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prostate cancer

edwardbg
Posts: 1
Joined: Sep 2002

I have prostate cancer.
Should I do radiation or surgery?
I am 50 years old
Thanks

grandma
Posts: 162
Joined: Feb 2002

hi,
this is the first time on this site. My husband has prostate cancer, so I know a little about it.
Is your cancer outside the prostate gland? if so then surgery won't be an option, it wasn't for my hubby anyway.
Radiation? well if it is contained you can have a seed implant, or removal of the gland.
you need to talk to your Dr.'s and get info from them and advice on what kind of treatment is best for you.
Good luck to you and hope you have a long and happy life........grandma

george51
Posts: 11
Joined: Mar 2002

edwardbg,
This is something you will have to decide after weighing your options, and the side effects of each. I had surgery on 2/12/02 and for me it was the choice I felt best suited me. The cancer was confined to the prostate and removal gave me what I felt my best chance to beat it. However there was a price of incontenence, and impotency. One is almost gone the other may take some time yet, but it is getting better. With radiation, surgery is almost never an option afterwards. I recommend you read a book called "Guide to surving prostate cancer" by Patrick C. Walsh, M.D. It helped me considerably and answered many of my questions. It also gave me questions that I needed answered before I chose surgery.
Good Luck in your decision my friend.
George51

bwalker5839
Posts: 11
Joined: Sep 2002

Hi. I chose 25 days radiation & seed implant at St Louis Barnes. It didn't work. They recommended 2 docs in the US that are good at surrgery after radiation. One of them tried & couldn't cause of the bleeding and adhesions. SO i went to Pittsburgh for Cryo. It worked (it seems).
If to do over, i'd go to Mayo clinic in Minnesota & do surgery. I was 58 when diagnosed, 3 years ago.
Bill Walker

rogermoore's picture
rogermoore
Posts: 265
Joined: Mar 2002

edwardbg,

A decision of this magnitude requires considerable research and fact-finding. I was 58 when I was diagnosed, the cancer was confined to the prostate, and I was in good health. After my research I elected to have a Surgeon (highly credentialed) at Vanderbilt Clinic in Nashville perform my surgery. It has been 1 1/2 yrs since surgery and I have no issues with contenance (sp) or potency. In short, my life has returned to normal. If you have any questions please don't hesitate to e-mail me.

Roger

Morris
Posts: 12
Joined: Dec 2002

Hi Roger,
I have recently been diagnosed with prostate cancer--I live in Spokane Wa.--I just got back for Pheonix Az. where I got a 2 nd. opinion at the Mayo Clinic---same news as at home --I am torn betwee the retropubic and perineal surgery--which one did you have and how was your recovery --did you have a choice and why did you choose the one you did--thanks Morris

rogermoore's picture
rogermoore
Posts: 265
Joined: Mar 2002

Hello Morris,

I'm sorry I did not respond yesterday, but the ACS just recently changed the format of this site and I did not catch your imquiry.

I had the retropubic surgery and the pain associated with the surgery was minimal. I had surgery on Fri morning and was dismissed on Sunday. I then rode for 5 hrs in a car from the city (Nashville) I had the surgery getting home. I was walking approx. 1/2 mile before having catheter removed which was 10 days following surgery.
I chose the retropubic because I thought the incision would be easier to maintain during the healing process.

I returned to work after 4 weeks recovery. I have no continence problems and sexual activity has returned to pre-surgery status. (Very Active)
Please e-mail me with any other questions you might have. My address is listed on my personal page of this site.

Roger

Eric55
Posts: 2
Joined: Dec 2002

There is a third surgical option. I had my RP done arthroscopically. Only a few places do it, but the number is growing. Takes a lot of expensive equipment and OR time. But saves you from being opened up. The surgeon claims he can do a better job because the cameras let him see better than with an open prostetectomy. Too early to tell if he was right or not.

JR1949
Posts: 230
Joined: Jun 2009

Hello,
Did you have radical prostatectomy?
I had diagnosis of prostate cancer, PSA 22 and combined Gleason of 7 at age 60. After consultation with urologist and research I opted for radical prostatectomy March 09 considering my age and high PSA. Currently I am still having some problem with incontinence and potency not there.
I am hopeful that after another 6 months IC and ED will get better. I have done the kegels and IC has improved, but still wear diaper and use 3-4 pads a day. I have good and bad days, I mean some days I barely wet my pad after 6 or more hours and sometimes I pee it full in less than 3 hours. While I am thankful that I now have a PSA of 0.008 and cancer was contained in prostate, it is a little frustrating with the incontinence and inability to have sexual relations with my wife. God bless her, my wife has been very understanding. What was your experience with incontinence and potency?

Well I have vented enough for now.

nutt
Posts: 140
Joined: Sep 2001

Ed,
I was/am 58 with prostate cancer. I elected to have the radiated seed implant for multiple reasons
1. I was suitable for this procedure (not everyone is)
2. researched all aspects and came to the opinion that IF, the cancer is limited to the prostate THEN IT MIGHT be better to have it completly removed (problem, no one will guarantee it is confined to the prostate only)PLUS, the potential side effects.
3. 8 weeks of external beam radiation seemed like another good choice except I was not in a position to spend 15 minutes every day for 8 weeks.
4. Seed implant was in and out same day, put the radiation into the prostate where the cancer supposedly was and I went on about my life.
5. I also had hormone therapy 3 months before and after the seed implant as I was told:
a. the hormones made the cancer more sensititve to the radiated seeds
b. it starved the cancer of the testosterone which it lives on
c. it shrank the prostate which allowed for fewer radioactive seeds into a much smaller area.

There is also the cryo method of shrinking and killing of the prostate by freezing.
The bottom line is..... what is the best treatment for you cancer status?
what treatment can you comfortably accept?
what treatment can you afford including incapacity as well the emotional drain each of these treatments causes?
Either way, be advised, they (the doctors) make no guarantees on anything and it is you who will have to live with whatever the end result is.
Research the internet / contact different institutions / doctors etc... I found that for the most part contacting institutions was merely an invitation to be solicited for their services after an exam.
YOU, need to become famailiar with what is out there and what YOU choose.
Good luck
Joe
ps. Seed implant 1/14/02 - psa after 6 mos. is 0.1 Also, be aware that everyone has different psa levels and you can't just say on is better than the other. Don't get caught up into the one answer, one treatment, or psa level is the right answer.
Joe

beckhop
Posts: 1
Joined: Oct 2002

If it were me I would have the surgery. But make sure you go to a reputable hospital where they have the equiptment to detect certain muscles. There is incontience involved but they say,today, this is not a problem like in the past. My father in law had radiation (10yrs.ago) He was baked so he died of other complications. I know the treatment with radiation has been greatly improved since then. Read all you can. You can understand it. Get a second opinion and take a tape recorder as you will not remember everything the doctor say. We did.
Good luck. BeckHop

nwlms's picture
nwlms
Posts: 6
Joined: Nov 2002

I'm replying to this without reading what others had written. I did't want to be influenced. I had surgery (da Vinci Surgical System Laparoscopic Prostatectomy)in late August after a PSA of 4.7, biopsy showed 2 of 12 samples cancerous with a gleason of 7. Results were, no blood loss, one day hospital stay, catheter in only 6 days, 6 wk recovery and back to normal working, jogging and golfing routine. Incontinence and impotence recovering at an acceptable rate after only 2 1/2 months. BUT - more important that all of this - My cancer is totally gone. Last PSA was less that 0.1. Recommendation - read, read and read as much as possible. Consult with qualified urologists.
Good Luck!!

nutt
Posts: 140
Joined: Sep 2001

It isn't that simple actually. I am 58, I had radioactive seed implant (internally radioactive pellets are placed in the prostate) after RESEARCHING, hormone therapy, surgery and conformal beam radiation (external radiation)and much discussion between my surgeron, oncolgist and reading much about all options from the web, American Cancer Society and etc...
A lot depends on your specific cancer. Is is contained in the prostate? Has it spread? How agressive is it(what is your Gleason score)?
AND, what side effects are you potentially willing to risk?
They all have risks, some more than others and there are no guarantes either way in my view. The real goal is to kill the cancer (period) with the least side effects. Some side effects can be potent, loss of sexual function, leakage, frequent urination problems, loss of erection etc....
My surgeon wanted to operate BUT suggested I get a second opinion AND confer with the oncolgist who was part of his treatment team.
You may not be a canidate for seed implant etc.
Please, discuss, read, research and then make an informed decision that you and your family believe best.
I took a course of treatment (seed implant) that essentially eliminates the possibility of surgery later. With surgery, you can still have radiation later if needed. Weigh the odds and options!
Discuss with YOUR doctor(s). If, they won't refer or give you qualified other doctors for another opinion contact the American Cancer Society in your area for assistance in referals. Just be aware that the AMC won't get into the middle of this but are generally helpful.
Good luck and let me know if I can help
Joe Nutter
559-432-1759 if you want to talk. (Fresno, CA)

warren612
Posts: 23
Joined: Dec 2002

I am 53. Just had my prostate removed. My PSA was 5.2 My Gleason was 5. Most Dr.'s will tell you at your age with 30 years of life left you should have it removed. If you have a good surgeon it's the best way to go..

warren612
Posts: 23
Joined: Dec 2002

Ed,
I am 53. Had a PSA of 5.2 Gleason score of 5. I opted for RP on 9/12 at Brigham and Womens in Boston. Dr. Jerome Richie performed the surgery and did a great job. Scar is only 3" long. Had surgery Thursday could have gone home Friday but stayed until Saturday morning. Cancer was confined to the prostate. Incontinents is almost gone. Sexual function is returning. My problem was I felt too good after surgery and didn't rest. I was playing golf in 3 1/2 weeks. I spoke with a dozen Dr.'s prior to making my decision. What made me decide surgery was a Dr. saying if you opt for radiation and the cancer comes back your chance of successful surgery is very slim. Picture this: Take a piece of cheese put it between two pieces of bread. Now take the cheese out. Pretty simple. Take the cheese put it between two pieces of bread, put it in a microwave for a minute and try to take the cheese out. Can't be done. Take to alot of people who have had a RP. They will tell you they were glad they did if they had a surgeon who cares. Mine is one of the best. I am glad I picked surgery. E-mail me if you have questions. It's been three months since you posted this. You may have already decided.

fjessup
Posts: 6
Joined: Dec 2009

Warren612,

It's been a long time since you had surgery, and I don't know if you are still reading this list at all, but if you have any further comments on Dr. Richie, any further information on his work since, and any further comments on your own status since (8 yrs later) I would very much welcome hearing. I am on edge of doing surgery (but Gleason 7 [3+4], biopsy last August 2009...have waited longer than I should), but still a bit uncertain whether to use Dr. Richie, whom I like very much, but a bit older (perhaps a little less in practice now?), or Dr. Francis McGovern at MGH, who is younger, very active, heard good things about, uses a hydrodissection technique that promises better nerve sparing (and supposedly better cancer control, but I'm not sure), but is still more junior and less years of experience. Hope things are still good and healthy for you.

Thank you,

FJessup

john Rodriguez
Posts: 1
Joined: Feb 2010

read everything you can, as for me I am going with robotic surgery on March the 12th I'll be 60 by then but I want it out Good Luck edwardbg I'll pray for you

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