Guest guest Posted July 29, 2007 Report Share Posted July 29, 2007 Hi Jody, 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. For more information, you can read my book below my signature. Over 20 MDs and several survivors contributed to it. 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 Welcome to jodycoker jodycoker who has joined the ProstateCancerSupport group and says: Hi, my name is Jody. I am 49 and I have Prostate Cancer. I found out on July 18, 2007. I’m just looking for some Info and support. Thanks JodyGet a sneak peek of the all-new AOL.com. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 29, 2007 Report Share Posted July 29, 2007 > > Welcome to jodycoker jodycoker@... who has joined the > ProstateCancerSupport group and says: > > > > Hi, my name is Jody. I am 49 and I have Prostate Cancer. I found out on July > 18, 2007. I'm just looking for some Info and support. > > Thanks Jody > > > > Sorry to hear of your diagnosis but welcome to the club you never wanted to > join. No doubt you're in a bit of a state of shock, and perhaps feeling > isolated. You'll find plenty of friendly folk on this List who will do what > they can to help you through. > > > > You might find it useful to visit YANA - You Are Not Alone Now > www.yananow.net <http://www.yananow.net/> a site set up for newly diagnosed > people. The first section gives some basic information in plain language > with links to more complex and technical sites. The second section of the > site is where men are invited to tell their prostate cancer stories and how > they arrived at their decisions regarding treatment. Many people have mailed > to say how useful they have found this, especially because most of the men > are happy to respond to specific questions. The section of the site can be > found by clicking the link labelled Experiences or going to > http://www.yananow.net/Experiences.html > > > > But in any event, please post some details of your diagnosis - your Age, > your PSAs leading up to the diagnosis, your Gleason Score and Staging (these > terms are all explained on the YANA site) and any questions you might have. > Just remember - there are no dumb questions. We all started off where you > are now, but we've collectively learned a lot over the years. > > > > > > > > All the best > > > > Terry Herbert > > in Melbourne Australia > > Diagnosed '96: Age 54: Stage T2b: PSA 7.2: Gleason 3+3=6: No treatment. Jun > '07 PSA 42.0 - Bony Metastasis: starting ADT > > My site is at www.prostatecancerwatchfulwaiting.co.za > > It is a tragedy of the world that no one knows what he doesn't know, and the > less a man knows, the more sure he is that he knows everything. Joyce > Carey > Thanks Terry My PSA was 4.2 when I was tested by my family Doctor. I have had a number of PSA tests done in the past. When ever I happened to think about it. Maybe 4 over the past 8 or 10 years well this one was high enough for my Doctor to think that I needed to have a follow up by an Urologist. The DRE was set up for about 3 weeks later. The Doctor was very nice and answered all of my questions about what was going to happen. When he finished the exam he told me that the right side of my Prostate was " Firm " and he felt that we need to proceed with a TRUS biopsy. That was another week of waiting. My Doctor explained what was going to happen, a voice of experience (he's had two) it was not fun but in hind sight I would do it again if needed. Wait another week. July 18 4:00 PM, I am the last person in the waiting room. The nurse takes me back to the exam room and I wait! I wish I had my PDA so I could at least play a game or read the news. The Doctor finally comes in. I can tell that right now he is not enjoying his job. Mr. Coker the results of you're the came back positive for all the samples from the right side. Well that was not what I wanted to hear. OK what now? We sat and talked for a long time going over the options that were ahead of me and what the tests meant. What percent of cells where cancerous. Two samples where 80%. What was the Gleason Score, 6 and 7? He was in no hurry to leave and answered any and all of my uninformed questions. Being only 49 and in fairly go health for a man that likes a good stake and a s we decided that taking the prostate out was the beast course for me. I have two great kids, a boy 15 and a girl 7. No need to have more. Right now I want to do anything that gives me the best chance of seeing them grow up. We are still doing test to determine the extent of my cancer. I will keep up posted. Oh by the way. The way I have come to look at this is it is better to know that not to. You can not fight what you don't see. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 29, 2007 Report Share Posted July 29, 2007 Jody: Here are some things that you may want to consider, as you start your search for the treatment that is right for you: Sorry about the PCa, but do your homework. Here are my " Rules for Newbies: " Recommendations for the " Newly Diagnosed " Prostate Cancer Patient 1. Do Not Panic! Many of us have been down this road before, and there is much to learn before you choose the solution " best for you. " You have had this thing longer than you think, and taking the time to do the proper investigation into your options will not hurt. Since you have posted on the Internet, you obviously have the means to do most of the research that you need to do. There is a wealth of knowledge and experience for you to draw on. 2. Do Not Accept the First Recommendation From the Urologist! (Or any other " first " recommendation) Get second, (or more) opinions from experts in other specialties. Depending on your Gleason score, you have time to figure this thing out! Gleason of 6 or less, take your time and be thorough; Gleason 7 and up, you need to do something sooner than later, but remember that it " is not going to kill you tomorrow, " so you still have time to do a good job of fact gathering. Your PSA value enters into this equation also. This is the time to learn and thoroughly examine ALL your options, because whatever you choose, you will live with the consequences the rest of your days. 3. I recommend that you also join " YANA " (You Are Not Alone " ) http://www.yananow.net/ Explore it. (My story is on YANA, under Proton Beam). 4. Get Bob Marckini's book, " You Can Beat Prostate Cancer … " and read it cover to cover BEFORE you visit your doctor again if possible. Order from Amazon or from Bob at www.protonbob.com. READING THIS BOOK IS PROBABLY THE MOST IMPORTANT RECOMMENDATION IN THIS LIST! 5. Go here: and read Aubrey Pilgrims work: http://www.cancer.prostate-help.org/capilgr.htm 6. A Summary of Options: (These are the primary options, approved by the medical profession, Medicare, and most insurance companies in the U. S.) A. If there is no " velocity " in the PSA value (it is not increasing rapidly) and the tumor is judged to be very slow growing, " Active Surveillance " ( " Careful Monitoring " ) may be a viable option, if the PSA and other symptoms are checked every three to six months. Lifestyle changes and diet with supplements sometimes go with this option. B. Depending on the aggressiveness of the tumor; and if the prostate is enlarged, some specialists may recommend hormone treatment or ADT (Androgen Deprivation Therapy, sometimes called AST or Androgen Suppression Therapy). This is chemical castration to reduce or eliminate the body's production of testosterone, upon which the cancerous cells " feed. " This will also " shrink " the prostate gland (sometimes necessary for the indicated final treatment). If it is used, it will " stall " the cancer growth and/or perhaps decrease the tumor volume, thus delaying the need for immediate treatment by some other method. There are serious side effects to hormone therapy that you should be aware of. For PCa that has already metastasized this may be a primary treatment. C. Surgeons will usually recommend surgery, either RP (radical prostatectomy) or Da Vinci Robotic Prostatectomy. The skill of the surgeon is paramount! Too much, in my opinion, depends on the surgeon. D. Some urologists will recommend brachytherapy, either with or without supplemental radiation. Again skill and experience count, but this is a very viable option with a proven track record, with a short recovery time but with potential for urinary problems. E. Some urologists, who consider themselves " Cryosurgeons, " will recommend cryotherapy (freezing the complete gland to " kill " the cancer). This again is a very viable option, but the skill of the " artist " physician is again of utmost importance to the eventual outcome. If " Focal " freezing is not done, then sexual function is impacted. F. Radiologists or Radiation Oncologists may recommend EBRT (External Beam Radiation Therapy) using normal photon based X-rays, and possibly with the latest in conformal intensity modulated radiation therapy (IMRT), Or the same thing with a special technology called " Image Guided; " this them becomes " IG-IMRT, which of all photon based radiation is probably the best choice with the least side effects compared to other " normal " X-ray treatment. G. Finally, there is Proton Beam Radiation Therapy (PBRT), which is only available at five " Centers of Excellence " in the U. S. This is the ONLY treatment (other than " Watchful Waiting " which of course has no side effects) that has the least amount of side effects, with at least as good or better long-term results (documented) as all other options above. Usually you will not hear of this option from other doctors or specialists! Do NOT allow the fact that the doctor did not mention it prevent you from considering this option along with the others! At the very least, study the records about PBRT and if possible, visit one of the centers for a consultation. Go to www.protonbob.com , and READ THE TESTIMONIALS! You will find that many are " independent thinkers, " that make up their own mind about things, irrespective of the crowd. There are a preponderance of professionals, including engineers and medical professionals, that have chosen this treatment. (I am an engineer.) FULL DISCLOSURE: I HAVE " EMBRACED " THIS TREATMENT AND CONSIDER MYSELF A " PROTON BEAM ADVOCATE! " I completed my PBRT in March of 2007. Whatever method you choose for your treatment, you should be comfortable with it. Be happy that you made the choice, based on your personal situation. This is many times better than accepting the recommendation of the diagnosing specialist, then later wondering why you did not do your " due diligence " and make your own decision! Whatever method you choose, rest assured that the outcome, with experienced surgeons or other specialists, is approximately the same for most modalities. The major differences in the outcomes may be in " quality of life " issues, which may or may not happen in every case. For me, these were the main drivers in my decision. E-mail me directly with any questions about Proton Therapy or other general questions. I will be quick to answer to the best of my ability. cnsjones@.... Best regards, Fuller > > > > Welcome to jodycoker jodycoker@ who has joined the > > ProstateCancerSupport group and says: > > > > > > > > Hi, my name is Jody. I am 49 and I have Prostate Cancer. I found > out on July > > 18, 2007. I'm just looking for some Info and support. > > > > Thanks Jody > > > > > Thanks Terry > > My PSA was 4.2 when I was tested by my family Doctor. I have had a > number of PSA tests done in the past. When ever I happened to think > about it. Maybe 4 over the past 8 or 10 years well this one was high > enough for my Doctor to think that I needed to have a follow up by an > Urologist. The DRE was set up for about 3 weeks later. The Doctor > was very nice and answered all of my questions about what was going > to happen. When he finished the exam he told me that the right side > of my Prostate was " Firm " and he felt that we need to proceed with a > TRUS biopsy. That was another week of waiting. My Doctor explained > what was going to happen, a voice of experience (he's had two) it was > not fun but in hind sight I would do it again if needed. Wait > another week. July 18 4:00 PM, I am the last person in the waiting > room. The nurse takes me back to the exam room and I wait! I wish I > had my PDA so I could at least play a game or read the news. The > Doctor finally comes in. I can tell that right now he is not > enjoying his job. Mr. Coker the results of you're the came back > positive for all the samples from the right side. Well that was not > what I wanted to hear. OK what now? We sat and talked for a long > time going over the options that were ahead of me and what the tests > meant. What percent of cells where cancerous. Two samples where > 80%. What was the Gleason Score, 6 and 7? > He was in no hurry to leave and answered any and all of my uninformed > questions. > Being only 49 and in fairly go health for a man that likes a good > stake and a s we decided that taking the prostate out was the > beast course for me. I have two great kids, a boy 15 and a girl 7. > No need to have more. Right now I want to do anything that gives me > the best chance of seeing them grow up. We are still doing test to > determine the extent of my cancer. I will keep up posted. > > Oh by the way. The way I have come to look at this is it is better > to know that not to. You can not fight what you don't see. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 30, 2007 Report Share Posted July 30, 2007 Jody, It sounds like you have made your decision to proceed with surgery. At your relatively young age, it makes a lot of sense to put that option at the top of the list. Assuming the cancer is still confined to the prostate, the surgery offers the highest probability of eliminating all of the cancer cells from your body. And you retain radiation as a possible backup treatment in the event of a local recurrence. Clearly you are not a candidate for watchful waiting given the extent of your cancer and the fact that there is some Gleason 7. These days, those men who choose surgery have the choice between the " old fashioned " RRP and robotic surgery. As you will see on this site, it seems that a lot of men are choosing robotic these days, so I would examine their experiences carefully. I had an RRP five years ago (when there was very little experience with robotic) at age 59 and have been very pleased with the outcome. I bounced back quickly with no incontinence issues and am cancer-free five years later. The most important thing to know with respect to the surgical alternative is the importance of choosing a highly experienced surgeon -- one who has done hundreds of the operations. Certainly don't limit yourself to your current urologist in your search for the best surgeon for you. If I had done that, I would have been operated on by a man who averaged less than one surgery each month, instead of the surgeon I chose (at s Hopkins) who does 150-200 each year. There is too much at stake for you to settle for less than the best. I highly recommend that you read " Dr. Walsh's Guide to Surviving Prostate Cancer " (2nd Edition is just out in paperback) and " Dr. Scardino's Prostate Book. " Dr. Walsh is the legendary surgeon at s Hopkins who perfected the nerve-sparing surgery, and Dr. Scardino is Chairman of the Dept. of Urology at Memorial Sloan-Kettering Cancer Center in NYC (and a top surgeon as well). By the way, you can choose to bank sperm prior to the surgery should you wish to retain the option of fathering additional children. Bill, NYC > > > > Welcome to jodycoker jodycoker@ who has joined the > > ProstateCancerSupport group and says: > > > > > > > > Hi, my name is Jody. I am 49 and I have Prostate Cancer. I found > out on July > > 18, 2007. I'm just looking for some Info and support. > > > > Thanks Jody > > > > > > > > Sorry to hear of your diagnosis but welcome to the club you never > wanted to > > join. No doubt you're in a bit of a state of shock, and perhaps > feeling > > isolated. You'll find plenty of friendly folk on this List who will > do what > > they can to help you through. > > > > > > > > You might find it useful to visit YANA - You Are Not Alone Now > > www.yananow.net <http://www.yananow.net/> a site set up for newly > diagnosed > > people. The first section gives some basic information in plain > language > > with links to more complex and technical sites. The second section > of the > > site is where men are invited to tell their prostate cancer stories > and how > > they arrived at their decisions regarding treatment. Many people > have mailed > > to say how useful they have found this, especially because most of > the men > > are happy to respond to specific questions. The section of the site > can be > > found by clicking the link labelled Experiences or going to > > http://www.yananow.net/Experiences.html > > > > > > > > But in any event, please post some details of your diagnosis - > your Age, > > your PSAs leading up to the diagnosis, your Gleason Score and > Staging (these > > terms are all explained on the YANA site) and any questions you > might have. > > Just remember - there are no dumb questions. We all started off > where you > > are now, but we've collectively learned a lot over the years. > > > > > > > > > > > > > > > > All the best > > > > > > > > Terry Herbert > > > > in Melbourne Australia > > > > Diagnosed '96: Age 54: Stage T2b: PSA 7.2: Gleason 3+3=6: No > treatment. Jun > > '07 PSA 42.0 - Bony Metastasis: starting ADT > > > > My site is at www.prostatecancerwatchfulwaiting.co.za > > > > It is a tragedy of the world that no one knows what he doesn't > know, and the > > less a man knows, the more sure he is that he knows everything. > Joyce > > Carey > > > > Thanks Terry > > My PSA was 4.2 when I was tested by my family Doctor. I have had a > number of PSA tests done in the past. When ever I happened to think > about it. Maybe 4 over the past 8 or 10 years well this one was high > enough for my Doctor to think that I needed to have a follow up by an > Urologist. The DRE was set up for about 3 weeks later. The Doctor > was very nice and answered all of my questions about what was going > to happen. When he finished the exam he told me that the right side > of my Prostate was " Firm " and he felt that we need to proceed with a > TRUS biopsy. That was another week of waiting. My Doctor explained > what was going to happen, a voice of experience (he's had two) it was > not fun but in hind sight I would do it again if needed. Wait > another week. July 18 4:00 PM, I am the last person in the waiting > room. The nurse takes me back to the exam room and I wait! I wish I > had my PDA so I could at least play a game or read the news. The > Doctor finally comes in. I can tell that right now he is not > enjoying his job. Mr. Coker the results of you're the came back > positive for all the samples from the right side. Well that was not > what I wanted to hear. OK what now? We sat and talked for a long > time going over the options that were ahead of me and what the tests > meant. What percent of cells where cancerous. Two samples where > 80%. What was the Gleason Score, 6 and 7? > He was in no hurry to leave and answered any and all of my uninformed > questions. > Being only 49 and in fairly go health for a man that likes a good > stake and a s we decided that taking the prostate out was the > beast course for me. I have two great kids, a boy 15 and a girl 7. > No need to have more. Right now I want to do anything that gives me > the best chance of seeing them grow up. We are still doing test to > determine the extent of my cancer. I will keep up posted. > > Oh by the way. The way I have come to look at this is it is better > to know that not to. You can not fight what you don't see. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 30, 2007 Report Share Posted July 30, 2007 Bill, I am happy for you that you are cancer free and continent 5 years out from your sugery. I respectfully disagree that surgery provides the best chance for getting all of the cancer. Simply not true. I have read study after study and countless articles which support the statement that all of the treaments have a similar cure rate. In your post to new member Jody you do not comment on your post sugery sexual function. Why the ommision? This is one of the biggest issues with regard to prostate cancer and quality of life following diagnosis and treatment. I would imagine that this would be a very important issue for a 49 year old man. Don't mean to be in your face but if you are going to give advice on treament I feel that you should get your facts straight and fully disclose your own post surgery situation. Laurel > > > Jody, > > It sounds like you have made your decision to proceed with surgery. > At your relatively young age, it makes a lot of sense to put that > option at the top of the list. Assuming the cancer is still confined > to the prostate, the surgery offers the highest probability of > eliminating all of the cancer cells from your body. And you retain > radiation as a possible backup treatment in the event of a local > recurrence. Clearly you are not a candidate for watchful waiting > given the extent of your cancer and the fact that there is some > Gleason 7. > > These days, those men who choose surgery have the choice between > the " old fashioned " RRP and robotic surgery. As you will see on > this site, it seems that a lot of men are choosing robotic these > days, so I would examine their experiences carefully. I had an RRP > five years ago (when there was very little experience with robotic) > at age 59 and have been very pleased with the outcome. I bounced > back quickly with no incontinence issues and am cancer-free five > years later. > > The most important thing to know with respect to the surgical > alternative is the importance of choosing a highly experienced > surgeon -- one who has done hundreds of the operations. Certainly > don't limit yourself to your current urologist in your search for > the best surgeon for you. If I had done that, I would have been > operated on by a man who averaged less than one surgery each month, > instead of the surgeon I chose (at s Hopkins) who does 150-200 > each year. There is too much at stake for you to settle for less > than the best. > > I highly recommend that you read " Dr. Walsh's Guide to > Surviving Prostate Cancer " (2nd Edition is just out in paperback) > and " Dr. Scardino's Prostate Book. " Dr. Walsh is the > legendary surgeon at s Hopkins who perfected the nerve-sparing > surgery, and Dr. Scardino is Chairman of the Dept. of Urology at > Memorial Sloan-Kettering Cancer Center in NYC (and a top surgeon as > well). > > By the way, you can choose to bank sperm prior to the surgery should > you wish to retain the option of fathering additional children. > > Bill, NYC Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 30, 2007 Report Share Posted July 30, 2007 Hi Jody, I am sure you will be okay. I know how scary the word cancer can be. Your life will be forever changed, but it does not necessarily mean that it will be all bad. I have had over 15 good years since my RRP. I would not choose that therapy today, but I did not have too many options at that time. By all means talk to your kids, don't try to hide it. I am sure they will understand. 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 Thanks Aubrey I have a lot to think about. The side affects of RP are one thing that I need to think about. I have two great kids (a Boy 15 and a Girl 7) and at 49 really don’t think that I need any more. I have plenty of things to ask my Doctor the next time we get together. Your reply has made me think about a lot of things. Thanks Jody Get a sneak peek of the all-new AOL.com. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 30, 2007 Report Share Posted July 30, 2007 Jody, at the risk of being repetitive, I want to attempt to set the record straight regarding the statements that a younger prostate cancer patient is automatically a better candidate for surgery. Granted there may be longer to recover from potential problems resulting from surgery (incontinence, impotence, etc.) but the same thing is true about other modalities (treatment methods) as well. It has been stated over and over that the cure rates for all the different treatments appear to be approximately the same. Therefore, I urge you to carefully consider all the factors and potentialities before making your final decision. I urge you again to get Bob marckini's book, it is an excellent reference for ALL the different treatments, although he does, as I do, prefer proton beam radiation therapy because of the lack of side effects, and the quality of life issues such as incontinence that it avoids. I hope that you will consider this message as a sincere effort to help you through a trying time; we have all been through the same stress, and understand. Whatever treatment you choose, it should be the one that you are most comfortable with, and you will do well. Best regards, Fuller > > > > > > Welcome to jodycoker jodycoker@ who has joined the > > > ProstateCancerSupport group and says: > > > > > > > > > > > > Hi, my name is Jody. I am 49 and I have Prostate Cancer. I found > > out on July > > > 18, 2007. I'm just looking for some Info and support. > > > > > > Thanks Jody > > > > > > > > > > > > Sorry to hear of your diagnosis but welcome to the club you > never > > wanted to > > > join. No doubt you're in a bit of a state of shock, and perhaps > > feeling > > > isolated. You'll find plenty of friendly folk on this List who > will > > do what > > > they can to help you through. > > > > > > > > > > > > You might find it useful to visit YANA - You Are Not Alone Now > > > www.yananow.net <http://www.yananow.net/> a site set up for > newly > > diagnosed > > > people. The first section gives some basic information in plain > > language > > > with links to more complex and technical sites. The second > section > > of the > > > site is where men are invited to tell their prostate cancer > stories > > and how > > > they arrived at their decisions regarding treatment. Many people > > have mailed > > > to say how useful they have found this, especially because most > of > > the men > > > are happy to respond to specific questions. The section of the > site > > can be > > > found by clicking the link labelled Experiences or going to > > > http://www.yananow.net/Experiences.html > > > > > > > > > > > > But in any event, please post some details of your diagnosis - > > your Age, > > > your PSAs leading up to the diagnosis, your Gleason Score and > > Staging (these > > > terms are all explained on the YANA site) and any questions you > > might have. > > > Just remember - there are no dumb questions. We all started off > > where you > > > are now, but we've collectively learned a lot over the years. > > > > > > > > > > > > > > > > > > > > > > > > All the best > > > > > > > > > > > > Terry Herbert > > > > > > in Melbourne Australia > > > > > > Diagnosed '96: Age 54: Stage T2b: PSA 7.2: Gleason 3+3=6: No > > treatment. Jun > > > '07 PSA 42.0 - Bony Metastasis: starting ADT > > > > > > My site is at www.prostatecancerwatchfulwaiting.co.za > > > > > > It is a tragedy of the world that no one knows what he doesn't > > know, and the > > > less a man knows, the more sure he is that he knows > everything. > > Joyce > > > Carey > > > > > > > Thanks Terry > > > > My PSA was 4.2 when I was tested by my family Doctor. I have had > a > > number of PSA tests done in the past. When ever I happened to > think > > about it. Maybe 4 over the past 8 or 10 years well this one was > high > > enough for my Doctor to think that I needed to have a follow up by > an > > Urologist. The DRE was set up for about 3 weeks later. The > Doctor > > was very nice and answered all of my questions about what was > going > > to happen. When he finished the exam he told me that the right > side > > of my Prostate was " Firm " and he felt that we need to proceed with > a > > TRUS biopsy. That was another week of waiting. My Doctor > explained > > what was going to happen, a voice of experience (he's had two) it > was > > not fun but in hind sight I would do it again if needed. Wait > > another week. July 18 4:00 PM, I am the last person in the > waiting > > room. The nurse takes me back to the exam room and I wait! I > wish I > > had my PDA so I could at least play a game or read the news. The > > Doctor finally comes in. I can tell that right now he is not > > enjoying his job. Mr. Coker the results of you're the came back > > positive for all the samples from the right side. Well that was > not > > what I wanted to hear. OK what now? We sat and talked for a long > > time going over the options that were ahead of me and what the > tests > > meant. What percent of cells where cancerous. Two samples where > > 80%. What was the Gleason Score, 6 and 7? > > He was in no hurry to leave and answered any and all of my > uninformed > > questions. > > Being only 49 and in fairly go health for a man that likes a good > > stake and a s we decided that taking the prostate out was > the > > beast course for me. I have two great kids, a boy 15 and a girl > 7. > > No need to have more. Right now I want to do anything that gives > me > > the best chance of seeing them grow up. We are still doing test > to > > determine the extent of my cancer. I will keep up posted. > > > > Oh by the way. The way I have come to look at this is it is > better > > to know that not to. You can not fight what you don't see. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 30, 2007 Report Share Posted July 30, 2007 Thanks Aubrey I have a lot to think about. The side affects of RP are one thing that I need to think about. I have two great kids (a Boy 15 and a Girl 7) and at 49 really don’t think that I need any more. I have plenty of things to ask my Doctor the next time we get together. Your reply has made me think about a lot of things. Thanks Jody APilgrm@... wrote: Hi Jody, 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. For more information, you can read my book below my signature. Over 20 MDs and several survivors contributed to it. 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 7/29/2007 1:34:42 P.M. Pacific Daylight Time, ghenesh_49optusnet.au writes: Welcome to jodycoker jodycoker who has joined the ProstateCancerSupport group and says: Hi, my name is Jody. I am 49 and I have Prostate Cancer. I found out on July 18, 2007. I’m just looking for some Info and support. Thanks Jody Get a sneak peek of the all-new AOL.com. Need a vacation? Get great deals to amazing places on Yahoo! Travel. Luggage? GPS? Comic books? Check out fitting gifts for grads at Yahoo! Search. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 30, 2007 Report Share Posted July 30, 2007 Laurel, I have said before and will say again that the effect on erectile function is a wild card with any of the treatment modalities. It's impossible to extrapolate from my experience to anyone else's. I had issues after the surgery, but then I also had issues before the surgery (which is one of the variables that can indicate the likelihood of recovery of function). Age is another variable, and I was 10 years older than Jody is now at the time of my surgery. Many men have excellent return of erectile function after the nerve- sparing surgery, but I always tell people to expect some negative impact on erectile function and treat it as a pleasant surprise if it does not occur. That said, I know you are one of the " proton people " who claim no side effects from that treatment modality and equivalent cure rates. I know that is a view that is not widely accepted in the medical community and I am highly skeptical as well. Often the side effects of radiation therapy are delayed compared with surgery, but they manifest themselves over time. But I now know better than to get into an extended argument with a fervent proton adherent in this group -- it is the equivalent of getting into a debate with Graham on the existence of God. While I have counseled men to avoid surgery in different situations in the past (for example, when they are over 70 and the chances of side effects are substantially higher), Jody's case struck me as one where the choice of surgery makes the most sense due to his age and, assuming the cancer has not spread beyond the capsule, the chances of eliminating all of the cancer are the highest. Bill, NYC > > > > > > Jody, > > > > It sounds like you have made your decision to proceed with > surgery. > > At your relatively young age, it makes a lot of sense to put that > > option at the top of the list. Assuming the cancer is still > confined > > to the prostate, the surgery offers the highest probability of > > eliminating all of the cancer cells from your body. And you retain > > radiation as a possible backup treatment in the event of a local > > recurrence. Clearly you are not a candidate for watchful waiting > > given the extent of your cancer and the fact that there is some > > Gleason 7. > > > > These days, those men who choose surgery have the choice between > > the " old fashioned " RRP and robotic surgery. As you will see on > > this site, it seems that a lot of men are choosing robotic these > > days, so I would examine their experiences carefully. I had an RRP > > five years ago (when there was very little experience with robotic) > > at age 59 and have been very pleased with the outcome. I bounced > > back quickly with no incontinence issues and am cancer-free five > > years later. > > > > The most important thing to know with respect to the surgical > > alternative is the importance of choosing a highly experienced > > surgeon -- one who has done hundreds of the operations. Certainly > > don't limit yourself to your current urologist in your search for > > the best surgeon for you. If I had done that, I would have been > > operated on by a man who averaged less than one surgery each month, > > instead of the surgeon I chose (at s Hopkins) who does 150- 200 > > each year. There is too much at stake for you to settle for less > > than the best. > > > > I highly recommend that you read " Dr. Walsh's Guide to > > Surviving Prostate Cancer " (2nd Edition is just out in paperback) > > and " Dr. Scardino's Prostate Book. " Dr. Walsh is the > > legendary surgeon at s Hopkins who perfected the nerve- sparing > > surgery, and Dr. Scardino is Chairman of the Dept. of Urology at > > Memorial Sloan-Kettering Cancer Center in NYC (and a top surgeon as > > well). > > > > By the way, you can choose to bank sperm prior to the surgery > should > > you wish to retain the option of fathering additional children. > > > > Bill, NYC > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 30, 2007 Report Share Posted July 30, 2007 Re the bone scan and ct scan, these tests as Louis says are standard " screening " tests and in my book pretty much useless except in extreme and advanced cases. Better methods exist, such as MRI spectroscopy, that will help to rule out escape from the prostate to the pelvic regiion and I offer the following: (see http://radiographics.rsnajnls.org/cgi/content/full/24/suppl_1/S167 ----------------------------------------- " LOWER GENITOURINARY TRACT IMAGING Pretreatment Evaluation of Prostate Cancer: Role of MR Imaging and 1H MR Spectroscopy1 Filip G. Claus, MD, PhD, Hedvig Hricak, MD, PhD and R. Hattery, MD 1 From the Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, C278, New York, NY 10021 (F.G.C., H.H.); and Department of Diagnostic Radiology, University of Arizona, Tucson (R.R.H.). Received March 30, 2004; revision requested April 19; revision received May 5 and accepted May 11. All authors have no financial relationships to disclose. Supported by National Institutes of Health grant R01 CA76423. Address correspondence to F.G.C. (e- mail: clausf@...). Prostate cancer is the most common cancer and the second leading cause of cancer death in American men. The American Cancer Society estimates that in 2004, 230,110 new cases of prostate cancer will be diagnosed in the United States and 29,900 people will die of the disease, increases of 4.5% and 3.5%, respectively, compared with 2003 data (1). Because of the advent of prostate-specific antigen (PSA) screening, most prostate cancers are now diagnosed at an earlier stage. At present, 86% of newly diagnosed prostate cancers are localized within the gland and patients have a 5-year relative (ie, adjusted for life expectancy) survival rate of 100%. The 5-year relative survival rate for all stages of prostate cancer is 98%, which indicates that prostate tumors have a slow growth rate and allow for prolonged survival, even in patients with metastases at diagnosis (2,3). Controversy exists with regard to the appropriate management of prostate cancer. The choice of treatment depends on the patient's age at diagnosis, the stage and aggressiveness of the tumor, the potential side effects of the treatment, and patient comorbidity (4– 6). The most common treatment side effects are erectile dysfunction and urinary incontinence. Efforts to reduce treatment morbidity while maximizing treatment effects have led to the demand for patient- specific and disease-targeted therapies. Although there are a number of clinical parameters and clinical nomograms to help with the choice of treatment, there is a growing demand for further individualization of treatment plans (3,7). For all clinical nomograms, the highest priority is the differentiation between indolent and aggressive disease. The major indicator of tumor aggressiveness is the Gleason grade. A biopsy-determined Gleason grade, although valuable, is subject to sampling error. It has been reported that after radical prostatectomy the biopsy-determined Gleason grade is increased in as many as 54% of patients (8). Furthermore, prostate cancer is histologically heterogeneous and multifocal in as many as 85% of patients. Thus, a technique that noninvasively demonstrates the presence, extent, and aggressiveness of prostate cancer could make a substantial contribution to the decision-making process for individualized treatment. Magnetic resonance (MR) imaging and proton MR spectroscopy (hydrogen 1 MR spectroscopy) enable the noninvasive evaluation of anatomic and biologic tumor features and, thus, may play an important role in the detection, localization, and staging of prostate cancer and help guide treatment selection and planning (9). This article addresses the advantages, limitations, and need for critical evaluation of endorectal MR imaging and proton MR spectroscopy in the diagnostic evaluation of prostate cancer. Key findings of zonal anatomy and spectroscopic features of the normal prostate gland are discussed. Our objective is to illustrate the potential incremental value of MR imaging and MR spectroscopy in the diagnostic work-up of prostate cancer, with emphasis on tumor localization, metabolic interrogation, and staging. We include examples to illustrate the key MR imaging features used to detect prostate cancer and determine local extent, and we discuss the role of MR imaging and MR spectroscopy in treatment planning.... " --------------------------------------------- This is a very instructive article, and is worth navigating to and studying. Fuller > > > > > > Welcome to jodycoker jodycoker@ who has joined the > > > ProstateCancerSuppo rt group and says: > > > > > > > > > > > > Hi, my name is Jody. I am 49 and I have Prostate Cancer. I found > > out on July > > > 18, 2007. I'm just looking for some Info and support. > > > > > > Thanks Jody > > > > > > > > > > > > Sorry to hear of your diagnosis but welcome to the club you > never > > wanted to > > > join. No doubt you're in a bit of a state of shock, and perhaps > > feeling > > > isolated. You'll find plenty of friendly folk on this List who > will > > do what > > > they can to help you through. > > > > > > > > > > > > You might find it useful to visit YANA - You Are Not Alone Now > > > www.yananow. net <http://www.yananow. net/> a site set up for > newly > > diagnosed > > > people. The first section gives some basic information in plain > > language > > > with links to more complex and technical sites. The second > section > > of the > > > site is where men are invited to tell their prostate cancer > stories > > and how > > > they arrived at their decisions regarding treatment. Many people > > have mailed > > > to say how useful they have found this, especially because most > of > > the men > > > are happy to respond to specific questions. The section of the > site > > can be > > > found by clicking the link labelled Experiences or going to > > > http://www.yananow. net/Experiences. html > > > > > > > > > > > > But in any event, please post some details of your diagnosis - > > your Age, > > > your PSAs leading up to the diagnosis, your Gleason Score and > > Staging (these > > > terms are all explained on the YANA site) and any questions you > > might have. > > > Just remember - there are no dumb questions. We all started off > > where you > > > are now, but we've collectively learned a lot over the years. > > > > > > > > > > > > > > > > > > > > > > > > All the best > > > > > > > > > > > > Terry Herbert > > > > > > in Melbourne Australia > > > > > > Diagnosed '96: Age 54: Stage T2b: PSA 7.2: Gleason 3+3=6: No > > treatment. Jun > > > '07 PSA 42.0 - Bony Metastasis: starting ADT > > > > > > My site is at www.prostatecancerw atchfulwaiting. co.za > > > > > > It is a tragedy of the world that no one knows what he doesn't > > know, and the > > > less a man knows, the more sure he is that he knows > everything. > > Joyce > > > Carey > > > > > > > Thanks Terry > > > > My PSA was 4.2 when I was tested by my family Doctor. I have had > a > > number of PSA tests done in the past. When ever I happened to > think > > about it. Maybe 4 over the past 8 or 10 years well this one was > high > > enough for my Doctor to think that I needed to have a follow up by > an > > Urologist. The DRE was set up for about 3 weeks later. The > Doctor > > was very nice and answered all of my questions about what was > going > > to happen. When he finished the exam he told me that the right > side > > of my Prostate was " Firm " and he felt that we need to proceed with > a > > TRUS biopsy. That was another week of waiting. My Doctor > explained > > what was going to happen, a voice of experience (he's had two) it > was > > not fun but in hind sight I would do it again if needed. Wait > > another week. July 18 4:00 PM, I am the last person in the > waiting > > room. The nurse takes me back to the exam room and I wait! I > wish I > > had my PDA so I could at least play a game or read the news. The > > Doctor finally comes in. I can tell that right now he is not > > enjoying his job. Mr. Coker the results of you're the came back > > positive for all the samples from the right side. Well that was > not > > what I wanted to hear. OK what now? We sat and talked for a long > > time going over the options that were ahead of me and what the > tests > > meant. What percent of cells where cancerous. Two samples where > > 80%. What was the Gleason Score, 6 and 7? > > He was in no hurry to leave and answered any and all of my > uninformed > > questions. > > Being only 49 and in fairly go health for a man that likes a good > > stake and a s we decided that taking the prostate out was > the > > beast course for me. I have two great kids, a boy 15 and a girl > 7. > > No need to have more. Right now I want to do anything that gives > me > > the best chance of seeing them grow up. We are still doing test > to > > determine the extent of my cancer. I will keep up posted. > > > > Oh by the way. The way I have come to look at this is it is > better > > to know that not to. You can not fight what you don't see. > > > > > > > > > Building a website is a piece of cake. > Yahoo! Small Business gives you all the tools to get online. > > > > > Take the Internet to Go: Yahoo!Go puts the Internet in your pocket: mail, news, photos more. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 30, 2007 Report Share Posted July 30, 2007 Mick: In my opinion, the following is not entirely good advice for every patient: " At your relatively young age, it makes a lot of sense to put that option at the top of the list. Assuming the cancer is still confined to the prostate, the surgery offers the highest probability of eliminating all of the cancer cells from your body. And you retain radiation as a possible backup treatment in the event of a local recurrence. " This may make sense to Bill, but may not be the best for Jody. I also take exception to the statement " surgery offers the highest probobility of eliminating all of the cancer cells from your body... " All data thus far indicates approximately equal " cure rates " for the different modalities. So there remain other considerations in making this very important decision. One last point, which has been mentined by others here, is that " retaining radiation as a possible backup treatment... " is not entirely logical in view of the fact that if it is good enough to be a backup, it must and should therefore be just as viable as a primary treatment. And incidentally, the fact that the cure rates are similar is the crux of the problem we all faced and newly diagnosed prostate cancer patients face. It AIN'T easy! Fuller > > Laurel - What advice did Bill give to Jody, and what was incorrect about it? Was it that he should choose carefully between robotic and open surgery, or was it his suggestion to read Walsh's book called A Guide To Surviving Prostate Cancer? That was the only advice I read. And since when are group members required to discuss their post surgery sexual function? I prefer that we let members discuss these things when they are comfortable doing so as opposed to putting them on the spot in open forum. > > Mick > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 31, 2007 Report Share Posted July 31, 2007 In the event that the cancer has not spread beyond the prostate, there can be no question that surgery offers the highest probability of eliminating all of the cancer cells from your body. With radiation, there is always the possibility that some cancer cells in the prostate will remain. If the prostate is completely removed by an experienced surgeon, that possibility is eliminated. It's really pretty elementary. Bill, NYC > > > > Laurel - What advice did Bill give to Jody, and what was incorrect > about it? Was it that he should choose carefully between robotic > and open surgery, or was it his suggestion to read Walsh's > book called A Guide To Surviving Prostate Cancer? That was the only > advice I read. And since when are group members required to discuss > their post surgery sexual function? I prefer that we let members > discuss these things when they are comfortable doing so as opposed to > putting them on the spot in open forum. > > > > Mick > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 31, 2007 Report Share Posted July 31, 2007 Dr. Scardino says that the value of a bone scan in most cases is highly questionable. He states, " While it is common for advanced prostate cancer to spread to bones, it's very uncommon for cancer to register on a bone scan if the PSA is less than 20 and extremely rare with a PSA under 8. Having a bone scan makes little sense unless you have a high risk of serious disease. Otherwise, you'd run a serious risk of false positives. " With respect to CT scans, Scardino says they have little use in the evaluation of prostate cancer except for patients with aggressive disease and a high suspicion of lymph node involvement. He states further that lymph nodes can only be seen on the scan if they are enlarged, and microscopic deposits of cancer cells won't show up at all. The CT scan is also not very good at detecting the presence of cancer in bone. Bill, NYC > > > > > > Welcome to jodycoker jodycoker@ who has joined the > > > ProstateCancerSupport group and says: > > > > > > > > > > > > Hi, my name is Jody. I am 49 and I have Prostate Cancer. I found > > out on July > > > 18, 2007. I'm just looking for some Info and support. > > > > > > Thanks Jody > > > > > > > > > > > > Sorry to hear of your diagnosis but welcome to the club you > never > > wanted to > > > join. No doubt you're in a bit of a state of shock, and perhaps > > feeling > > > isolated. You'll find plenty of friendly folk on this List who > will > > do what > > > they can to help you through. > > > > > > > > > > > > You might find it useful to visit YANA - You Are Not Alone Now > > > www.yananow.net <http://www.yananow.net/> a site set up for > newly > > diagnosed > > > people. The first section gives some basic information in plain > > language > > > with links to more complex and technical sites. The second > section > > of the > > > site is where men are invited to tell their prostate cancer > stories > > and how > > > they arrived at their decisions regarding treatment. Many people > > have mailed > > > to say how useful they have found this, especially because most > of > > the men > > > are happy to respond to specific questions. The section of the > site > > can be > > > found by clicking the link labelled Experiences or going to > > > http://www.yananow.net/Experiences.html > > > > > > > > > > > > But in any event, please post some details of your diagnosis - > > your Age, > > > your PSAs leading up to the diagnosis, your Gleason Score and > > Staging (these > > > terms are all explained on the YANA site) and any questions you > > might have. > > > Just remember - there are no dumb questions. We all started off > > where you > > > are now, but we've collectively learned a lot over the years. > > > > > > > > > > > > > > > > > > > > > > > > All the best > > > > > > > > > > > > Terry Herbert > > > > > > in Melbourne Australia > > > > > > Diagnosed '96: Age 54: Stage T2b: PSA 7.2: Gleason 3+3=6: No > > treatment. Jun > > > '07 PSA 42.0 - Bony Metastasis: starting ADT > > > > > > My site is at www.prostatecancerwatchfulwaiting.co.za > > > > > > It is a tragedy of the world that no one knows what he doesn't > > know, and the > > > less a man knows, the more sure he is that he knows > everything. > > Joyce > > > Carey > > > > > > > Thanks Terry > > > > My PSA was 4.2 when I was tested by my family Doctor. I have had > a > > number of PSA tests done in the past. When ever I happened to > think > > about it. Maybe 4 over the past 8 or 10 years well this one was > high > > enough for my Doctor to think that I needed to have a follow up by > an > > Urologist. The DRE was set up for about 3 weeks later. The > Doctor > > was very nice and answered all of my questions about what was > going > > to happen. When he finished the exam he told me that the right > side > > of my Prostate was " Firm " and he felt that we need to proceed with > a > > TRUS biopsy. That was another week of waiting. My Doctor > explained > > what was going to happen, a voice of experience (he's had two) it > was > > not fun but in hind sight I would do it again if needed. Wait > > another week. July 18 4:00 PM, I am the last person in the > waiting > > room. The nurse takes me back to the exam room and I wait! I > wish I > > had my PDA so I could at least play a game or read the news. The > > Doctor finally comes in. I can tell that right now he is not > > enjoying his job. Mr. Coker the results of you're the came back > > positive for all the samples from the right side. Well that was > not > > what I wanted to hear. OK what now? We sat and talked for a long > > time going over the options that were ahead of me and what the > tests > > meant. What percent of cells where cancerous. Two samples where > > 80%. What was the Gleason Score, 6 and 7? > > He was in no hurry to leave and answered any and all of my > uninformed > > questions. > > Being only 49 and in fairly go health for a man that likes a good > > stake and a s we decided that taking the prostate out was > the > > beast course for me. I have two great kids, a boy 15 and a girl > 7. > > No need to have more. Right now I want to do anything that gives > me > > the best chance of seeing them grow up. We are still doing test > to > > determine the extent of my cancer. I will keep up posted. > > > > Oh by the way. The way I have come to look at this is it is > better > > to know that not to. You can not fight what you don't see. > > > > > > > > --------------------------------- > Building a website is a piece of cake. > Yahoo! Small Business gives you all the tools to get online. > > > > > --------------------------------- > Take the Internet to Go: Yahoo!Go puts the Internet in your pocket: mail, news, photos & more. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 31, 2007 Report Share Posted July 31, 2007 <Snip> In the event that the cancer has not spread beyond the prostate...<snip> This is the problem. One cannot really be 100% positive that the microscopic cancer cells have not escaped. This point is emphasized in the recent postings regarding the usefullness of bone scans, CT scans, etc. Prostate cancer is an insiduous and stealthy adversary! The biopsy itself may even contribute to this possible escape. To further emphasize this point, I knew three men undergoing photon/proton " salvage " treatment at LLUMC following recurrence of prostate cancer AFTER prostatectomy. One friend, when diagnosed was what we call " early stage " with Gleason 3+3=6, and negative bone scan/CT scan results before the surgery to remove the prostate. So surgery is not always the " cure " just because the prostate gland has been removed. In the battle against prostate cancer nothing is 100% sure. We do the best we can with whatever information and inteligence we have. Fuller > > > > Mick: In my opinion, the following is not entirely good advice for > > every patient: " At your relatively young age, it makes a lot of > > sense to put that option at the top of the list. Assuming the > cancer > > is still confined to the prostate, the surgery offers the highest > > probability of eliminating all of the cancer cells from your body. > > And you retain radiation as a possible backup treatment in the > event > > of a local recurrence. " > > > > This may make sense to Bill, but may not be the best for Jody. > > > > I also take exception to the statement " surgery offers the highest > > probobility of eliminating all of the cancer cells from your > body... " > > > > All data thus far indicates approximately equal " cure rates " for > the > > different modalities. So there remain other considerations in > making > > this very important decision. > > > > One last point, which has been mentined by others here, is > > that " retaining radiation as a possible backup treatment... " is > not > > entirely logical in view of the fact that if it is good enough to > be > > a backup, it must and should therefore be just as viable as a > primary > > treatment. > > > > And incidentally, the fact that the cure rates are similar is the > > crux of the problem we all faced and newly diagnosed prostate > cancer > > patients face. It AIN'T easy! > > > > Fuller > > > > Quote Link to comment Share on other sites More sharing options...
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