? - and did you have any discomfort with ejaculation?). In any event it led you to investigate the cause and you've been diagnosed. Tell me (again, if you already did and I forgot) how many cores did your uro get on biopsy, and how many of those were positive for cancer? What percentage of each of those cores? And did the pathology report(s) comment at all about the cell type? A low PSA can be either a good prognosticator, or in some cases the opposite, although in the latter case there is generally a palpable nodule on rectal exam. Personally mine was a Gleason 6 with several, but not all, of 12 cores positive, and the positive cores came from several/most parts of the gland (in my case it was a diffuse involvement, and in general I think that's true of most adenocarcinoma of the prostate). My postop path was again Gleason 6 (3+3) with diffuse involvement, but by no means all cancer, and there was no perineural invasion, no involvement of the seminal vesicles or lymph nodes. I lost one of my nerve bundles due to anatomical considerations (not cancer involvement), but still function well with just one intact neurovascular bundle. For these reasons and for the fact that I consider myself cured, I am most grateful and thankful to god and to my surgeon and physicians. Nonetheless, there is always the possibility that my PSA (essentially zero for the 3 1/2 years since my open RRP), might someday again show up and start rising. I have a few patients, including my best friend, who are in that category (fortunately none are symptomatic at this time). The possibility of local and distant spread can be predicted preoperatively through the use of the "Partin tables," developed by Dr. Partin at s Hopkins. Have you asked your uros, Mick, what your Partin tables score predicts? I would suggest you do, and share it with us if you don't mind. In my experience (anecdotal, but I would bet my life on it!), a positive attitude such as you exhibit Mick, predicts a successful outcome (and generally a successful life). The fact that nothing in life is really assured suggests to me that thankfulness for our health, friends and loved ones is a key. Your attitude and example will ultimately mean more to your 4 sons than reminding them to screen for PCa (which of course they absolutely should do at 30!). Thanks for keeping us informed. - jdn> > > > > I was diagnosed with PC on October 24, 2005 and I had a 2nd opinion > > > from a urologist yesterday. First off if you are going through this > > > right now, I urge you to get a second opinion like I did. If for no > > > other reason, do it for peace of mind. My second doctor, who works > > > in a much larger town and does his operations out of one of the > > > largest hospitals in my state....Nebraska, had more experience with > > > PC and was able to offer me options that my first doctor wasn't able > > > to offer. Guys, you have to empower yourselves. You have to learn > > > everything you can about this disease and the treatments available > > > for YOU. It's vital that you understand that there are options, but > > > not all of them may be best for YOU. Your age, your current health > > > and the stage of your cancer are major factors in determining what > > > will be your best option for treatment. Chat rooms such as this are > > > great, but remember they are just chat rooms and they are only for > > > support. You have to talk to your doctor face to face to find out > > > what is best for you. I have decided to have a Robotic Assisted LRP > > > because I want the cancer out of my body and I am convinced based on > > > the stage of my cancer and my age and my current health status, that > > > the LRP is the best way to do this. My doctor is a surgeon, but > > > nonetheless he told me that radiation treatments would likely work > > > well for me too. But...he also explained that if they didn't work, I > > > would be stuck. He explained that once you have radiation treatments > > > on the prostate it is in most cases almost impossible to go in and do > > > a LRP without causing further damage to surrounding organs. But if > > > you have the LRP first you always have the option to follow-up with > > > radiation if it becomes necessary down the road. Today I feel > > > blessed that I was diagnosed early enough that I can take advantage > > > of what most doctors agree is the best way to tackle prostate > > > cancer...total removal. I would rather deal with the side effects > > > from surgery than face the last 20 years of my life dealing with late-> > > stage PC. > > > > > > Mick> > > > > > > > > > > > > > > > > > > > > > >