gleason score

[Guest guest]

Hi Louis,

I know that you prefer surgery for prostate cancer. But I am

sure that you must know that up to 20% or more men who

have surgery have a recurrence. There are several procedures

which I believe are better than surgery. I had surgery and still

have impotence and incontinence.

I strongly believe that there are several procedures which are

better than surgery.

I wish you all the bestAubrey Pilgrim, DC (Ret.) Author ofA Revolutionary Approach to Prostate Cancer-Read the original book for FREE at: http://www.prostatepointers.org/prostate/lay/apilgrim/Read new edition for FREE at http://www.cancer.prostate-help.org/capilgr.htmDr. E. Crawford is co-author of the revision

If you are in your fifties or older, you would be ideal for surgery. At least the cancer will be out and you will not have to later endure the effects of hormone therapy.

If you are younger and still wish to retain all sexual function, including semen production, then you would like to go with proton beam therapy. I would stay away from IMRT and brachytherapy as of the strong possibility of side effects developing down the road of a permanent nature.

Surgery done well is most likely to leave you free of most side effects down the road other than loss of semen production.

Louis. . . .

gleason score

My Name is Tim. I have a psa of 5.4 and a gleason score of 6. i was wondering if this is considered localized enough for surgery . no palpable tumour was found just some light firmness on the dre

Create a Home Theater Like the Pros. Watch the video on AOL Home.

[Guest guest]

My Name is Tim. I have a psa of 5.4 and a gleason score of 6. i was wondering if this is considered localized enough for surgery . no palpable tumour was found just some light firmness on the dre

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[Guest guest]

I am tim Back on line . I am located in New Jersey close to New York, My age is 47 and my general health is good. I do not have my file or my my specific biopsy>The urologist  simply to me I was 3,3 . i have been on line and read through a lot of material and am reading Pat walsh;s book, He ws my dad dr when he had prostate surgery Re: gleason score

> I have a psa of 5.4 and a gleason score of 6. i was

> wondering if this is considered localized enough for surgery . no

> palpable tumour was found just some light firmness on the dre

Where is Tim? His geographical location can have a great effect upon his

treatment (tx).

Age? General health?

I'm wondering why Tim is considering surgery, especially if he has not

considered other options, including so-called "watchful waiting" better

called "active surveillance. "

What is the breakdown of the Gleason score? There are two components,

called "grades." So a Gleason 6 could be a 3,3 or 2,4 or some such. And

the amount of PCa in each specimen (how many were taken? How many showed

PCa?)

is very important. For example, a 4,2 is more risky than a 2,4.

I'm not being critical of Tim or any other newby. We were all newbies

once upon a time. We learn (I hope) as we go.

Here are my recommendations, which, if followed, I hope will lead Tim to

an optimum result:

(1) Go to the encyclopedic and authoritative website of the Prostate

Cancer Research Institute (PCRI) at

http://prostate- cancer.org/ index.html and begin with the section "Newly

Diagnosed."

There is a huge amount of reliable information on this site.

(2) Have the biopsy specimens and paraffin block sent to a pathology lab

that specializes in PCa. this is a "second opinion" and undoubtedly

covered by insurance. I know that it is covered by Medicare.

This is of vital importance, as everything that is done from here on is

absolutely dependent upon the accuracy of the biopsy. The second opinion

may or may not change the score, but it is well to be sure of its accuracy.

The specialist lab has far more experience in examining prostate biopsy

specimens than any local generalist lab possibly could have.

Here is a list:

Bostwick Laboratories [800] 214-6628

Dianon Laboratories [800] 328-2666 (select 5 for client services)

Jon Epstein (at s Hopkins) [410] 955-5043 or [410] 955-2162

Grignon (Michigan) [313] 745-2520

Jon Oppenheimer (Tennessee) [888] 868-7522

UroCor, Inc. [800] 411-1839

Caveat: Some local labs will raise bureaucratic objections. As in

civilized jurisdictions those specimens are the property of the

*patient* and no one else, I recommend insisting. Be unpleasant if

necessary..

(3) Buy and study the best PCa textbook on the market, _A Primer on

Prostate Cancer_ 2nd ed., subtitled "The Empowered Patient's Guide" by

medical oncologist and PCa specialist B. Strum, MD and PCa

warrior Donna Pogliano. It is available from the PCRI website and the

like, as well as Amazon (30+ five-star reviews), & Noble, and

bookstores. A lifesaver, as I very well know.

(4) Meet with others in the same situation at a local chapter of the

international support group Us Too. Chapters can be found via the home

page at http://www.ustoo. com/

(5) Do not panic. Do not allow anyone -- anyone at all -- to influence

the selection of tx. That choice is the patient's and his alone. For

purposes of self-preservation if nothing else (plus perhaps regard for

his loved ones) it is the patient's job to study, learn and take charge

of his case.

Regards,

Steve J

Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try it now.

[Guest guest]

If you are in your fifties or older, you would be ideal for surgery. At least the cancer will be out and you will not have to later endure the effects of hormone therapy.

If you are younger and still wish to retain all sexual function, including semen production, then you would like to go with proton beam therapy. I would stay away from IMRT and brachytherapy as of the strong possibility of side effects developing down the road of a permanent nature.

Surgery done well is most likely to leave you free of most side effects down the road other than loss of semen production.

Louis. . . .

gleason score

My Name is Tim. I have a psa of 5.4 and a gleason score of 6. i was wondering if this is considered localized enough for surgery . no palpable tumour was found just some light firmness on the dre

Looking for last minute shopping deals? Find them fast with Yahoo! Search.

[Guest guest]

Tim: I also live in north Jersey. For information purposes: There is an UsToo Support group that meets at town Memorial Hospital the first Tuesday evening of each month. There is none in Passaic county. There is one in Bergen county but do not know where or when it meets. Theses groups are great for info, speakers and to talk with other men who have been through the process. Best of luck. To: ProstateCancerSupport From: twperry3@...Date: Sun, 30 Mar 2008 17:29:08 -0700Subject: Re: gleason score

I am tim Back on line . I am located in New Jersey close to New York, My age is 47 and my general health is good. I do not have my file or my my specific biopsy>The urologist simply to me I was 3,3 . i have been on line and read through a lot of material and am reading Pat walsh;s book, He ws my dad dr when he had prostate surgery Re: gleason score

> I have a psa of 5.4 and a gleason score of 6. i was

> wondering if this is considered localized enough for surgery . no

> palpable tumour was found just some light firmness on the dre

Where is Tim? His geographical location can have a great effect upon his

treatment (tx).

Age? General health?

I'm wondering why Tim is considering surgery, especially if he has not

considered other options, including so-called "watchful waiting" better

called "active surveillance. "

What is the breakdown of the Gleason score? There are two components,

called "grades." So a Gleason 6 could be a 3,3 or 2,4 or some such. And

the amount of PCa in each specimen (how many were taken? How many showed

PCa?)

is very important. For example, a 4,2 is more risky than a 2,4.

I'm not being critical of Tim or any other newby. We were all newbies

once upon a time. We learn (I hope) as we go.

Here are my recommendations, which, if followed, I hope will lead Tim to

an optimum result:

(1) Go to the encyclopedic and authoritative website of the Prostate

Cancer Research Institute (PCRI) at

http://prostate- cancer.org/ index.html and begin with the section "Newly

Diagnosed."

There is a huge amount of reliable information on this site.

(2) Have the biopsy specimens and paraffin block sent to a pathology lab

that specializes in PCa. this is a "second opinion" and undoubtedly

covered by insurance. I know that it is covered by Medicare.

This is of vital importance, as everything that is done from here on is

absolutely dependent upon the accuracy of the biopsy. The second opinion

may or may not change the score, but it is well to be sure of its accuracy.

The specialist lab has far more experience in examining prostate biopsy

specimens than any local generalist lab possibly could have.

Here is a list:

Bostwick Laboratories [800] 214-6628

Dianon Laboratories [800] 328-2666 (select 5 for client services)

Jon Epstein (at s Hopkins) [410] 955-5043 or [410] 955-2162

Grignon (Michigan) [313] 745-2520

Jon Oppenheimer (Tennessee) [888] 868-7522

UroCor, Inc. [800] 411-1839

Caveat: Some local labs will raise bureaucratic objections. As in

civilized jurisdictions those specimens are the property of the

*patient* and no one else, I recommend insisting. Be unpleasant if

necessary..

(3) Buy and study the best PCa textbook on the market, _A Primer on

Prostate Cancer_ 2nd ed., subtitled "The Empowered Patient's Guide" by

medical oncologist and PCa specialist B. Strum, MD and PCa

warrior Donna Pogliano. It is available from the PCRI website and the

like, as well as Amazon (30+ five-star reviews), & Noble, and

bookstores. A lifesaver, as I very well know.

(4) Meet with others in the same situation at a local chapter of the

international support group Us Too. Chapters can be found via the home

page at http://www.ustoo. com/

(5) Do not panic. Do not allow anyone -- anyone at all -- to influence

the selection of tx. That choice is the patient's and his alone. For

purposes of self-preservation if nothing else (plus perhaps regard for

his loved ones) it is the patient's job to study, learn and take charge

of his case.

Regards,

Steve J

Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try it now.

In a rush? Get real-time answers with Windows Live Messenger.

[Guest guest]

Just to put things into perspective, your operation took place almost 16 years ago and techniques have improve immensely over that time. If the person is under his mid-fifities, there is a terrible choice. In the early stage in which the cancer is confined to the prostate and the Gleason score is 6 to 7 or below, outcome is likely to be best with surgery, but the price, assuming that the side-effects resolve in a decent time interval, is the loss of semen production. With radiation, other than proton beam treatment, the side effects will be less initially, but the risk of the cancer recurring and the dreaded side effects developing to a permanent state over the long term (ED and rectal issues). Also, salvage procedures, should treatment fail, will be rather messy.

I was going to go with Brachytherapy until I was confronted with the prospect of ADT shots. I am less than two years (this coming September) with some ED issues, but these appear to be very slowly resolving themselves. My most recent PSA level was at the unmeasurable point. My original Gleason score was 6 to 7. The other thing do before surgery is to use Avodart or Poscar (or their generic equivalent) to shrink the gland prior to surgery. I believe that this measure will reduce the side effect of penile shortening. I would start on penile rehabilitation some six months after surgery, but my health plan did not cover it.

Louis. . .

gleason score

My Name is Tim. I have a psa of 5.4 and a gleason score of 6. i was wondering if this is considered localized enough for surgery . no palpable tumour was found just some light firmness on the dre

Create a Home Theater Like the Pros. Watch the video on AOL Home.

[Guest guest]

Hi Louis,

Can you tell me why surgery today is any different than

surgery 16 years ago? The removal of the prostate is

still the same with the same unpleasant side effects.

You seem to be quite knowledgeable, but you are

definitely biased to surgery. I have been studying this

disease for several years. I have known hundreds of

men who have had all the various therapies. They are

all different- no one size fits all.

There are several prostate cancer support groups in

Los Angeles. I have personally known many of the men

and the therapies they have had. I strongly believe that

for many men, surgery is not the best therapy.

I wish you all the bestAubrey Pilgrim, DC (Ret.) Author ofA Revolutionary Approach to Prostate Cancer-Read the original book for FREE at: http://www.prostatepointers.org/prostate/lay/apilgrim/Read new edition for FREE at http://www.cancer.prostate-help.org/capilgr.htmDr. E. Crawford is co-author of the revision

Just to put things into perspective, your operation took place almost 16 years ago and techniques have improve immensely over that time. If the person is under his mid-fifities, there is a terrible choice. In the early stage in which the cancer is confined to the prostate and the Gleason score is 6 to 7 or below, outcome is likely to be best with surgery, but the price, assuming that the side-effects resolve in a decent time interval, is the loss of semen production. With radiation, other than proton beam treatment, the side effects will be less initially, but the risk of the cancer recurring and the dreaded side effects developing to a permanent state over the long term (ED and rectal issues). Also, salvage procedures, should treatment fail, will be rather messy.

I was going to go with Brachytherapy until I was confronted with the prospect of ADT shots. I am less than two years (this coming September) with some ED issues, but these appear to be very slowly resolving themselves. My most recent PSA level was at the unmeasurable point. My original Gleason score was 6 to 7. The other thing do before surgery is to use Avodart or Poscar (or their generic equivalent) to shrink the gland prior to surgery. I believe that this measure will reduce the side effect of penile shortening. I would start on penile rehabilitation some six months after surgery, but my health plan did not cover it.

Louis. . . Create a Home Theater Like the Pros. Watch the video on AOL Home.

[Guest guest]

If you are going to make such a strong statement as : " I would stay away from IMRT and brachytherapy as of the strong possibility of side effects developing down the road of a permanent nature. "

then I think you should cite some studies that shows this to be true, and define what you mean by a " strong possibility " , and what kind of side effects you are talking about. If this is merely your opinion, then you should make that clear. It is really unfair to someone who was just diagnosed to casually disparage what might be viable treatments for that person.

If you are in your fifties or older, you would be ideal for surgery. At least the cancer will be out and you will not have to later endure the effects of hormone therapy.

If you are younger and still wish to retain all sexual function, including semen production, then you would like to go with proton beam therapy. I would stay away from IMRT and brachytherapy as of the strong possibility of side effects developing down the road of a permanent nature.

Surgery done well is most likely to leave you free of most side effects down the road other than loss of semen production.

Louis. . . .

gleason score

My Name is Tim. I have a psa of 5.4 and a gleason score of 6. i was wondering if this is considered localized enough for surgery . no palpable tumour was found just some light firmness on the dre

Looking for last minute shopping deals? Find them fast with Yahoo! Search.

-- Bobinnv

[Guest guest]

,

Thanks I am just reading up on some options and will meet with a few DRs in NYC. I libe in Bergen county and will try to get to that group.

Re: [ProstateCancerSupp ort] gleason score

> I have a psa of 5.4 and a gleason score of 6. i was > wondering if this is considered localized enough for surgery . no > palpable tumour was found just some light firmness on the dreWhere is Tim? His geographical location can have a great effect upon his treatment (tx).Age? General health?I'm wondering why Tim is considering surgery, especially if he has not considered other options, including so-called "watchful waiting" better called "active surveillance. "What is the breakdown of the Gleason score? There are two components, called "grades." So a Gleason 6 could be a 3,3 or 2,4 or some such. And the amount of PCa in each specimen (how many were taken? How many showed PCa?)is very important. For example, a 4,2 is more risky than a 2,4.I'm not being critical of Tim or any other newby. We were all newbies

once upon a time. We learn (I hope) as we go.Here are my recommendations, which, if followed, I hope will lead Tim to an optimum result:(1) Go to the encyclopedic and authoritative website of the Prostate Cancer Research Institute (PCRI) at http://prostate- cancer.org/ index.html and begin with the section "Newly Diagnosed."There is a huge amount of reliable information on this site.(2) Have the biopsy specimens and paraffin block sent to a pathology lab that specializes in PCa. this is a "second opinion" and undoubtedly covered by insurance. I know that it is covered by Medicare.This is of vital importance, as everything that is done from here on is absolutely dependent upon the accuracy of the biopsy. The second opinion may or may not change the score, but it is well to be sure of its

accuracy.The specialist lab has far more experience in examining prostate biopsy specimens than any local generalist lab possibly could have.Here is a list:Bostwick Laboratories [800] 214-6628Dianon Laboratories [800] 328-2666 (select 5 for client services)Jon Epstein (at s Hopkins) [410] 955-5043 or [410] 955-2162 Grignon (Michigan) [313] 745-2520Jon Oppenheimer (Tennessee) [888] 868-7522UroCor, Inc. [800] 411-1839Caveat: Some local labs will raise bureaucratic objections. As in civilized jurisdictions those specimens are the property of the *patient* and no one else, I recommend insisting. Be unpleasant if necessary..(3) Buy and study the best PCa textbook on the market, _A Primer on Prostate Cancer_ 2nd ed., subtitled "The Empowered Patient's Guide" by medical oncologist and PCa specialist B. Strum, MD and PCa warrior Donna Pogliano. It is

available from the PCRI website and the like, as well as Amazon (30+ five-star reviews), & Noble, and bookstores. A lifesaver, as I very well know.(4) Meet with others in the same situation at a local chapter of the international support group Us Too. Chapters can be found via the home page at http://www.ustoo. com/(5) Do not panic. Do not allow anyone -- anyone at all -- to influence the selection of tx. That choice is the patient's and his alone. For purposes of self-preservation if nothing else (plus perhaps regard for his loved ones) it is the patient's job to study, learn and take charge of his case.Regards,Steve J

Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try it now.

In a rush? Get real-time answers with Windows Live Messenger.

Like movies? Here's a limited-time offer: Blockbuster Total Access for one month at no cost.

[Guest guest]

Bobinnv,

After reading this post I was a bit upset. My husband is due to start his IMRT treatments in May and this statement I don't feel is accurate also. I don't think it was a good post for someone who has just been diagnosed, I think it could lead to more confusion.

Sheila

--------- gleason score

My Name is Tim. I have a psa of 5.4 and a gleason score of 6. i was wondering if this is considered localized enough for surgery . no palpable tumour was found just some light firmness on the dre

Looking for last minute shopping deals? Find them fast with Yahoo! Search.

-- Bobinnv

[Guest guest]

Hello Tim,

The only thing I can add to the other replies is to insist on getting a copy of the biopsy report. You should be able to do this with a phone call to the doctor. It is esssential information for following up and deciding on treatment as it will contain important details-- the TRUS volume of your prostate, how many cores were positive, what percent or how much of the positive cores have cancer, whether the cancer is one one or both sides of the prostate. You need this information to make an objective decision on what to do next.

Also, having a second opinion on the biopsy slides before deciding your next step is an excellent investment. Here are three labs often recommended. Bostwick also can do a 'ploidy analysis' to look at the cancer DNA to assess, in addition to the Gleason score, how aggressive the cancer may be.

Urologic Pathology Laboratory s Hopkins Hospital Check the web page and call 1-

Bostwick Laboratories, Virginia, a pathology reference laboratory serving patients as well as physicians and managed care. Dr. Bostwick is one of the authors of the ACS book Prostate Cancer, What Every Man - and His Family - Needs to Know). (800)214-6628

The Prostate Lab (Dr. Oppenheimer), Nashville Tn, 1-888-8OURLAB

The Best to You and Yours!

Jon

>> My Name is Tim. I have a psa of 5.4 and a gleason score of 6. i was wondering if this is considered localized enough for surgery . no palpable tumour was found just some light firmness on the dre> > > > > ____________________________________________________________________________________> No Cost - Get a month of Blockbuster Total Access now. Sweet deal for Yahoo! users and friends. > http://tc.deals.yahoo.com/tc/blockbuster/text1.com>

[Guest guest]

To throw in my two cents, I

had brachytherapy in September, I have not suffered any unpleasant side

effects, and both my radiation oncologist and urological oncologist don’t

anticipate that I will. I am 51 and it was my urological oncologist

(head of urology at Beaumont Hospital in Detroit and the surgeon I was sent to

by my urologist after my diagnosis) who suggested that I visit with the

radiation guy before rushing to surgery. I would be the last person to argue

against surgery if one was more comfortable with that option, but clearly I believe

brachy was a great option for me.

From:

ProstateCancerSupport [mailto:ProstateCancerSupport ]

On Behalf Of APilgrm@...

Sent: Monday, March 31, 2008 1:37 PM

To: ProstateCancerSupport ; lcarliner@...

Subject: Re: gleason score

Hi

Louis,

Can

you tell me why surgery today is any different than

surgery

16 years ago? The removal of the prostate is

still

the same with the same unpleasant side effects.

You

seem to be quite knowledgeable, but you are

definitely

biased to surgery. I have been studying this

disease

for several years. I have known hundreds of

men

who have had all the various therapies. They are

all

different- no one size fits all.

There

are several prostate cancer support groups in

Los

Angeles. I have personally known many of the men

and

the therapies they have had. I strongly believe that

for

many men, surgery is not the best therapy.

I

wish you all the best

Aubrey Pilgrim, DC (Ret.) Author of

A Revolutionary Approach to Prostate Cancer-Read the original book

for FREE at: http://www.prostatepointers.org/prostate/lay/apilgrim/

Read new edition for FREE at http://www.cancer.prostate-help.org/capilgr.htm

Dr. E. Crawford is co-author of the revision

In

a message dated 3/30/2008 8:52:07 P.M. Pacific Daylight Time,

lcarliner@... writes:

Just to put things into perspective, your operation took

place almost 16 years ago and techniques have improve immensely over that time.

If the person is under his mid-fifities, there is a terrible choice. In the

early stage in which the cancer is confined to the prostate and the Gleason

score is 6 to 7 or below, outcome is likely to be best with surgery, but the

price, assuming that the side-effects resolve in a decent time interval, is the

loss of semen production. With radiation, other than proton beam treatment, the

side effects will be less initially, but the risk of the cancer recurring and

the dreaded side effects developing to a permanent state over the long term (ED

and rectal issues). Also, salvage procedures, should treatment fail, will be

rather messy.

I was going to go with Brachytherapy until I was confronted with

the prospect of ADT shots. I am less than two years (this coming September)

with some ED issues, but these appear to be very slowly resolving themselves.

My most recent PSA level was at the unmeasurable point. My original Gleason

score was 6 to 7. The other thing do before surgery is to use Avodart or Poscar

(or their generic equivalent) to shrink the gland prior to surgery. I believe

that this measure will reduce the side effect of penile shortening. I would

start on penile rehabilitation some six months after surgery, but my health

plan did not cover it.

Louis. . .

[Guest guest]

Aubrey,

There is no question about the fact that you are much more knowledgeable then I in regards to prostate cancer, its treatment options and the possible side effects. I have read many of your posts and gained knowledge from each and every one of them.

However, I think there is absolutely no doubt that prostate removal today is much different then it was 16 years ago. I'm not suggesting that the side effects have gone away but the procedures available today are much more advanced.

With the new DaVinci procedure major blood loss during the procedure is at a point today that stockpiling your blood prior to the procedure is no longer a requirement. The hospital stay providing all goes well is only one day. I had my catheter removed in eight days and went back to work in two weeks. These types of things were unheard of sixteen years ago.

There is no doubt that the surgeons visualization of the surgical site with less blood loss and the magnification that is part of the DaVinci procedure is much more advanced then the procedures that were available sixteen years ago.

As for the side effects, yes they are still there but there are so many other things that must be factored into the equation of how you will do after surgery.

Just my one cent worth.

Regards,

Rick

Re: gleason score

Hi Louis,

Can you tell me why surgery today is any different than

surgery 16 years ago? The removal of the prostate is

still the same with the same unpleasant side effects.

You seem to be quite knowledgeable, but you are

definitely biased to surgery. I have been studying this

disease for several years. I have known hundreds of

men who have had all the various therapies. They are

all different- no one size fits all.

There are several prostate cancer support groups in

Los Angeles. I have personally known many of the men

and the therapies they have had. I strongly believe that

for many men, surgery is not the best therapy.

I wish you all the bestAubrey Pilgrim, DC (Ret.) Author ofA Revolutionary Approach to Prostate Cancer-Read the original book for FREE at: http://www.prostate pointers. org/prostate/ lay/apilgrim/Read new edition for FREE at http://www.cancer. prostate- help.org/ capilgr.htmDr. E. Crawford is co-author of the revision

In a message dated 3/30/2008 8:52:07 P.M. Pacific Daylight Time, lcarliner@earthlink .net writes:

Just to put things into perspective, your operation took place almost 16 years ago and techniques have improve immensely over that time. If the person is under his mid-fifities, there is a terrible choice. In the early stage in which the cancer is confined to the prostate and the Gleason score is 6 to 7 or below, outcome is likely to be best with surgery, but the price, assuming that the side-effects resolve in a decent time interval, is the loss of semen production. With radiation, other than proton beam treatment, the side effects will be less initially, but the risk of the cancer recurring and the dreaded side effects developing to a permanent state over the long term (ED and rectal issues). Also, salvage procedures, should treatment fail, will be rather messy.

I was going to go with Brachytherapy until I was confronted with the prospect of ADT shots. I am less than two years (this coming September) with some ED issues, but these appear to be very slowly resolving themselves. My most recent PSA level was at the unmeasurable point. My original Gleason score was 6 to 7. The other thing do before surgery is to use Avodart or Poscar (or their generic equivalent) to shrink the gland prior to surgery. I believe that this measure will reduce the side effect of penile shortening. I would start on penile rehabilitation some six months after surgery, but my health plan did not cover it.

Louis. . .

Create a Home Theater Like the Pros. Watch the video on AOL Home.

Like movies? Here's a limited-time offer: Blockbuster Total Access for one month at no cost.

[Guest guest]

I go in April 17th to get the details of my surgery and pre-admission

on the 30th. He will be using the de'Vinci method. I have read and

read and still don't know what to expect. I am havoing problems with

sexual function even before the operation. Will that change for the

worse after surgery? I am 67 and have met this 45 year old that

really wants to go out with me but I am scared. She does not know my

condition. I have a much older friend that has a very

expensive " pump " . Do they work? I have taken Viagra without too much

sucess. The closer my surgery date comes the more nervous I get. I

cannot be still. I have heard of medicine injected for a good

erection. There are exercises you can you. " Strum " said use it or

lose it. I think he is right. I have had penile shrinkage, and not

even had surgery. I hate to embarrass myself out on a date, or sleep

over, but I am nervous about it. Maybe I will claim lower hernia;

which I have and then see what may transpire...Bob

>

> Hi Rick,

>

> I am glad that you are happy with your therapy. But I believe

> that there are other therapies which have fewer side effects.

> I know men who have had brachytheray (seed implants) who

> have had many fewer side effects. Those who have been

> fortunate to have had Proton Beam therapy seem to have

> even less side effects.

>

> I wish you all the best

>

> Aubrey Pilgrim, DC (Ret.) Author of

> A Revolutionary Approach to Prostate Cancer-Read the original book

> for FREE at:

_http://www.prostatepointers.org/prostate/lay/apilgrim/_

> (http://www.prostatepointers.org/prostate/lay/apilgrim/)

> Read new edition for FREE at

> _http://www.cancer.prostate-help.org/capilgr.htm_

(http://www.cancer.prostate-help.org/capilgr.htm)

> Dr. E. Crawford is co-author of the revision

>

>

> In a message dated 3/31/2008 12:01:22 P.M. Pacific Daylight Time,

> white.richard54@... writes:

>

> Aubrey,

> There is no question about the fact that you are much more

knowledgeable

> then I in regards to prostate cancer, its treatment options and the

possible

> side effects. I have read many of your posts and gained knowledge

from each and

> every one of them.

> However, I think there is absolutely no doubt that prostate removal

today is

> much different then it was 16 years ago. I'm not suggesting that

the side

> effects have gone away but the procedures available today are much

more

> advanced.

> With the new DaVinci procedure major blood loss during the

procedure is at a

> point today that stockpiling your blood prior to the procedure is

no longer

> a requirement. The hospital stay providing all goes well is only

one day. I

> had my catheter removed in eight days and went back to work in two

weeks.

> These types of things were unheard of sixteen years ago.

> There is no doubt that the surgeons visualization of the surgical

site with

> less blood loss and the magnification that is part of the DaVinci

procedure

> is much more advanced then the procedures that were available

sixteen years

> ago.

> As for the side effects, yes they are still there but there are so

many

> other things that must be factored into the equation of how you

will do after

> surgery.

> Just my one cent worth.

> Regards,

> Rick

>

>

>

>

>

>

> **************Create a Home Theater Like the Pros. Watch the video

on AOL

> Home.

> (http://home.aol.com/diy/home-improvement-eric-stromer?

video=15 & ncid=aolhom00030000000001)

>

[Guest guest]

With the possible exception of proton beam therapy, the tradeoffs in the various treatment options are not very appetizing. In early stage prostate cancer, in which the capsule has not been breeched, for a relatively young person, surgery is still considered to be the gold standard. Unfortunately, compromise in sexual function and loss of sperm production is inevitable. Agressive 24-plus mapping biopsy followed by cyrosurgery or maybe tightly focused ultrasound may have the best potential for very minimal damage to any functions. Unfortunately, the jury is still out on its long-term survival rate, and is applicable only to relatively non-aggressive cancers that is confined in the capsule.

The best hope for the future is breakthroughs in immiotherapies that will make surgery or radiation or the dreaded hormone blockade treatments things of the past.

Louis. . .

Re: gleason score

Hi Mickey and All,

Can you tell me that sex is still the same as it was before

your prostate was removed? Of course it is not. It would

not be the same no matter what therapy you had, but some

of the treatments have many fewer unpleasant side effects.

I am still impotent and still have an incontinence problem. I

know several men who have had other therapies for prostate

cancer and they have not endured many of the unpleasant side

effects that are present with surgery.

Removal of the prostate no matter how it is done will result

in side effects- sex will never ever be the same. You may

be able to have an orgasm, but it is not the same.

Folks, it is your body and your right to choose the therapy

you want. But the choice should be well researched.

I wish you all the bestAubrey Pilgrim, DC (Ret.) Author ofA Revolutionary Approach to Prostate Cancer-Read the original book for FREE at: http://www.prostatepointers.org/prostate/lay/apilgrim/Read new edition for FREE at http://www.cancer.prostate-help.org/capilgr.htmDr. E. Crawford is co-author of the revision

In a message dated 3/31/2008 2:47:24 P.M. Pacific Daylight Time, mickeybbpb writes:

Aubrey, you of all people, I didn't think you would or could make a statement that prostate surgery hasn't achnged in 16 years. The end, more likely some of the end process, is the same - you don't have a prostate after the surgery. But, The surgery itself and much of the side effects that were very traumatic before have been greatly lessened in the past few years in prostate surgery.

You had a bad experience, but not everyone who has had suregery has.APilgrmaol wrote:

Hi Louis,

Can you tell me why surgery today is any different than

surgery 16 years ago? The removal of the prostate is

still the same with the same unpleasant side effects.

You seem to be quite knowledgeable, but you are

definitely biased to surgery. I have been studying this

disease for several years. I have known hundreds of

men who have had all the various therapies. They are

all different- no one size fits all.

There are several prostate cancer support groups in

Los Angeles. I have personally known many of the men

and the therapies they have had. I strongly believe that

for many men, surgery is not the best therapy.

I wish you all the bestAubrey Pilgrim, DC (Ret.) Author ofA Revolutionary Approach to Prostate Cancer-Read the original book for FREE at: http://www.prostatepointers.org/prostate/lay/apilgrim/Read new edition for FREE at http://www.cancer.prostate-help.org/capilgr.htmDr. E. Crawford is co-author of the revision

In a message dated 3/30/2008 8:52:07 P.M. Pacific Daylight Time, lcarlinerearthlink (DOT) net writes:

Just to put things into perspective, your operation took place almost 16 years ago and techniques have improve immensely over that time. If the person is under his mid-fifities, there is a terrible choice. In the early stage in which the cancer is confined to the prostate and the Gleason score is 6 to 7 or below, outcome is likely to be best with surgery, but the price, assuming that the side-effects resolve in a decent time interval, is the loss of semen production. With radiation, other than proton beam treatment, the side effects will be less initially, but the risk of the cancer recurring and the dreaded side effects developing to a permanent state over the long term (ED and rectal issues). Also, salvage procedures, should treatment fail, will be rather messy.

I was going to go with Brachytherapy until I was confronted with the prospect of ADT shots. I am less than two years (this coming September) with some ED issues, but these appear to be very slowly resolving themselves. My most recent PSA level was at the unmeasurable point. My original Gleason score was 6 to 7. The other thing do before surgery is to use Avodart or Poscar (or their generic equivalent) to shrink the gland prior to surgery. I believe that this measure will reduce the side effect of penile shortening. I would start on penile rehabilitation some six months after surgery, but my health plan did not cover it.

Louis. . .

Create a Home Theater Like the Pros. Watch the video on AOL Home.

[Guest guest]

I feel that I must weigh in on this:

------------------------------------------------------

>

> If you are in your fifties or older, you would be ideal for

surgery. At least the cancer will be out and you will not have to

later endure the effects of hormone therapy.

>

> If you are younger and still wish to retain all sexual function,

including semen production, then you would like to go with proton

beam therapy. I would stay away from IMRT and brachytherapy as of the

strong possibility of side effects developing down the road of a

permanent nature.

>

> Surgery done well is most likely to leave you free of most side

effects down the road other than loss of semen production.

>

> Louis. . . .

> ---------------------------------------------------

Seldom have I seen a post here that is so likely to further confuse a

newly diagnosed patient.

There on record many cases of failed PCa surgery. Just having the

gland cut out does not mean that one is " cured " -- A person having

surgery at any age had better continue his periodic PSA tests for the

rest of his life! And the same is true for ANY treatment!

And likewise, there are many cases of IMRT and Brachtherapy that have

provided long term good results with minimum side effects.

Each of us is different, and therefore results from any given

modality may indeed vary, but that does not mean that surgery is the

best for any person, nor does it mean that IMRT or Brachytherpy

procedures inevitably lead to terrible side effects.

This is why we must each decide for ourselves which treatment is the

best for us as an individual after studying aall the facts that we

can find and our own charactistics and requirements.

Fuller

[Guest guest]

Hi Bob,

Have you investigated ALL of your options? If you are having

problems now, you will have even more if you have a radical

prostatectomy.

I had a radical prostatectomy in 1992. I believe that there are

many therapies which have fewer side effects. If it were me,

I would look at brachytherapy, or proton beam therapy rather

than surgery. For me, sex has never been the same since my

surgery. I am impotent and have an incontinence problem.

By all means look at all of your options.

I wish you all the bestAubrey Pilgrim, DC (Ret.) Author ofA Revolutionary Approach to Prostate Cancer-Read the original book for FREE at: http://www.prostatepointers.org/prostate/lay/apilgrim/Read new edition for FREE at http://www.cancer.prostate-help.org/capilgr.htmDr. E. Crawford is co-author of the revision

I go in April 17th to get the details of my surgery and pre-admission on the 30th. He will be using the de'Vinci method. I have read and read and still don't know what to expect. I am havoing problems with sexual function even before the operation. Will that change for the worse after surgery? I am 67 and have met this 45 year old that really wants to go out with me but I am scared. She does not know my condition. I have a much older friend that has a very expensive "pump". Do they work? I have taken Viagra without too much sucess. The closer my surgery date comes the more nervous I get. I cannot be still. I have heard of medicine injected for a good erection. There are exercises you can you. "Strum" said use it or lose it. I think he is right. I have had penile shrinkage, and not even had surgery. I hate to embarrass myself out on a date, or sleep over, but I am nervous about it. Maybe I will claim lower hernia; which I have and then see what may transpire...Bob Create a Home Theater Like the Pros. Watch the video on AOL Home.

[Guest guest]

There is an alternative surgical technique that has just as rapid recovery, if not more, as the Da Vinci robotic form. It is the older perineal access form. In my case hospitalization was just one night with two long days. That form has the advantage of less probability of urinary continence side effect than the retropubic forms. There has been some concern that nerve sparing ability is impaired, but my surgeon assured me that nerve sparing ability is just as good, if not better than the other forms. The only disadvantage of that form is the inability to perform pelvic lymph node dissection at the same time. However, unless that cancer is aggressive, this would be of little consequence.

In your case, the perineal form avoids the abdominal scar tissue that would otherwise pose a problem with robotic surgery in your case. It may be to your advantage to seek out a surgeon that is well experienced in that technique and an advocate of the same.

Having the cancer out, as well as the ability for post surgery pathology, as well as avoiding the time involved and possible permanent long-term side effects makes surgery the most convenient and certain form. Also, should any recurrence occurs, the option of radiation treatment is quite viable. The opposite is not so true. Salvage surgery after radiation treatment is difficult, with cyrosurgery the preferred salvage choice.

If you live in West Central Florida, there is a surgeon that is most experienced in perineal surgical mode.

Louis. . .

Re: gleason score

Hi Louis,

Can you tell me why surgery today is any different than

surgery 16 years ago? The removal of the prostate is

still the same with the same unpleasant side effects.

You seem to be quite knowledgeable, but you are

definitely biased to surgery. I have been studying this

disease for several years. I have known hundreds of

men who have had all the various therapies. They are

all different- no one size fits all.

There are several prostate cancer support groups in

Los Angeles. I have personally known many of the men

and the therapies they have had. I strongly believe that

for many men, surgery is not the best therapy.

I wish you all the bestAubrey Pilgrim, DC (Ret.) Author ofA Revolutionary Approach to Prostate Cancer-Read the original book for FREE at: http://www.prostate pointers. org/prostate/ lay/apilgrim/Read new edition for FREE at http://www.cancer. prostate- help.org/ capilgr.htmDr. E. Crawford is co-author of the revision

In a message dated 3/30/2008 8:52:07 P.M. Pacific Daylight Time, lcarliner@earthlink .net writes:

Just to put things into perspective, your operation took place almost 16 years ago and techniques have improve immensely over that time. If the person is under his mid-fifities, there is a terrible choice. In the early stage in which the cancer is confined to the prostate and the Gleason score is 6 to 7 or below, outcome is likely to be best with surgery, but the price, assuming that the side-effects resolve in a decent time interval, is the loss of semen production. With radiation, other than proton beam treatment, the side effects will be less initially, but the risk of the cancer recurring and the dreaded side effects developing to a permanent state over the long term (ED and rectal issues). Also, salvage procedures, should treatment fail, will be rather messy.

I was going to go with Brachytherapy until I was confronted with the prospect of ADT shots. I am less than two years (this coming September) with some ED issues, but these appear to be very slowly resolving themselves. My most recent PSA level was at the unmeasurable point. My original Gleason score was 6 to 7. The other thing do before surgery is to use Avodart or Poscar (or their generic equivalent) to shrink the gland prior to surgery. I believe that this measure will reduce the side effect of penile shortening. I would start on penile rehabilitation some six months after surgery, but my health plan did not cover it.

Louis. . .

Create a Home Theater Like the Pros. Watch the video on AOL Home.

Like movies? Here's a limited-time offer: Blockbuster Total Access for one month at no cost.

Special deal for Yahoo! users friends - No Cost. Get a month of Blockbuster Total Access now

[Guest guest]

Pilgrim. I have studied all options and talked with many co-workers

of years past that had surgery. Mine will not be the radical. I will

have the de'vincci method with five puncture holes by a well known

urologist. I go in April 17th to get all the details. I just hate it

that my sex life will come to a close. Like you said it cannot be the

same anymore. Bob

In ProstateCancerSupport , APilgrm@... wrote:

>

> Hi Bob,

>

> Have you investigated ALL of your options? If you are having

> problems now, you will have even more if you have a radical

> prostatectomy.

>

> I had a radical prostatectomy in 1992. I believe that there are

> many therapies which have fewer side effects. If it were me,

> I would look at brachytherapy, or proton beam therapy rather

> than surgery. For me, sex has never been the same since my

> surgery. I am impotent and have an incontinence problem.

>

> By all means look at all of your options.

>

> I wish you all the best

>

> Aubrey Pilgrim, DC (Ret.) Author of

> A Revolutionary Approach to Prostate Cancer-Read the original book

> for FREE at:

_http://www.prostatepointers.org/prostate/lay/apilgrim/_

> (http://www.prostatepointers.org/prostate/lay/apilgrim/)

> Read new edition for FREE at

> _http://www.cancer.prostate-help.org/capilgr.htm_

(http://www.cancer.prostate-help.org/capilgr.htm)

> Dr. E. Crawford is co-author of the revision

>

>

> In a message dated 3/31/2008 7:01:21 P.M. Pacific Daylight Time,

> rwright010@... writes:

>

>

>

>

> I go in April 17th to get the details of my surgery and pre-

admission

> on the 30th. He will be using the de'Vinci method. I have read and

> read and still don't know what to expect. I am havoing problems

with

> sexual function even before the operation. Will that change for

the

> worse after surgery? I am 67 and have met this 45 year old that

> really wants to go out with me but I am scared. She does not know

my

> condition. I have a much older friend that has a very

> expensive " pump " . Do they work? I have taken Viagra without too

much

> sucess. The closer my surgery date comes the more nervous I get. I

> cannot be still. I have heard of medicine injected for a good

> erection. There are exercises you can you. " Strum " said use it or

> lose it. I think he is right. I have had penile shrinkage, and not

> even had surgery. I hate to embarrass myself out on a date, or

sleep

> over, but I am nervous about it. Maybe I will claim lower hernia;

> which I have and then see what may transpire...which I

>

>

>

>

>

>

>

>

>

>

> **************Create a Home Theater Like the Pros. Watch the video

on AOL

> Home.

> (http://home.aol.com/diy/home-improvement-eric-stromer?

video=15 & ncid=aolhom00030000000001)

>

[Guest guest]

Aubry, have you investigated prosthetic means for dealing with the incontinence and ED problems? From what I have been reading, the degree of satisfaction using today's technology has been very high. The anesthea needed is relatively light.

Louis. . .

Re: Re: gleason score

Hi Bob,

Have you investigated ALL of your options? If you are having

problems now, you will have even more if you have a radical

prostatectomy.

I had a radical prostatectomy in 1992. I believe that there are

many therapies which have fewer side effects. If it were me,

I would look at brachytherapy, or proton beam therapy rather

than surgery. For me, sex has never been the same since my

surgery. I am impotent and have an incontinence problem.

By all means look at all of your options.

I wish you all the bestAubrey Pilgrim, DC (Ret.) Author ofA Revolutionary Approach to Prostate Cancer-Read the original book for FREE at: http://www.prostatepointers.org/prostate/lay/apilgrim/Read new edition for FREE at http://www.cancer.prostate-help.org/capilgr.htmDr. E. Crawford is co-author of the revision

In a message dated 3/31/2008 7:01:21 P.M. Pacific Daylight Time, rwright010centurytel (DOT) net writes:

I go in April 17th to get the details of my surgery and pre-admission on the 30th. He will be using the de'Vinci method. I have read and read and still don't know what to expect. I am havoing problems with sexual function even before the operation. Will that change for the worse after surgery? I am 67 and have met this 45 year old that really wants to go out with me but I am scared. She does not know my condition. I have a much older friend that has a very expensive "pump". Do they work? I have taken Viagra without too much sucess. The closer my surgery date comes the more nervous I get. I cannot be still. I have heard of medicine injected for a good erection. There are exercises you can you. "Strum" said use it or lose it. I think he is right. I have had penile shrinkage, and not even had surgery. I hate to embarrass myself out on a date, or sleep over, but I am nervous about it. Maybe I will claim lower hernia; which I have and then see what may transpire...Bob

Create a Home Theater Like the Pros. Watch the video on AOL Home.

[Guest guest]

Hi Bob,

No matter how it is done, you will still have the side effects

of the radical prostatectomy. If I had it to do over, I would

seriously investigate the brachytherapy or seed implants.

Better yet would be the proton beam therapy if possible.

But it is your body and your decision.

I wish you all the bestAubrey Pilgrim, DC (Ret.) Author ofA Revolutionary Approach to Prostate Cancer-Read the original book for FREE at: http://www.prostatepointers.org/prostate/lay/apilgrim/Read new edition for FREE at http://www.cancer.prostate-help.org/capilgr.htmDr. E. Crawford is co-author of the revision

Pilgrim. I have studied all options and talked with many co-workers of years past that had surgery. Mine will not be the radical. I will have the de'vincci method with five puncture holes by a well known urologist. I go in April 17th to get all the details. I just hate it that my sex life will come to a close. Like you said it cannot be the same anymore. BobCreate a Home Theater Like the Pros. Watch the video on AOL Home.

[Guest guest]

Hi Louis,

Yes, I have looked at all of the procedures. If I were younger,

I might choose some thing other than just to deal with it. I am

trying a medication that seems to help. It is called Vesicare.

Aubrey

Aubry, have you investigated prosthetic means for dealing with the incontinence and ED problems? From what I have been reading, the degree of satisfaction using today's technology has been very high. The anesthea needed is relatively light.

Louis. . Create a Home Theater Like the Pros. Watch the video on AOL Home.

[Guest guest]

Hi Louis. I will be having the de'Vincci procedure on April 30th.

The Urologist has done over 200 so far with good results. He did not

tell me how many he's killed either. I refusted the radical, and the

radiation, the pellets and whatever. I just hope to come out of this

alive. I do not like being put under for four hours as i have had

problems in the past with general surgery. Just thing of me on April

30th. I will be at the University of Alabama Hospital in Birmingham.

I have no family support as they are in denial as I was to start with.

They do not realize how serious this operation, nor the quality of

life afterwards. I have been told I may need help when I get home for

a few days. I need to line up someone that is not working the hours I

may need them.

> Aubrey,

> There is no question about the fact that you are much more

knowledgeable then I in regards to prostate cancer, its treatment

options and the possible side effects. I have read many of your posts

and gained knowledge from each and every one of them.

> However, I think there is absolutely no doubt that prostate

removal today is much different then it was 16 years ago. I'm not

suggesting that the side effects have gone away but the procedures

available today are much more advanced.

> With the new DaVinci procedure major blood loss during the

procedure is at a point today that stockpiling your blood prior to

the procedure is no longer a requirement. The hospital stay providing

all goes well is only one day. I had my catheter removed in eight

days and went back to work in two weeks. These types of things were

unheard of sixteen years ago.

> There is no doubt that the surgeons visualization of the

surgical site with less blood loss and the magnification that is part

of the DaVinci procedure is much more advanced then the procedures

that were available sixteen years ago.

> As for the side effects, yes they are still there but there

are so many other things that must be factored into the equation of

how you will do after surgery.

> Just my one cent worth.

> Regards,

> Rick

>

>

>

>

>

> Re: gleason score

>

>

> Hi Louis,

>

> Can you tell me why surgery today is any different than

> surgery 16 years ago? The removal of the prostate is

> still the same with the same unpleasant side effects.

>

> You seem to be quite knowledgeable, but you are

> definitely biased to surgery. I have been studying this

> disease for several years. I have known hundreds of

> men who have had all the various therapies. They are

> all different- no one size fits all.

>

> There are several prostate cancer support groups in

> Los Angeles. I have personally known many of the men

> and the therapies they have had. I strongly believe that

> for many men, surgery is not the best therapy.

>

> I wish you all the best

>

> Aubrey Pilgrim, DC (Ret.) Author of

> A Revolutionary Approach to Prostate Cancer-Read the original

book

> for FREE at: http://www.prostate pointers. org/prostate/

lay/apilgrim/

> Read new edition for FREE at http://www.cancer. prostate-

help.org/ capilgr.htm

> Dr. E. Crawford is co-author of the revision

>

> In a message dated 3/30/2008 8:52:07 P.M. Pacific Daylight

Time, lcarliner@earthlink .net writes:

> Just to put things into perspective, your operation took

place almost 16 years ago and techniques have improve immensely over

that time. If the person is under his mid-fifities, there is a

terrible choice. In the early stage in which the cancer is confined

to the prostate and the Gleason score is 6 to 7 or below, outcome is

likely to be best with surgery, but the price, assuming that the side-

effects resolve in a decent time interval, is the loss of semen

production. With radiation, other than proton beam treatment, the

side effects will be less initially, but the risk of the cancer

recurring and the dreaded side effects developing to a permanent

state over the long term (ED and rectal issues). Also, salvage

procedures, should treatment fail, will be rather messy.

>

> I was going to go with Brachytherapy until I was confronted

with the prospect of ADT shots. I am less than two years (this coming

September) with some ED issues, but these appear to be very slowly

resolving themselves. My most recent PSA level was at the

unmeasurable point. My original Gleason score was 6 to 7. The other

thing do before surgery is to use Avodart or Poscar (or their generic

equivalent) to shrink the gland prior to surgery. I believe that this

measure will reduce the side effect of penile shortening. I would

start on penile rehabilitation some six months after surgery, but my

health plan did not cover it.

>

> Louis. . .

>

>

>

>

> Create a Home Theater Like the Pros. Watch the video on AOL

Home.

>

>

>

>

> --------------------------------------------------------------------

------

> Like movies? Here's a limited-time offer: Blockbuster Total

Access for one month at no cost.

>

>

>

>

>

> --------------------------------------------------------------------

--------

> Special deal for Yahoo! users friends - No Cost. Get a month of

Blockbuster Total Access now

>

[Guest guest]

I have. If you want the best you can expect to fork over $20.000.00. I will try to stay calm and collective and make my partner happy in other ways....

Re: Re: gleason score

Hi Bob,

Have you investigated ALL of your options? If you are having

problems now, you will have even more if you have a radical

prostatectomy.

I had a radical prostatectomy in 1992. I believe that there are

many therapies which have fewer side effects. If it were me,

I would look at brachytherapy, or proton beam therapy rather

than surgery. For me, sex has never been the same since my

surgery. I am impotent and have an incontinence problem.

By all means look at all of your options.

I wish you all the bestAubrey Pilgrim, DC (Ret.) Author ofA Revolutionary Approach to Prostate Cancer-Read the original book for FREE at: http://www.prostatepointers.org/prostate/lay/apilgrim/Read new edition for FREE at http://www.cancer.prostate-help.org/capilgr.htmDr. E. Crawford is co-author of the revision

In a message dated 3/31/2008 7:01:21 P.M. Pacific Daylight Time, rwright010centurytel (DOT) net writes:

I go in April 17th to get the details of my surgery and pre-admission on the 30th. He will be using the de'Vinci method. I have read and read and still don't know what to expect. I am havoing problems with sexual function even before the operation. Will that change for the worse after surgery? I am 67 and have met this 45 year old that really wants to go out with me but I am scared. She does not know my condition. I have a much older friend that has a very expensive "pump". Do they work? I have taken Viagra without too much sucess. The closer my surgery date comes the more nervous I get. I cannot be still. I have heard of medicine injected for a good erection. There are exercises you can you. "Strum" said use it or lose it. I think he is right. I have had penile shrinkage, and not even had surgery. I hate to embarrass myself out on a date, or sleep over, but I am nervous about it. Maybe I will claim lower hernia; which I have and then see what may transpire...Bob

Create a Home Theater Like the Pros. Watch the video on AOL Home.

[Guest guest]

You should ask the anesthesiologist what measures will be taken to avoid the occurrence of anesthesia awareness. This is most important. In my case, the job the anesthesiologist did was superb. I went under quite quickly and woke up in my room without any anesthesia-related side-effects. Also, ask what measures will be taken to prevent post surgical blood clots in the legs. In my case, air squeeze leggings were used.

You should ask your urologist about aggressive penile rehabilitation if function is slow to return six months post surgery. Until immunotherapy becomes available, surgery will still be the gold standard for early stage prostate cancer unless age (over 70) or medical condition precludes surgery.

Louis. . .

Re: gleason score> > > Hi Louis,> > Can you tell me why surgery today is any different than> surgery 16 years ago? The removal of the prostate is> still the same with the same unpleasant side effects. > > You seem to be quite knowledgeable, but you are > definitely biased to surgery. I have been studying this> disease for several years. I have known hundreds of> men who have had all the various therapies. They are> all different- no one size fits all. > > There are several prostate cancer support groups in > Los Angeles. I have personally known many of the men> and the therapies they have had. I strongly believe that> for many men, surgery is not the best therapy.> > I wish you all the best> > Aubrey Pilgrim, DC (Ret.) Author of> A Revolutionary Approach to Prostate Cancer-Read the original book > for FREE at: http://www.prostate pointers. org/prostate/ lay/apilgrim/> Read new edition for FREE at http://www.cancer. prostate- help.org/ capilgr.htm> Dr. E. Crawford is co-author of the revision > > In a message dated 3/30/2008 8:52:07 P.M. Pacific Daylight Time, lcarliner@earthlink .net writes:> Just to put things into perspective, your operation took place almost 16 years ago and techniques have improve immensely over that time. If the person is under his mid-fifities, there is a terrible choice. In the early stage in which the cancer is confined to the prostate and the Gleason score is 6 to 7 or below, outcome is likely to be best with surgery, but the price, assuming that the side-effects resolve in a decent time interval, is the loss of semen production. With radiation, other than proton beam treatment, the side effects will be less initially, but the risk of the cancer recurring and the dreaded side effects developing to a permanent state over the long term (ED and rectal issues). Also, salvage procedures, should treatment fail, will be rather messy. > > I was going to go with Brachytherapy until I was confronted with the prospect of ADT shots. I am less than two years (this coming September) with some ED issues, but these appear to be very slowly resolving themselves. My most recent PSA level was at the unmeasurable point. My original Gleason score was 6 to 7. The other thing do before surgery is to use Avodart or Poscar (or their generic equivalent) to shrink the gland prior to surgery. I believe that this measure will reduce the side effect of penile shortening. I would start on penile rehabilitation some six months after surgery, but my health plan did not cover it.> > Louis. . . > > > > > Create a Home Theater Like the Pros. Watch the video on AOL Home.> > > > > ----------------------------------------------------------------> Like movies? Here's a limited-time offer: Blockbuster Total Access for one month at no cost. > > > > > > ------------------------------------------------------------------> Special deal for Yahoo! users friends - No Cost. Get a month of Blockbuster Total Access now>