Sep 13, 2007 - 11:34 am
I had da Vinci RP on August 29. Thanks again to those who responded to my original post of 7/6/07. Your support was very helpful. The surgery went quite well.
I have some follow up questions about post-surgical treatment. As background, I'm 48 and in good health. My path report came out: tumor is a T3, Gleason 7 on almost all of one side, nothing on the other side (nerve on this side was spared), cancer did extend outside of prostate, there was one positive margin, no involvement of seminal vesicles or lymph nodes, PSA was about 8 going into the surgery.
Of course there will be the usual follow up of PSA test one month out, then again three months after the first test. According to my uro, there is a rough rule if thumb that if the PSA does go back up, if it is going up slowly, the cancer is probably confined to the prostate area, if it is rising rapidly it has possibly spread elsewhere. He said that for a slowly rising PSA, the probable treatment would be radiation to the pelvic area.
I have follow up appointment with my onco and another onco for a second opinion. Here are my questions to prepare for these appointments:
- According to Dr. Walsh's book Surviving Prostate Cancer (2007 edition), there is a school of thought that for high-risk cancers, one doesn't wait for the PSA to begin to rise, but instead starts post-surgical treatment immediately. As I understand it, my cancer is on the low end of high risk. One possible treatment is with Taxotere. Can anyone comment on either the theory of starting treatment immediately or on their experience with Taxotere?
- I understand that each person's reaction to chemo is different, but one of my main questions with Taxotere is can the side effects be controlled well enough that you can continue working?
- What about long term side effects? For example, it seems that neuropathy can be an issue.
- I know there are various courses of treatment, but about how long would the treatment continue?
Any thoughts on Taxotere or other post-surgical treatment would be appreciated.
- By the by, does anyone have experience with restoring erectile function with one nerve left intact? So far nada for me, but I know it's too early to tell anything. My uro prescribed Levitra to begin getting the blood flow going.
Thanks for wading through another long post. I think I have "post" nasal drip or something!