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Prostate Cancer "Watchful Waiting"?

Triplempe's picture
Triplempe
Posts: 16
Joined: Mar 2008

Hi. This is my first post and I am a new member to CSN. I was diagnosed with prostate cancer in Nov. 07 PSA was 7.8, Gleason score (3+3) of 6. Cancer was found on only one biopsy slide and it was only 5% involve. A Ploidy analysis of the cancer cells also revealed that the cells were "diploid" which means that it is probably slow growing. I am 63. When they were looking at my torso with a CT scan, they also found a tumor on my right kidney which was small but located on the artery feeding the kidney. They recommend surgery right away on the kidney.

I would like to know if anyone on this site is presently performing "Watchful waiting" or "Active Surveilance" on their prostate cancer. How are you doing this? tri-monthly? Bi anually?
Are you only watching your PSA? Any replies are most welcome. I will be scheduling surgery for removal of my kidney on the 11th of march 2008 and may schedule prostate surgery (I am not a good candidate for radiation treatment) after that if I don't feel comfortable with watchful waiting.

Thanks, Mike in La Mesa, CA

RoyPoff
Posts: 6
Joined: Aug 2007

Iam 64yrs old and had prostate cancer on a mild grade and question 3 doctors on watchfull waiting and all advised "not to wait" and had to a treatment/operation done.
I beleieve watchful waiting is for someone in their mid to late 70's as prostate cance is slow growing and most of time will not effect a person for 10yrs. But,can easily go from a low grade to high grade also.
Had "Robotic Radical Prostatectomy" removal of prostate and it is the best way to go.
Out of Hostipal the next day and very easy recovery!!!
I believe if the cancer is only in prostate have it remove as it can spread to other parts of body and I don't want to get into those treatments!!.
Good Luck,
Roy

Bunny1's picture
Bunny1
Posts: 4
Joined: Apr 2007

MIKE! 2nd opinions? 3rd??

Triplempe's picture
Triplempe
Posts: 16
Joined: Mar 2008

Bunny1,

I have gotton a second opinion and that is for surgery since I am not a good candidate for radiation. Thanks for asking. Mike

Triplempe's picture
Triplempe
Posts: 16
Joined: Mar 2008

Thanks, Roy. I think you are right about the age factor. My wife and I do enjoy a good sex life now but if came to giving that up or having the cancer spread, I choose celibacy. Mike

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

Mike,

Sorry to hear of your diagnosis!! The last posting suggested a 2nd or 3rd opinion. That is excellent advice. Also, selection of the surgeon is of the utmost importance!!

I am a 7yr survivor of Prostate Cancer which was removed via a Radical Prostatectomy in 2001. That was before robotic's became available. I have been fully recovered from any possible side-effects since 6 wks post op. From what I hear on this site Robotics is the current "gold standard". I would definitely recommend removal. At your age you don't want to live with the possibility of a reoccurance of the cancer. Feel free to e-mail me with any questions you feel too personal to post. I was 58 at time of my surgery and have never regretted my decision (s).

Roger

Triplempe's picture
Triplempe
Posts: 16
Joined: Mar 2008

Thanks, rogermoore, The one thing I admire about what you said is that you have never regretted your decision(s). I hope that I will have the same feelings. Mike

fcatroneo
Posts: 89
Joined: Jan 2007

Triplempe....I had an RP at 60 years old. My plumbing in working fine. No Incontinence or ED issues. No regrets on the surgery. I do believe that Robotics is the "gold standard"...just make sure your doctor has over 400 procedures under his belt. I was out of the hospital in a few days. I wore one pad after the catheder was taken out and had sex with my wife the morning after I had my catheder taken out. My surgeon has done over 3.000 procedures and still does 4 every week. Dr. Fray Marshall at Emory University is probably in the top 5 Prostate Surgeons in the country.

I was told by a Urologist friend who had prostate cancer.."when in doubt, take it out". It makes sense. You are still young. Take care of your Kidney issue then find a good robotic surgeon. Travel if you must to find the right doctor. You will be glad you did.
Good luck with the kidney surgery.
Frank

Triplempe's picture
Triplempe
Posts: 16
Joined: Mar 2008

Frank,

Thanks for the advice and well wishes. I have been waiting for my life to settle down a bit and now it has. I am sure I will select a treatment in OCT. 08. I would prefer the robotic laproscopic (Da Vinci) system. Kaiser Permanente i LA now offers it and a friend of mine just had it done there. I will be talking to my doctor about it on the 28th of this month .

Thanks again,

Mike

whats_next
Posts: 1
Joined: Sep 2008

I'm curious about the 400 procedures metric/recommendation - where did that come from and what is it based on? I've been talking to a PC surgeon that's been doing - from what I understand - nothing but robotics surgeries on PC for ~2 years and he's got no where near 400 surgeries under his belt in that time.

And the robotics route hasn't been the PC surgery "standard" for much longer than a couple years. It seems that a 400 and up measure would exclude the majority of the surgeons in the field today. And what about follow up care if you travel to a more experienced surgeon?

I've got a feeling my insurance company - and probably all insurance companies - will "herd" me to a local provider or provide substantial financial disincentives for looking to go to a top center at some distance from me.

I know I'm only doing this once, but traveling for the surgery has its own down sides too.

nodawgs's picture
nodawgs
Posts: 118
Joined: Mar 2001

Heck, no, Man! You're way too darn young for any of this watchful waiting bs. Have you looked into proton beam therapy? M.D. Anderson-Houston has a new installation and there's one on the west coast...another somewhere else, can't remember. I've lived with this wretched disease for quite awhile and pretty much stay up on treatment innovations. To my knowledge, proton beam is the only procedure with reasonably assured, success in preserving the cavernous nerve bundle and other pheripheral tissues. Also, it's a diagnostic fact that a pathologist's Gleason Score assignment is a very subjective number, resulting in misjudging aggressiveness of the cell structure. If you don't elect or aren't a candidate for proton beam therapy, I'd go for a minimally invasive, robotic procedure (DaVinci, etc.) to get that damned thing out of your bod...and the sooner, the better. When it comes to so-called, "watchful waiting," no one knows what point in time that cancerous cells escape the prostate capsule. If you were 85-90 years old...different ball game.

For pete's sake, don't fall for cut-rate deals or your local uro! Go to nothing less than a top-rated, major cancer center only!...and even then, one having a genitourinary center with in-depth experience in robotic surgical procedures. Do a search on "best hospitals," select the category, "cancer"...and the nation's top NCI-designated cancer centers will pop up. You probably have one close by.

"Watchful waiting for a dude only 63? That's nuts! Unless you have some other, serious, near-term, life-threatening health probs that could nail you long before PC, forget it!

Do it!...and don't wind up like me...end stage...with mets to about everything but my damned hair.

nodawgs's picture
nodawgs
Posts: 118
Joined: Mar 2001

Hey!...I just read another thread in here about a guy having some big-time probs after proton beam therapy. I thought I was pretty well read on the technology for a layperson and now I don't think so. I was reading propaganda. At any rate, after reading the other thread about excrutiating penile pain, I want to retract any good things I said. It's true...there's no exit wound with proton beam, but their darn sure is coming out. Anyway, I've been down the same road as the proton guy with penile pain, but damage to the cavernous nerve bundle was a result of cryo, not proton beam...and man, like he said, it's bad! Some of the most excrutiating pain I've ever felt. It was about 6-months of inhumane hell before it even started subsiding. To add insult to injury, the cryo didn't get it all and metastasized to my bones...right shoulder, neck, spine, ribs, and pelvis.

I'd lean toward robotics...no doubt about it. Sorry if I mislead, but now I know.

Good luck, dude

Nodawgs

Triplempe's picture
Triplempe
Posts: 16
Joined: Mar 2008

I do appreciate your response . Nodawgs, I like your bike. Ride safe. I am still watchful waiting but will for sure settle on a treatment in Oct. 08 when I will be having another CT scan for the kidney tumor and another PSA for the prostate. A good friend of mine had the Proton Beam treatment in Florida two months ago and so far he says he feels great. I hope so .

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