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Prostate cancer diagnosis

paquitin
Posts: 7
Joined: Mar 2009

I was recently diagnosed with prostate cancer at age 56. I have checked my PSA for the past 10 years, the reason being that my father had prostate cancer too.
Although my PSA was never outside the normal range( highest level was 3)it had changed by more than 0.75 within a year and that prompted a biopsy.(painless procedure)
I had 12 cores 2 of which were positive with Gleason of 6 (3+3).

Lesson #1- The incidence of prostate cancer is 1:6, it increases to 1:3 if you have a first line relative with the disease. Closer observation will be required in this case. Always talk to your doctor and ask and demand. Remember you are your best advocate.

lesson #2- a normal PSA does not exclude the diagnosis of prostate cancer.It is important to follow the trend and if there is significant variability within a year you should request a biopsy. Remember the earlier you know the better your chance especially if you have more than 25-30 years life expectancy.

I opted to have surgery rather than radiation for the following reasons. I had4consultations, 3 urologist one of them an expert in robotic surgery,2 experts in open procedure, and one radiaqtion oncologist)
There is no data regarding the benefit of radiation after 10 years.This mean taht the cancer may recurr after radiation.If localized it is likely you will be cured after surgery.

The potential complications of radiation cystitis, urethritis,proctitis and rectal bledding were not acceptable to me.

Regarding erectile dysfunction it is my understanding that it usually progress with years after radiation because of radiation damage to vessels and the nerves themselves. So although less of a problem initially it may become one down the road.

Finally I wanted to get this over with and not have to worry as much.

Next hurdle was the decison of having the procedure done open versus laparoscopic with the robot so called Da-Vinci procedure.

After research I found that there is not much of difference between the two other than blood loss and post-op pain may be less with the robotic procedure as compared to open.
It appears that the most important thing is not how the procedure is done but who is doing the procedure.In other words if the open procedure is done by an experienced surgeon the results are about the same.

I finally opted for an open retropubic prostatectomy. I had surgery at Memorial Sloan Cancer Center in NYC.The care was unbelievable,fantastic, from everyone involved.
I had minimal blood loss approximately 400cc. Post op pain was not a big issue.I used 6 mgs of morphine in addition to toradol which is a non narcotic analgesic.
I was out of the hospital in 48 hours.
Catheter was in for 10 days. My main issue with it was bladder spasms which occured intermittently.Catheter is finally out. I am wearing a pad but incontinence is minimal.
Regarding erections, I have not tried to have one yet but I believe this will be OK in next several weeks.
My pathology showed no evidence of Lymph node metastases or extracapsular tumor involvement. So, I believe I am cured.
If you are like me, family history, fluctuating PSA level, please do yourself a favor and have a biopsy.
If needed, research your options and get the best opinions you can possibly get and then decide what is best for you.
There is hope and peace after diagnosis of prostate cancer
F,

hopeful and opt...
Posts: 1293
Joined: Apr 2009

I've been wondering, how can one measure the outcomes of prostate surgeons. It seems to me that selection is based mostly on reputation, length of time doing, operation quantities, and quality of hospital association. How does one really know? As a medical professional, can you provide some insight?
Thanks,
Ira

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