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robotic prostectomy vs. seed implant

waldo13
Posts: 4
Joined: Nov 2008

I'm scheduled for permament seed implant in 3 weeks. Having serious doubts about whether it's the right decision. I'm 51, otherwise very healthy, with a psa of 4.8,a gleason 6 with 6 of 12 biopsies positive.Prostate size is 26cm. Docs are confident it is contained. Tumors are on both sides but predominantly on one side. I know I've got a good chance of a positive outcome but I can't seem to get a clear picture of long range success rates for one procedure vs. the other. Thinking maybe I should switch. I live in San Francisco bay area. I like the seed rad. oncologist but have yet to meet a doc with enough robotic surgeries to convince me of better short or long term results. Getting very nervous. Paul

JoeMac's picture
JoeMac
Posts: 77
Joined: Jun 2008

Aloha Paul,
The Prostate Cancer Foundation has produced a "Report to the Nation on PC", a Guide for Men and Their Families. It is a long report, my wife & I read it prior to getting treated. It has lists of questions to ask your doc.
There is a web site
www.yananow.net
where you can read one heck of a lot of info from men who have been there, done that. You can also post questions.
Never loose Faith & Hope.
If you can, seek help from a therapy consult, we waited too long .... over a year, now we are working out our problems.
No mater what choice you make for treatment, there are side effects ... ask questions, demand answers, from your doc's. The web can provide info, but your choice of treatment is between you, your partner, and your doctor.
Joe 67 Hamakua Coast

waldo13
Posts: 4
Joined: Nov 2008

JOe. Just wanted to thank you for your speedy response. I've read that report. The website you recommended has been helpful in that I don't see many men even getting the seed implants. Wonder what that means.

johndeer
Posts: 17
Joined: Oct 2008

I can totally relate to your dilemma. I am in SoCal and I am in a tie between Loma Linda and the proton beam radiation treatments and the City of Hope for the daVinci procedure. My daVinci surgeon will be Dr Kawachi and he is on track to do 377 of them this year, after doing 325+ per year since 2003. He is highly recommended. My PCa is very early: I am 54, PSA 2, Gleason 3+3 and the prognosis is very good, no matter what I choose. Kawachi is very accessible and will answer all your questions. He gave me his stats for patient outcomes and they were impressive. He is also concerned for me beyond the cure, and is sensitive to what I think is important, like potency and continence. Dr Rossi at Loma Linda was equally impressive. Their program looks completely appealing to me as well. I just think that what makes sense to me is that if I were older, like closer to 70 I would not hesitate to do the proton beam. But I think the clean break is to have the prostate removed by the most precise method around, and be done with it. Also the complications seem to fade away over time with surgery where they may sneak back into your life later with radiation. My impressions of my humble research so far. I think I may never feel 100% sure of my choice. I want to, but there aren't enough long-range figures available to get the best long term picture. The numbers are not available. Every patient is different, too. I wasn't really sure I was doing the right thing when I married my wife, either, we are coming up on our 31st anniversary in December, so I did ok with limited information then, why not now? Best of luck to you. Rick

whubbs
Posts: 77
Joined: Sep 2008

I would suggest not rushing into anything until you are comfortable with the projected outcome. 3 weeks is a good amount of time for some research.
See my thread that I just opened up regarding my prostatectomy, http://csn.cancer.org/node/163769
In it you can email me with any questions, I'd be happy to walk you through my experience.
Please do as much on-line research as you can and get second and third opinions.
You only get one ride, be sure its the right one for you.
Good luck!

kalar7856's picture
kalar7856
Posts: 35
Joined: Sep 2004

Hi Waldo13,

I am a 4 year survivor exactly the same age as you. I chose the RP over the seed implants
for one reason. My age. The radiation from the seeds damages the walls of the lower intestine as well and can lead to holes and tears many years following the procedure. That is no big deal if you are 75, but at our young age that risk is unacceptable. The seeds also damage the nerves that control sexual function as well as kill the cancer. The rate of impotence is very high.

My stats were very similar to yours and I am cancer free and leave a totally normal life with full functionality.

Best Wishes.. Kalar7856

laszlo5000's picture
laszlo5000
Posts: 7
Joined: Dec 2008

Hi Paul, My stats were nearly identical to your own...i'm 52. I decided on robotic radical prostatectomy for a number of reasons, mostly because of my age and the local experienced surgeon, Dr. Peter Carroll at UCSF. With a young son, I was all for getting rid of it so I didn't have to worry about recurrence as much. It sounds like you, too, are a good candidate for the nerve preserving robotic procedure.

You can read about my humorous account of my experience at

www.prostatecancerisfunny.com.

It is dedicated to laughing your way through the greatest challenges of your life.

Best of luck, Paul. You will survive.

Dan

waldo13
Posts: 4
Joined: Nov 2008

Dan. Your response was sure appreciated. The day before I heard from you I had tried to reach Dr Carroll's assistant to find out more about his availability and his experience with the robotic nerve sparing procedure. If you have any advice as to how to reach him quickly I'd sure like to hear from you. In fact any info. regarding your experience I'm sure I'd find helpful. Thanks again for your help. Paul

laszlo5000's picture
laszlo5000
Posts: 7
Joined: Dec 2008

Hi Paul...good to hear back from you. I think the best way to go about it is to have your Urologist make the appointment for you. These guys have a network...at least that's what mine did....Did you call his office? feel free to contact me directly at danlaszlo@prostatecancerisfunny.com. Keep your spirits and humor up...Dan

waldo13
Posts: 4
Joined: Nov 2008

Thank you for your input. After much reading, interveiwing and yes, handwringing I went with the seed implants. Dr. Pedadda in Los Gatos, Ca. did the procedure on Dec. 17, 2008. It's been about 5 weeks with only minor issues with urgency and slight burning during urination. Very early to report much. First PSA in March. Just wanted to thank everyone for their support.You guys are wonderful. I'll be posting my future progress here for those seeking another testimonial.

gkrapil
Posts: 2
Joined: Mar 2009

I am interessted in how you are doing and if you have had any results yet. My husband is considering seeding and we are seeing and hearing conflicting information. It is overwhelming. I hope you are doing well and healing.

gkrapil
Posts: 2
Joined: Mar 2009

I am interessted in how you are doing and if you have had any results yet. My husband is considering seeding and we are seeing and hearing conflicting information. It is overwhelming. I hope you are doing well and healing.

mike1a
Posts: 2
Joined: Jul 2009

I have just decided to go with the seed implant and am just trying to research the best location/doctors based upon their experience/volume of procedures. Now that you are about 7 months post-procedure, how is it going? With the seeds having a half-life of six months, have you begun to move past the side effects? What have your side effects been like? I was diagnosed in May with a PSA 4.4, Gleason=6, 5 out of 11 positive on the biopsy, with 4in one half and one in the other, ranging 5-35%, am 63 and have two daughters, 17 & 15. Am planning on having the implant in August after getting my oldest settled in at college.

Would really appreciate hearing from you.

Mike

mikeambrester@bellsouth.net

shubbysr's picture
shubbysr
Posts: 87
Joined: Jun 2009

Hi Mike,

I know you have reviewed and pondered all your options. I can only think about the "what if's". If your cancer does not respond to radiation, you have few options. From my research, there can be long-term effects from radiation later on in your life (tissue damage in surrounding areas, rectal bleeding, etc)
Not trying to discourage your decision, as we all have to make our own choices.
Good thoughts and prayers continuing your way!

Jim (shubbysr)

ATLSteve
Posts: 4
Joined: Mar 2009

Mike -
As you've likely noticed, this board is about 95% surgery folks so that's the primary topic of discussion.

I happened to have PSA done during physical after turning 40 last fall - elevated....tried antibiotics...then biopsy. Mine was very small and early - highest PSA has been 3.5, Gleason 3+3/6, 10% involvement in 1 of 12 samples. My urologist said he stopped doing surgery years ago and works closely with the ProstRcision clinic here in Atlanta.

Very happy w/ the rad onc I met there ... seeds implanted two days ago - OP procedure...had catheter for that day/night - removed the next morning. No urinary issues ....just some bruising around the lower buttocks.

Will start radiation in a few weeks. Since this method does both, radiation from each source is lower thus reducing side effects.

Given my findings, I equated surgery for me to cutting off my arm because I had a cancerous mole on it - just didn't make sense.

Hope you find what works for you.

lewvino's picture
lewvino
Posts: 1007
Joined: May 2009

ATLSteve,
I live up the road from you near Chattanooga Tn. I had an appointment down there at the ProstRcision clinic while I was evaluating my treatment options. Based on various things I decided to have the DaVinci Procedure coming up in August.

Good luck to you on your treatments down there.

Larry

mrdezzy
Posts: 23
Joined: Mar 2012

Going through what you have been through...trying to decide on therapy. am 67, PSA 7 Gleason 3+3 2 positive cores out of 16 taken on biospy. Have really though a lot about the ProstRicision but for some reason cant get over why other centers dont do this, just in Atlanta and if it works so well why dont others start doing it. Steve, how has it been so far for you and if anyone has any advise i am all ears!

Beau2
Posts: 245
Joined: Sep 2010

Hey Mrdezzy,

Welcome to the forum ... sorry you have to be here.

I haven't seen ATLsteve post, beyond this thread ... he may not be an active member.

Based on what appear to be very good numbers, you would appear to be a very good candidate for just about any kind of treatment. You may also want to consider Active Surveillance. From the recent articles that I have read, AS may be the way to go for many low grade "indolent" Prostate Cancers.

Sorry, I do not know much about ProstRicision; however, I am sure that other members will be able to answer your questions.

Good luck in your fight against PCa.

bdhilton
Posts: 759
Joined: Jan 2010

I talked with ProstRicision when I was investigating my treatment options and from my perspective, I did not like their “commercializing” aspect to their treatment center (billboards all over Atlanta) and “guarantee” outcome (like a sliding scale of your outcome) …It seemed to me that they were just looking for “perfect” candidates that would raise their advertised “success rate” ….Again, this is my perspective…

I would suggest that Mrdezzy start a new "topic" as this one is almost 4 years old....Best to all

hopeful and opt...
Posts: 1357
Joined: Apr 2009

http://www.youtube.com/watch?v=vRFeh5xXe-k

bdhilton
Posts: 759
Joined: Jan 2010

Well it is nice to know a professional feels the same way I did….What is more interesting in this clip is that the MD states that there is no medical proof that one radiation treatment is less damaging than another…something I thought as well when I was selecting my treatment choice….Thanks for posting

SCOOTER9800
Posts: 2
Joined: Apr 2009

Waldo I am about to have the seed implant within the next month or so.I have a volume study in 5 days to see if my prostate has shrunk from the Lupron shot I got two months ago.I would like to know how things have gone with you and what kind of seed you got Palladium or Iodine.

tonybear
Posts: 92
Joined: Mar 2009

another option besides seeds or robotic is brachy therapy and tomo radiation. there are no seeds implanted. i had the brachy and tomo and so far everything is going okay. i caught my cancer at a very early stage so i think i had more options because of that. take your time and do what's right for your body and your loved ones. there's no silver bullet, but there are options. the best to you for your health and your family. tony

dachem
Posts: 3
Joined: Apr 2009

I was age 62 when PC was discovered. Gleason of 6, PSA of 4.6. I chose seed implants and am totally happy with the outcome. That was 11 years ago, my PSA has stayed low and I have had no after-effects of the procedure at all. In fact, I played 18 holes of golf 11 days after the procedure and have continued to have an active life. I chose seeds because I thought they would have the smallest probability of radically affecting the quality of my life, and so far I think I made the right choice.

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