Re: Welcome new member - trying to decide

[Guest guest]

>

> Email address: jab11007

>

> Comment from user:

> I was biopsied for prostate cancer 12/15/2006.

> I am trying to decide between surgery and

> radiation treatment.

>

> Jab

>

> Sorry to hear that you have to make this decision. we all remember

it was a difficult time!

>

> Tell us about your stats

>

> PSA

> Gleason

> Staging

My PSA is either 3.1 or 3.6 (I can't remember) My Gleason Score

is 6. I believe I am stage T2 - localzed. I am a relatively

healthy 60 years old. I can live with ED but the idea

of incontinence is awful for me. I am leaning towards the

little pellet implants at a major cancer center.

I know that, psychologically, surgery would be difficult for me.

I almost walked out of the biopsy procedure because of a panic

attack.

>

> If you have them.

>

>

>

[Guest guest]

Reminds me of me, needles and doctors are way down on my list of

favorite things. My doctor wrote me a Rx for Ativan for anxiety and

stress to help with this before my surgery. It did seem to make a

difference. Not really a drug that has noticeable effect either, but

just calms a bit. I think we are pretty fortunate these days to have

the internet to get an idea of what to expect from whatever treatment

we go with.

[Guest guest]

Hi Jab,

With your stats and staging, I think Seed Implants or Brachytherapy is

a very good choice.

I am sorry to hear about your diagnosis. ABOVE ALL DO NOT

PANIC AND RUSH INTO TREATMENT. Your cancer has

probably been growing in your body for several years. It will not kill

you any time soon. It is your responsibility to make the treatment

decision, but it should be a well informed decisions. Before you

make a treatment decision that you will have to live with for the

rest of your life, get a second opinion from a doctor who does not

specialize entirely doing surgery. Take the time to learn all your

options. Have several PSA tests and make a chart. The PSA

will correlate fairly closely to the cancer activity.

I had my prostate removed in 1992- but we did not have as many

options at that time. I would not choose surgery today. I believe

that there are better options. If I had it to do over, I would choose

brachytherapy, (seed implants or HDR). Of course there are

other options such as External Beam Radiation or IMRT, Proton

Beam radiation (it is one of the better therapies, but expensive, some

insurance may not cover it), Cryo Surgery and soon we will have High

Intensity Focused Ultrasound (HIFU). HIFU may be the least invasive

of all, but still not FDA approved in U.S. Many are now choosing

Laparoscopic or Da Vinci robotic assisted surgery to remove

the prostate. But it has the same unpleasant side effects of

the Retropubic Radical Prostatectomy (RRP). For advanced

PCa, there is hormone ablation and several regimens of chemo.

For moderate or rather insignificant cancers. you may be better

off just doing Watch and Wait. Pay close attention to several

PSA tests.

No matter what therapy one chooses, there are always some side

effects, No matter who does it or how it is done, removal of the

prostate has side effects, some more pronounced and unpleasant

than others.

You are wise to do a lot of research. One reason not to have surgery

is because, for me, sex was never the same after my prostate was

removed. The prostate and the seminal vesicles manufacture almost

all of the ejaculate. During orgasm, the prostate squeezes down and

forces the semen out. This is a part of the pleasure of an orgasm.

One may still be able to have an orgasm after a RP, but it may take

a lot more stimulation.

Many men who have surgery are impotent afterwards. There are

nerves on each side of the prostate that control erectile function.

These nerves are difficult to see and quite often they are severed

or severely damaged.

Another side effect of RP is that many men lose some length and

girth afterwards. Several studies have been done on this subject.

Go to www.google.com and search for Loss of Penile Length and

Radical Prostatectomy.

Many men are also incontinent for some time after surgery because

the primary bladder valve is intimately connected to the prostate. It

is often damaged. Most men do recover urinary continence by

doing Kegel exercises which strengthens the secondary valve below

the prostate. Unfortunately, a few men never regain continence. A few

of these men have to have an Artificial Urinary Sphincter implanted

in order to control their urinary output.

But even if they do learn to control normal urinary functions by doing

Kegel exercises for this valve, when they try to have an erection or

become sexually aroused, this valve will open and they may have

leakage. This valve has always opened during sexual activities

and no amount of Kegel exercises will cause it do otherwise.

The primary valve is not involved in brachytherapy, or seed

implants so there is little or no incontinence.

The impotence rate is also very low. Some men will still have an

ejaculate, though it may be much less in volume. Some men are

even able to father children after brachytherapy. After a RP, one may

be able to have sperm aspirated from the testes and used to

impregnate a woman. But it is a difficult procedure, is expensive and

may not always be successful. If a man thinks he may want to father

children after a RP, he should consider banking some of his sperm. 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

Email address: jab11007 > > Comment from user:> I was biopsied for prostate cancer 12/15/2006.> I am trying to decide between surgery and> radiation treatment. > > Jab> > Sorry to hear that you have to make this decision. we all remember it was a difficult time!> > Tell us about your stats> > PSA> Gleason > Staging My PSA is either 3.1 or 3.6 (I can't remember) My Gleason Scoreis 6. I believe I am stage T2 - localzed. I am a relativelyhealthy 60 years old. I can live with ED but the ideaof incontinence is awful for me. I am leaning towards thelittle pellet implants at a major cancer center.I know that, psychologically, surgery would be difficult for me.I almost walked out of the biopsy procedure because of a panicattack.

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

[Guest guest]

Jab (and Pearly Nautilus)

You may be on the right lines, but consider active monitoring as well.

As one of our new members found out (pearly nautilus), some urologists view of watchful waiting seems to be to wait until symptoms develop.

Active monitoring starts (as mode) with scans and monthly PSA.

You would be looking at PSA movement not for symptoms - often symptoms come too late.

There are certain stages where even active monitoring is not an option. Terry will no doubt point you to his list of when to and when not to think about it.

We know that there is a 75% chance of no recurrence after the main treatments. What we don't know is how many of these men need not have taken immediate action.

We are a decade behind the ladies in pushing for research.

It would be magnificent to say on diagnosis this is a sleeping pussy cat go on active monitoring - or this is a potential tiger you need to act now.

Pearly Nautilus there may be some hope of barchytherapy and external beam radiation follow up if the cat is just out of the bag. Let us know a bit more detail

Best wishes

Re: Welcome new member - trying to decide

>> Email address: jab11007 > > Comment from user:> I was biopsied for prostate cancer 12/15/2006.> I am trying to decide between surgery and> radiation treatment. > > Jab> > Sorry to hear that you have to make this decision. we all remember it was a difficult time!> > Tell us about your stats> > PSA> Gleason > Staging My PSA is either 3.1 or 3.6 (I can't remember) My Gleason Scoreis 6. I believe I am stage T2 - localzed. I am a relativelyhealthy 60 years old. I can live with ED but the ideaof incontinence is awful for me. I am leaning towards thelittle pellet implants at a major cancer center.I know that, psychologically, surgery would be difficult for me.I almost walked out of the biopsy procedure because of a panicattack.> > If you have them.> > >