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Just Diagnosed.....

Uh_Oh
Posts: 17
Joined: Mar 2015

Hi, all. New here!

I've gone over a year and a half of various PSA readings, from 4.85 (9/2013 & my first ever PSA after turning 50 & was referred to a local uro practice) to a high of 6.7 (which bought me a TRUS biopsy-negative), back to 4.3, and then 5.7, 5.3, which is when the uro suggested a 24 core saturation biopsy. I really didn't want to do this. The aftermath of the 12 core was gross enough so I sure didn't think 24 needles was going to be any better and I feel as though the docs are shooting blind and hoping to hit something. I decided to seek another perspective, and for all that I don't like politically about living in Maryland, Johns Hopkins is a short drive away. I saw Dr. Carter at Hopkins earlier this month and had another blood test, which resulted in a PSA of 5.8 and fPSA of 17.4. It was decided that I'd have a MRI done, which showed a "suspicious area" after the scan. The next week I had a MRI-guided fusion biopsy with Dr. Carter, which I found out last week showed 2 of 14 cores positive, less than 5% involvement each, Gleason 3+3=6. The pathology report was reviewed by Dr. Epstein. The MRI also showed it was prostate confined. All DREs have been negative.

I have an appointment with the doc April 1 (figures!) to discuss treatment options. The doc assured me that in no way am I in a "life threatening" situation, that it's very treatable, and on a scale of 1-5 on the risk scale, I'm only a "1." At "only" 51.5 years old, I don't know what he'll suggest. I believe he also said that even in 10 years my situation isn't likely to change much. I guess I'm hoping he says I don't have to really do anything for the time being, other than monitoring. If I can make it a few more years, that gives me a bit more time to try for more "guilt sex" with the wife-LOL!

I have to say, turning 50 hasn't impressed me much thus far!

 

 

 

 

 

 

 

Old-timer's picture
Old-timer
Posts: 196
Joined: Apr 2011

It is my experienced opinion that, based on the information you gave, you do not need to accept any treatment. You are smart to look into the matter, get checked out, etc. It sounds as if you are doing that. I commend you and wish you the best.

You are right, turning 50 is a big deal. It was the only big one I was not eager to meet. I very much enjoyed arriving at all the other big ones. Now I am 88 and contemplating 90. My wife of nearly 66 years turned 90 yesterday. My experience with prostate cancer began 24 years ago. That is enough bragging. I just want to give you young folks the message that life can be good up here too! 

Old-timer (Jerry) 

hopeful and opt...
Posts: 2226
Joined: Apr 2009

You are a patient at a first class organization. Dr. Carter is well known. 

This is the first that I have heard that Johns Hopkins is doing a targeted biopsy.....up to now they have been doing yearly random biopsies for patients who follow an active surveillance program.

I wonder if you first had a multiparametric MRI T3, then a three dimensional biopsy...was that an Artimis biopsy machine?

Active surveillance protocol is not generally age related....there is a man where I am treated who was accepted in an Active Surveillance program at age 35 

I have been in an active surveillance program, this is the start of my seventh year.....my initial results were the same as yours.........I hope to die with, not because of P Ca. ...At any rate as a young man of 50, why choose an Active Treatment thay may have major side effects, when you can maintain a quality of life, for a life time, or at least for a while,and still receive the treatment that you would have at diagnosis if cancer progression is found.

If you click my name to the left, I listed the treatments that I have received and information about management and expert source for Active Surveillance.

I know that your name is not Uh_Oh, but it is time for you to celebrate. ...A toast to you(not Uh_Oh Tongue Out and good times.

I suggest that you change your name from Uh_Oh to Yes Yes

Best,

H

Old Salt
Posts: 720
Joined: Aug 2014

Active surveillance seems like the best solution for you. And you are already a patient of Dr. Carter (who heads that program) at Johns Hopkins University Hospital.

http://urology.jhu.edu/prostate/advice1.php

Uh_Oh
Posts: 17
Joined: Mar 2015

Hopefully I'll be doing a name change soon! I didn't pay much attention to the MRI at the time. I was thinking so much about if they were going to stick a "coil" up my rear-end that I couldn't concentrate! They didn't, thank God! LOL!! I notice on the test report it says "MRI 3D Reconstruction On Independent Workstation" and in the report narrative "TECHNIQUE: Imaging at 3 Tesla performed at JHH. Coil: Body Matrix coil" -- we'll see if I can opt into active surveillance at the doc meeting.

hopeful and opt...
Posts: 2226
Joined: Apr 2009

 

Here is a study at JohnsHopkins that I was able to google based on the information that you posted

 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3978179/

 

Good luck with the follow-up appointment that you will have with Dr. Carter.....I've read  some of his work........you will be in good hands.

 

I suggest that you acquire knowledge, read books, attend local support group(s), keep on posting here with questions, determine information about various treatment options

 

Notify relatives about your diagnosis, since there is a potential increase of diagnoses among family members of PCa patients. I suggest that they discuss with their medial porviders

 

PS When  I was first diagnosed, I had a 1.5T MRI and a spectroscopy that i had to pay $ 900.00 dollars for since it was considered investigational...at that time I had a coil (or in my mind a HOSE) up my butt. What fun!

 

 

 

 

 

VascodaGama's picture
VascodaGama
Posts: 3050
Joined: Nov 2010

Uh-Oh

In my opinion your diagnosis couldn’t be better. The team analysing your case is at the top and they used the very best means to find the status of your case. Now you got the “ball in your hands” and have to kick it or keep it. It is not easy to decide on how to proceed but you have all the time to think deeply before throwing the ball in play. Quality of living is as important as peace of mind.

I totally agree with the “tips” from the above survivors. These guys are precious. Old timer is our senior and his posts are wise and always very smart. I see his “quarters” at the top too far a climbing but the scenery and views from up there must be wonderful. I hope we all manage to reach there.

Thinking in living with the cancer is confusing particularly when we are at the 50th. It is a matter of being sick but feeling healthy. However that is the model we humans are made off. Jerry may explain this in better words. I was diagnosed at 50 too. The positive diagnosis strike me like a lightning bolt. Soon I realized that it was the start of a life style with healthy responsibilities. I would need to incorporate in my daily living a healthy behaviour tended with careful diets, fitness programs and life style.
This is the world of prevention and we should give more credit to those results of tests checking the lipids and markers of health. PCa concerns the immune system, bone health, liver and kidney functions and heart conditions. Cholesterol and testosterone levels are as much important as it is the PSA. And all these data should be filed and kept for future considerations.

Welcome “aboard”. Best wishes in your journey.

VG

Uh_Oh
Posts: 17
Joined: Mar 2015

I appreciate the advice from everyone. 

I met with Dr. Carter yesterday, and somewhat to my surprise, he did not believe AS was the best option for me and recommends surgery and removal. I was all set to hear that, due to my relatively los Gleasons (6) as well as low involvement of 2 cores, less than 5%), I'd be a "shoe in." His concern is that, even with my GS6, the cancer was found on 2 different areas of my prostate (left and right apex). Plus my prostate was a little larger than it should be for my age.

And here I was, gearing up for the argument I knew was coming with my wife over doing AS! She was relieved that he recommended surgery. She said "it was going to take a whole lot of convincing to get me to agree to leave that thing in you." LOL!

He didn't like the radiation option because of my age. He thought that at 51 there was too much time left in my life to risk potential side effects, including even development of other cancers, due to the radiation exposure.

He again assured me that my situation isn't "life threatening" but that I should get treatment within 6 months. Great... Well, that gives me some time to get in a little better shape, so it gave me the motivation I needed to join the local gym today. Time to start working on the wife for guilt sex now!

Ron

Swingshiftworker
Posts: 1013
Joined: Mar 2010

What is Dr. Carter's basis for suggesting that there is a risk of developing "other cancers" as a result of radiation treatment?  Whatever those risks are, I think they are minimal and certainly less than the risks associated with surgery.  Did he tell you that as a man w/PCa that you already have a risk of facing other cancers, whether you choose radiation treatment or not.   Did he tell you that you might need to get salvage radiation treatment anyway if the surgery fails, as it does for many men?

Did he go over ALL of the risks of surgery with you?  ED and incontinence are the major ones (both of which can last at least a year and in the worst casesbecome PERMANENT following PCa surgery) BUT did he also tell you about the visual shortening of the penis after the prostate is cut out (because of the gap that is created between top of the penis and bottom of the bladder when the prostate is removed), the risk of infection from the surgery (which is not a risk of radiation) and the risk of damage to associated organs (most likely the bladder and rectum) during surgery???  I bet not.

FWIW, I always get on my soap box when I hear that a urologist thinks that a man in his 50's should have surgery because he's "young" and supposedly better equipped (age wise) to endure and overcome the substantial trauma and risks of surgery.  I think that point of view is pure bullshit.  If surgery is inadvisable for someone older, there's no reason why it should not be inadvisable for someone younger either.

My recommendation is that, BEFORE you commit to surgery, you consult with some radiation oncologists -- specifically ones who specialize in IMRT, "high (as opposed to low) dose rate" aka HDR brachytherapy and CyberKnife (SBRT).  That's  at least 2-3 possible consultations to determine if you might be a better candidate for one of these therapies.  You can discuss the risks (if any) of developing further cancers (or any other side effects) from those treatments with them.

Personally, I was 59 when I chose CyberKnife, which I learned provides the MOST precise method of radiation delivery to the prostate currently available, which in turn minimizes the risks of any side effects.  I and other men on this forum w/the same diagnosis as you (Gleason 6, PSA less an 10) have been successfully treated with CK (which only requires 3-4 treatments BTW) without any side effects whatsoever -- no ED and no incontinence -- and without any disruption in our lives that other treatments -- especially surgery -- can cause.  CK was modeled on HDR Brachytherapy and IMRT is generally offered where CK is not available and as salvage treatment when surgery fails!!!

So, take the time to do this additional reserach before you commit to a treatment that can radically affect your life and will seem medieval by comparison to the modern radiation treatments available.

Good luck!!!

 

 

hopeful and opt...
Posts: 2226
Joined: Apr 2009

As a lay person I am in wonderment by the discussion that you had with Dr. Carter b yhis  recommendation that you not engage in an active surveillance program, not have a form of radiation, and only  consider surgery because of your age. Although I am in wonderment, I am not surprised by his directing you to surgery, since he is a SURGEON. Generally surgeons recommend surgery, radialogist recommend various forms of readiation.

You are the CEO of your life and YOUR treatment choice. As Swing strongly recommended, take the time to research, I can only agree with this.  You and your wife need to research your options, to include but not limited to various forms of  radiation. I also suggest that you get a second opinion by another doctor who manages Active Surveiillance patients.

There is a new treatment that is being done called "focal laser abalation" that is less invasive than other treatments. It is being done on a limited basis. It is very new and  is a devoloping treatment  that you may wish to investigate..it is a MRI guided treatment..there is a discussion about it at the USTOO discussion site.

Some thoughts for research are to attend local support groups. USTOO.org, international organization list local support groups that they sponsor at their site. They also publish a monthly HOTSHEET that provides up to date information that is worth reading. Read books, internet research...keep on asking questions here.

Remember PCa is slow growing. You have time to make the best decision for you....Do you homework.

Best

H

 

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3329
Joined: May 2012

Uh-Oh,

I think I read somewhere in this thread that your Dr. Carter is a renowned authority on AS. If so, his recommending against it (for surgery) must be based on something, even if it is just his "gut", which can never be ruled out.

My situation recently was similiar, mild disease by all criteria, a little older, at 58.  After speaking with five doctors, I chose surgery, but had over an hour discussion with a radiation oncologist whom I already knew and admire. His proposal was IGRT.  According to him, treatment with IGRT to 76 Gray would not increase my liklihood of getting a radiation-induced subsequent cancer in my lifetime. Point blank. I believe him.  I had asked this question because of my earlier experience with lymphoma, which combined with some forms of radiation renders lymphoma patients more prone to leukemia.

At a minimum I would recomment that you meet with a top-flight radiation oncologist and see what he thinks.

My surgery was by all indications curative and successful, but as several guys have said, RP is not easy, and the side-effects are significant.  After much study, I believe that in most cases, current-technology radiation probably has fewer short and long term side-effects than surgical removal, but RT is not risk-free or without its own potentially serious and dibilitating side-effects.

Many guys, like me, relate that the more they read, the more uncertain of what is best becomes. It is just a tough call to make in most cases. But I would at a bare minimum see a radiation guy... Get the guilt sex now; you quite likely won't be getting much for some time thereafter.

 

max

 

 

Old-timer's picture
Old-timer
Posts: 196
Joined: Apr 2011

Ron,

My thoughts, decisions, and experiences during the 24 years I have coped with PC may be interesting if not useful to you. Every PC situation is different in one or more respects. Just because I am old and PC experienced does not empower me with superior understanding; and, in no way, am I qualified to tell you what you should do.

I faced the decision that you are now dealing with in 1991, when I was 65 years old. I felt the way you say your wife does. "Get the thing out of there." My education about the problem and possible treatments was meager. Based on a sympton (cloudy semen) and a PSA reading of 4.0, my primary care physician referred me to a urologist. The biopsy report indicated PC. As the urologist recommended, I read a booklet on the male anatomy and discussed radiation treetment with an oncologist. To shorten a long story, I selected prostate removal as the treatment. That worked for awhile, but it was not the end of the matter. After 13 years, the cancer returned. Radiation failed to stop it. Seventeen years after surgery, I was placed on hormone therapy. That lowered the PSA to "undetectable." That is where it is today, nearly 24 years after RP.

I am OK about what I have experenced with PC. It was something with which I had to deal. Yes, there have been negative effects. In some repects, however, PC seems to have enriched my life. It gives me an increased awareness of the value of life. Obviously, sex is not what it used to be. It's different, but good. I think it is as enjoyable, or maybe even better than it was before. My bride of 65 years and I have been and continue to be partners in dealing with this matter.

I will watch your story as it unfolds. Lots of luck to you and your family.

Jerry (Old-timer)

Old Salt
Posts: 720
Joined: Aug 2014

 

I was also surprised to read that AS was not recommended by Dr. Carter. However, there is a 'simple' explanation for this. The AS protocol at Johns Hopkins states that (relatively) young, (very) low-risk patients such as you will only be accepted if they have unilateral disease. Unfortunately, both sides of your prostate are involved.

 

http://urology.jhu.edu/prostate/active_surveillance_selection.php

 

One can question the reasoning behind the inclusion criteria that the Johns Hopkins AS program has implemented. In fact, these criteria have been changed at least once. And I predict that they will change again at some point in the future once the results of the ongoing study with the current criteria have been analyzed and published.

Does this rule out AS for you? That is a decision that you will have to make. AS protocols at different institutions do vary and it would be of interest to research others to see if you might be a candidate at another place.

jerry 1957
Posts: 1
Joined: Apr 2015

Ron,

I had a robotic assisted surgery a weeks ago in MSKCC . I am 57 years old and in good physical shape.   They warned me about possible incontinence and probable ED for a few months, up to two years.

Four weeks later I have no incontinence and am back having sex. I use Viagra but other than that I can function fully with no issues (even my morning erections are back..) ...So while there are more fun things to do in life than having your prostate removed , recovery at your age should be relatively fast and hopefully you'll be back to your normal life cancer free within a few weeks. Just make sure your surgeon is very experienced and with has an excellent reputaion and you will do very well.

Good luck

 

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3329
Joined: May 2012

Jerry,

Your post here rang home for me, and since this Forum is largely about the "real-word" experiences that guys have, I wanted to mention my experience following surgical removal in January (this year). 

After my cath was removed a week following the surgery, I did not know what to expect, and went home in Attends (adult diapers).  Urinary issues were so limited that I quit wearing diapers two days later, going on just a pad for male incontinence.  I have since discontinued that and wear only a thin liner, since occasionally after a cough or sneeze I will have a small amount of leakage.  So, while I know my experience was atypical, incontinence was hardly an issue at all for me, except for the first ten days or so post-surgery. I am thankful that it went so well. We are almost the same age, since I am 58.

ED for me 2.5 months out is still an issue, but I do have limited arousal, but have never taken Viagra or any other med.  My uriologist told me that ED resolves much more slowly than incontinence, and could take a year or more. He has me scheduled for a "Trimed" injection soon, but I may cancel that appointment, and see how things work out naturally.

By all of what the Journal articles and books state, our experiences are not the norm, but it does show that RP can be less devastating than many suggest, and it is critical to find an experienced surgeon. Mine has done over 900 da Vinci RPs, and I was blessed to have him available. 

I have to wonder: How long is his yacht ?

max

Uh_Oh
Posts: 17
Joined: Mar 2015

Thanks, Jerry.

It looks like things are going well for you. I'm likely going to call and schedule my surgery very soon, possibly next week and for sometime in June. Seeing stories like yours is encouraging. While I'm relatively young at 51, I'm hoping that my age will be an advantage in my recovery and getting past ED and incontinence. 

Looking at my options, I don't think that I, personally, can comfortably live my life knowing this thing is inside of me, especially realizing that just because the biopsy only found 2 samples that were PCa, that doesn't meant there isn't more that it missed, and, I also realize that many times the pathology report upgrades the Gleason Score after removal. I just watched my stepfather succumb 11 days ago after 6 years of battling this disease, and his death, I felt, was unnecessary. He didn't get good advice from his primary care doctor when his PSA tests first became elevated and was told "sometimes they go up and down" and was never referred to a Uro until he had other problems and a DRE found a lump. After the robot removed his prostate his pathology report indicated a Gleason 8. I'm not quite convinced his surgeon was particularly experienced, either, and may not have gotten all that needed to be removed. It had escaped his prostate and had gotten into his bones. He didn't have a family history of PCa, but he was likely exposed to Agent Orange in Vietnam. He said "they used to dump that stuff on our heads!" He had an agonizing last couple of months and he and my mom went through hell. It was difficult to watch.

So, I just don't think I can risk it. And I know it would kill my mother if things went badly for me. Of course, everyone feels differently about what treatment is best for him, but I think I'll have constant worries if I keep it in there. And I already know what my wife wants! Reading good recovery stories like yours is very encouraging. Thanks.

 

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3329
Joined: May 2012

Uh_Oh,

Assuming you do get surgery, use a surgeon with a lot of RP experience.  The unofficial criteria for being "experienced" with robotic RP is 200 surgeries or more.

Also, ask the surgeon directly if he routinely practices erectile nerve sparing, when possible.  If any surgeon, after they open you up, finds perineural involvement (cancer growing out of the gland along the nerve fibers), they must cut the nerves out, but seemingly minor cases, with low-risk numbers like yours, do not normally reveal this problem.

The surgeon may not have done anything wrong in your stepfather's case, although it may well be that he was not a good candidate for surgery to begin with. Metastatic disease that has gone to the bone is not treatable surgically, so if that was the case, there was nothing he could do at that point.  All of this is speculative, of course.  You would need full pathology reports to evaluate his case.  I am sorry about his passing.  I have watched two dear friends die of PCa in the last several years, and although not relatives, I somewhat can relate to your experience.

I hope your decisions are all the correct ones, and that all goes very well for you,

max

Uh_Oh
Posts: 17
Joined: Mar 2015

He's a Distinguished Professor and the Director of Adult Urology at Hopkins and does "open" via the lower abdomen rather than robotic. According to the Johns Hopkins Brady Urological Institute site, he's seemed to have had lots of "practice!" LOL! I really don't have an issue as to how it's done, as long as I'm comfortable with the doctor. The robot seems to take quite a bit longer, and I don't know how I feel about being knocked out that long. Dr. Carter told me the procedure would "only" be about 1.5 hours long. One night in the hospital, and 9 additional days with the catheter, which I can remove myself--if I'm brave enough! 

He's assured me at our last meeting that his goal is to spare the nerves. As my 3T MRI showed nothing outside of the gland, then that's what I'm hoping for.

From his Bio:

"A patient undergoing the surgery described above could expect to have a carefully performed operation with the best chance of total cancer removal using visual magnification and tactile feedback rarely requiring blood transfusion, and that can be performed in just over an hour. Men are discharged from the hospital on the day after the procedure."

 

Hope it's right!

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3329
Joined: May 2012

 

Uh-Oh,

There is a lot of relief in deciding what treatment to go with, so I know you must feel better having made the decision.

Yes, you certainly have an experienced guy.  My da Vinci surgery this January took 2.5 hours.  I remember waking up in recovery, and feeling for a long time like I was on another planet.

Dr. Peter Scardino, chief of surgery at Sloan-Kettering CC, writes in his Dr Peter Scardino's Prostate Book that there are reasons to prefer open incision RP, and I believe that the open technique is what he himself uses.  I recall for certain that he mentions the value of touch in surgery.  Robotic surgeons brag that the incision is smaller with the machine, but when you add the lengths of my five incisions, I suspect that they together represent MORE cutting than a single entry point would represent (??).  Regardless, I was quite happy with the da Vinci experience, but understand that open technique has advantages as well

Good luck with everything,

max 

VascodaGama's picture
VascodaGama
Posts: 3050
Joined: Nov 2010

Ron

I agree with all the above opinions. I wonder what made Carter to recommend surgery. Reaching to such decision done solo in regards to Ron’s age is Bull ****.
What has he seen or influenced or made him to judge Ron’s case and conclude his status in need of an earlier (within 6 months) treatment is ambiguous. I would get details from Carter’s judgement before drawing conclusions.
Cancer at the apex is probably the easiest in targeted treatments. It is far from the bladder and sphincter (in the open) but closer to the rectum. In any case nowadays when dissecting the gland or frying it with rays the whole prostate is treated, not just a portion of it.
Was this “location” the influence factor in Carter’s judgement?

It doesn’t surprise me that Ron’s wife is worry and applauds a solution with a quick fix. Many guys (if not all of us) freak out once declared positive with cancer. It is obvious that we would rather be free of it but at what “price”?

Max confronted this same experience not long ago. He sets well his opinion on Ron’s case. Enjoy the guilt sex now but do not use it as a time boundary to trigger a therapy.

Whatever Ron decides (keeping the ball or throwing it into play) it will be the best choice for him and we all will participate and help. He will make an intelligent decision.

VG

Timlong
Posts: 42
Joined: Nov 2011

I say "GET RID OF THE QUEEN BEE SO THE WORKERS DO NOT ESCAPE"

The most important consideration is the experience level of the surgeon.

My freind Tim had Robotic RP by Dr. Eun of Temple in Philly who is known for doing great bladder necks

and did not leak from the time the cath was removed. That was three years ago.

I wish you well.

 

Jeff

 

 

 

Uh_Oh
Posts: 17
Joined: Mar 2015

I have my wife, who just "wants it out" and a doctor, who is a pioneer in AS, wanting to take it out.

 

Where to go.......?

Swingshiftworker
Posts: 1013
Joined: Mar 2010

What do you want?  That's what matters.

Your doctor is just an advisor and he is only of one opinion. You need to speak to others.  Your wife has NO idea what kind of pain and suffering you may experience if you undergo surgery AND how much of that pain and suffering she will have to share, especially if the surgery goes badly.  You have to make her realize that "cutting it out" is not necessarily the best course of action.  It may ultimately be the choice you make but that should be an INFORMED choice and it will not be one if you are BULLIED into choosing surgery by your wife and/or others.

Surgery is an IRREVOCABLE life altering decision that has gone VERY BADLY for many.  You have the time to do the additional research on alternative radiation treatments.  Take it!

Good luck! 

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3329
Joined: May 2012

Uh-Oh,

I know you may be in data overload at the moment, but in response to your rhetorical question, let me suggest again: Go see a good radiation oncologist. You have already spoken to a surgeon and an A/S expert.

A radiation oncologist is the obvious, almost glarring, next referral to make.   I am not recommending that you choose radiation; I am instead only saying that you owe it to yourself to investigate it before your monumentous decision.   

.

 

.

VascodaGama's picture
VascodaGama
Posts: 3050
Joined: Nov 2010

Ron,

No one here including your doctor can substitute you in the decision process. In any case your choice is for sure the best and you should trust it.

Trying to get cured is logical and a life free of cancer is beautiful but quality living is important in particular to those young patients with many years of life expectancy. Age should not be the triggering reason for a treatment in prostate cancer unless there are high healthy risks behind obliging the patient to act the soonest. Nowadays postponing such treatment in PCa cases is regarded possible without losing the possibility of cure in a later procedure. Would you be 62 with similar diagnosis and the choices and possibilities of cure would be the same.

When such timing to treat “arises” then one should look for the most successful outcome with the lesser risks and lesser side effects. Some guys would prefer to confront a sort of occurrences more that others, he would accept them better. It all resumes in what one puts preferences on. The risks involving the treatments are well documented so that you could try getting informed (second opinions from experts), prepare a list of the items and discuss the pros and cons one by one with your family for a final decision.
That would be an intelligent way of finding peace of mind.

Here I post links that I think will help you in understanding the problem better. Please read them all;

http://www.cancer.net/coping-and-emotions/managing-emotions/self-image-and-cancer

http://www.cancer.net/coping-and-emotions/sexual-and-reproductive-health/fertility-concerns-and-preservation-men

http://www.cancer.net/coping-and-emotions/sexual-and-reproductive-health/sexuality-and-cancer-treatment-men

http://www.pcf.org/site/c.leJRIROrEpH/b.5822789/k.9652/Side_Effects.htm

http://www.cancerresearchuk.org/about-cancer/type/prostate-cancer/treatment/radiotherapy/side-effects-of-prostate-cancer-radiotherapy

http://www.cancerresearchuk.org/about-cancer/type/prostate-cancer/treatment/hormone/side-effects-of-hormone-therapy-for-prostate-cancer

http://www.cancer.net/navigating-cancer-care/young-adults/family-friends-and-relationships/talking-your-spouse-or-partner

Best wishes for the very best conclusion.

VG

CC52
Posts: 103
Joined: Nov 2013

Swingshiftworker said all that needs to be said.

Good luck to you!

CC

stoniphi's picture
stoniphi
Posts: 54
Joined: Mar 2015

I was 62 years old when my PSA hit 11.1. DRE found a bump. Got a biopsy, 12 of 12 cores were dirty - acinar adenocarcinoma, Gleason (4+3) = 7. MRI & bone scan showed extensions in the upper left and lower right quarters. I was rated T3c N=0 M=0. Got robot - assisted Radical Prostatectomy in Dec of 2012. 35 gram tumor, positive margins, 1 seminal vesicle involved. No lymph node involvement. Some perinueral invasion, affected nerves removed. Final Gleason was (4+3) = 7....right on the cusp, as it were.

Did Firmagon starting 2 weeks after surgery for 3 months, then Lupron, then Eligard. Last 6 month hit of Eligard was on my birthday last Oct. After the first 3 months on Firmagon I did 2 months of daily radiation - 40 sessions, about 80 Grey total. The radiation oncologist said "The horsie hasn't left the stable yet, but he has got his head out and he is looking around."

 

I was put on daily Cialis to elevate nitrous oxide (not for sex as I have neither ability, interest or desire at this time) and a penis pump to keep the spongiform bodies functional. Also a prescription to take a 1 hour afternoon nap every day.

I am very well educated in the sciences, I understand that the treatment I recieved is state-of-the-art for locally advanced PCa like mine. Also that the doctors (I had a team) had all agreed that I was healthy enough to get through this well and that if the cancer didn't get me, I was likely to be around for quite some time. Cool

 

Yes, none of this has actually been much fun, but I started out very physically fit with a good attitude and the support & assistence of my family. My last blood test 2 months ago gave me testosterone of 2.2 ng/dl & PSA undetectable, as it has been since Jan of 2013. Next blood test is in 2 weeks, then next meet with the doc is the week after. At that time I expect to be let to move to my new normal as the last of the Eligard clears, likely in 2 - 4 months (as I am informed). Yes, I lost about 2 inches of my penis...it seems to have partially filled the void left by the removal of the prostate rather than actualy getting smaller though, so it is more like 'retracted'. It can and does come back out though, and I don't really care what others think of that. It does not upset my wife of 25 years, we value other stuff a lot more.

 

In my thinking, there is no cost without a commensurate benefit. I have paid a price and have been in this sometimes painful experience, but I have profited significantly from all that I have been through as well. If nothing else, it is really strange to have a non - sexual perspective on life events. Many things seem so silly from here.....

 

I also suggest talking to a bunch of different folks and getting those alternatives. Get a really good picture in your mind as to eactly what kind of beast it is and how nasty it can or will get. I must tell you not to let fear guide you, but follow the facts. Pain is transient and a life can be long.

Shiloh_Rene
Posts: 1
Joined: Apr 2015

Hi-   I am the wife of a Prostate Cancer Patient. His readings are Stage 1, Gleason score of 7 and T1c.  He was told the same thing, that he could have this for 10 years.  We did extensive Research and decided we did not want to "Watch & Wait" especially with his Gleason score being Intermediate.  During the next 10 years the cancer could Metastasize to other areas, which include Bladder, Kidneys, Liver, Lung, Brain and BONE.  So, after changing our Insurance, we currently are at Loma Linda Medical Center, as he undergoes Proton Treatments.  He has completed 10 so far, with no side effects other than more frequent urination.  Good Luck to you, hope you will find the right answer for yourself.

 

Uh_Oh
Posts: 17
Joined: Mar 2015

Curious.... What's your husband's age and how high did his PSA numbers go? Did you speak to a surgeon before deciding on radiation, and if so, what made you guys decide on one over the other?

Ron

hopeful and opt...
Posts: 2226
Joined: Apr 2009

 

This new  gene test developed at the Cleveland clinic and tested at UCSF, at a molecular level,  looks at 17 type genes found in your biopsy, and gives indication of how aggressive the cancer really is..

Your biopsy showed a Gleason 6....some Gleason 6's are wolves while most are sheep..........this test will tell what yours really is.

The results of this test can affect your decision for AS, or other treatment

 

Here is a discussion about the test

 

https://www.youtube.com/watch?v=Nkc7qfS-mcE

Best

Old Salt
Posts: 720
Joined: Aug 2014

Just expanding a bit on the previous post. This is from the company website:

About the Oncotype DX Prostate Cancer Test and Early-Stage Prostate Cancer

The Oncotype DX prostate cancer test is a standardized, validated biopsy-based test that measures the level of expression of multiple genes across multiple pathways that predict aggressive prostate cancer, overcoming issues related to tumor heterogeneity, biopsy under-sampling and under-staging to substantially improve individualized risk assessment at diagnosis, prior to treatment intervention. Further, the Oncotype DX prostate cancer test allows men with apparent low-risk disease who are identified to harbor higher risk features to have greater confidence in the decision to undergo potentially curative therapy. Based on the biology of each individual cancer, the information provided by the Oncotype DX prostate cancer test can help patients and doctors determine the most appropriate treatment.

Uh_Oh
Posts: 17
Joined: Mar 2015

I appreciate the thoughts here. I guess my main concern is the "not knowing" if the cancer is worse than the biopsy was able to find. I'm mostly coming into the acceptance that I'll just have it removed. While not particlarly happy with that decision, I feel it's less worrisome to me than always thinking about this thing inside of me. I haven't made the appointment yet, cuz I'm a big CHICKEN!!!

hopeful and opt...
Posts: 2226
Joined: Apr 2009

if you are alsways going to think about a cancer inside your body, AS is not for you.............For the first few months I focused on the cancer, now I just go on with my life......this is my seventh year............I believe that management of AS now a days will be sufficient so that I can seek the treatment that I might have, seven years ago when I was diagnosed, if that time ever comes, which to be honest at this point, I doubt.

 

If you decide on an Active treatment , there are other treatments other than surgery.....generally radiation especially SBRT is more effective with less side effects than surgery.

 

 

 

 

Swingshiftworker
Posts: 1013
Joined: Mar 2010

The "I want the thing out of me" is a common response of men who discover that they have PCa BUT is not necessarily the best response.

I know this is redundant but, if you've listened and done any kind of research on the topic, you should already know the significant risks that surgical removal of the prostate presents.  These risks include but are not limited to the possibility of PERMANENT ED and PERMANENT incontinence (the latter requiring the fitting of an AUS -- artificial urinary sphincter), infection, collateral surgical damage to associated organs such as the rectum and bladder and the visible shortening of the external penis by 1-2 inches which occurs after the prostate (which sits between the bottom of the bladder and the top of the penis) is removed.  This doesn't even deal w/the emotional distress and shame that you will feel if you can't get it up anymore, if you can't even see your dick any more or if you have to wear diapers and can't control when you pee anymore.  You should also know that even after surgery, many PCa patients are still forced to endure "salvage" radiation treatments and hormone therapy when surgery fails, which is all too common. 

Why subject yourself to such risks when radiation can effectively kill all of the cells in the prostate (cancerous and not) and essentially remove it from your body w/o all of the surgical risks?  This never made any sense to me, which is why I chose CyberKnife radiation treatment, which is THE most precise method of radiation treatment currently available.  That treatment only took 4 sessions administered every other day over a week's time and I experienced NO side effects whatsoever.  Some will say that if radiation fails you have no fall back position.  That is NOT true.  There is no point trying to surgically remove the prostate after it has been treated with radiation but there is nothing that says that you cannot be treated w/radiation again and administered hormones (as is done after a failed surgery).  So, what's the difference?  There are other men who worry about the long term effects of radiation but if you have to receive radiation after surgery has failed.  So, again, what's the difference?

It's your body and your choice.  You have to live w/the consequences.  There are certainly men here who have gone ahead w/surgery despite my and other people's advice to the contrary and are happy with that choice.  Just make sure, if you also make that choice, that it's the RIGHT choice for you.

Good luck!!

 

 

 

Uh_Oh
Posts: 17
Joined: Mar 2015

I haven't made my appointment, yet, and I'd be dishonest to say that I don't think about this decision ALL THE TIME!

Yes, I've heard the "repeat radiation" advice and it weighs on me. I guess a big part of my concern is my age (51)--for EVERY reason! I want function, but I also consider my age and hope it may be beneficial to recovery. Part of me wants to believe that, if I could buy a little more time, a better alternative may arise!

 

Radiation again, at least in the same area, I've been told is an issue, and hormones.....man, ..... this whole thing is a PITA!!! I sure wish it was "cut and dry."

hopeful and opt...
Posts: 2226
Joined: Apr 2009

you have time to research, interview specialists in different fields, attend local support groups (USTOO is an international organization that has local sites), read books. Take your time to research so that you will be comfortable with your decision...........also accomplish as many diagnostic tests as possible to increase the knowledge that you have available  about your condition , so you can make the best decision for you.

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3329
Joined: May 2012

Uh-Oh,

PCa is the best cancer to have for people who are (your term) "chickens," and can't decide on a treatment. It is usually indolent and very slow-moving.

However, cancer by definiton is "abnormally rapidly dividing cells."  That is how and why chemo works -- it focuses only on rapidly dividing cells.  Hair and the stomach lining are also naturally very fast growing, which is why chemo kills hair and causes nausea.

PCa grows slowly, but it does grow.  You can take a long time to decide, but in most cases, a man can't take forever.

.

 

Uh_Oh
Posts: 17
Joined: Mar 2015

I decided to go the surgery route. I'm awaiting a return call from doc's surgical coordinator to set up a date. It'll probably be about 2 months out or so before I can get in. I'm NOT looking forward to it, but I feel I need to put this chapter behind me and, hopefully, my relatively young age will be a "plus" for my recovery. In the meantime, I plan to use the time until then to get some exercise in, lose a few pounds, and prepare. My uncle just turned 73. He had his surgery in 1997 and his last PSA reading was .001, so hopefully I inherited _that_ part of the "gene equation" too!

 

Like you said, "a man can't take forever!"

 

Ron

schin
Posts: 9
Joined: Aug 2014

I am a 46 y/o who was diagnosed 9 months ago.

I was not interested in AS because of my relatively young age.  With possibly 5 more decades of life ahead of me, I felt like it was probable that my disease would progress to the point that chances for cure with therapy could be reduced.  But that was a decision my wife and I made based on our philosophy and situation.  Your perspective on this may be different, but is just as valid.

The good news is you have some time to think.  A cancer diagnosis is shocking and can provoke a knee-jerk response to "get it out of me!"  That is understandable, but premature.  You have the luxury of time, so you should use it.

I decided against surgery because I didn't want the side-effects (penis pumps, ED drugs, incontinence pads) or downtime from my job or lifestyle (I exercise religiously; surgery would have put that on hold for about a month).

After extensive conversation with Dr. Katz in NYC, and against the recommendation of my urologist, I chose CyberKnife therapy.  It has been wonderful.  Mild acute side-effects for a couple weeks consisting of minor pain with urination and mild pain/blood with bowel movements, but I was told to expect that.  Once that resolved I have had ZERO side-effects.

Anyway, get multiple opinions from both urologists and radiation oncologists, including ROs who offer CyberKnife for prostate cancer.  Then make the decision that YOU are most comfortable with.

Uh_Oh
Posts: 17
Joined: Mar 2015

While I don't know what your "stats" so to speak were before you opted for CyberKnife, I'm curious as to what were your urologist's concerns were to recommend against it? And what were you told about treatment in the (unfortunate) case there's a return down the road?

Thanks,

Ron

schin
Posts: 9
Joined: Aug 2014

Here's a link to the thread that contains my stats.  http://csn.cancer.org/node/286579

My urologist had no solid data against CyberKnife, except to say that he didn't know much about it, considered it experimental, and that choosing it was a risk given that surgery is proven.  CK is most definitely NOT experimental and long-term outcomes and side-effects have been published.  For low and intermediate risk guys, CK is equivalent to surgery in terms of efficacy, and side-effects are generally less.  Plus, with CK there is essentially no interruption in your normal life while you recover from surgery and then deal with surgical side-effects.

Surgery is generally not an option for any radiation patient with recurrence in the gland, but cure rates with CK for guys like me are 97-99% (equal to or better than surgery).

If you would like I would be happy to give you my CK doctor's email address.  He is arguably the most prominent prostate CK doctor in the world, and corresponded with me by email and phone extensively before we ever decied to meet, all at no charge.  I am certain he would do the same for you.  Just click on my username and send me a message.

 

hopeful and opt...
Posts: 2226
Joined: Apr 2009

http://csn.cancer.org/node/291691

 

OBJECTIVES: Stereotactic body radiation therapy (SBRT) yields excellent disease control for low- and intermediate-risk prostate cancer by delivering high doses of radiation in a small number of fractions.

Our report presents a 7-year update on treatment toxicity and quality of life (QOL) from 515 patients treated with prostate SBRT.

METHODS: From 2006 to 2009, 515 patients with clinically localized, low-, intermediate-, and high-risk prostate cancer were treated with SBRT using Cyberknife technology. Treatment consisted of 35-36.25 Gy in 5 fractions. Seventy-two patients received hormone therapy. Toxicity was assessed at each follow-up visit using the expanded prostate cancer index composite (EPIC) questionnaire and the radiation therapy oncology group urinary and rectal toxicity scale.

RESULTS: Median follow-up was 72 months. The actuarial 7-year freedom from biochemical failure was 95.8, 89.3, and 68.5% for low-, intermediate-, and high-risk groups, respectively (p < 0.001). No patients experienced acute Grade 3 or 4 acute complications. Fewer than 5% of patients had any acute Grade 2 urinary or rectal toxicity. Late toxicity was low, with Grade 2 rectal and urinary toxicity of 4 and 9.1%, respectively, and Grade 3 urinary toxicity of 1.7%. Mean EPIC urinary and bowel QOL declined at 1 month post-treatment, returned to baseline by 2 years and remained stable thereafter. EPIC sexual QOL declined by 23% at 6-12 months and remained stable afterwards. Of patients potent at baseline evaluation, 67% remained potent at last follow-up.

CONCLUSION: This study suggests that SBRT, when administered to doses of 35-36.25 Gy, is efficacious and safe. With long-term follow-up in our large patient cohort, we continue to find low rates of late toxicity and excellent rates of biochemical control.

Written by: 
Katz AJ, Kang J.   Are you the author? 
Flushing Radiation Oncology Services, Flushing, NY, USA; Department of Medicine, NYU Langone Medical Center, New York, NY, USA.

 

Reference: Front Oncol. 2014 Oct 28;4:301. 
doi: 10.3389/fonc.2014.00301

PubMed Abstract
PMID: 25389521

UroToday.com Prostate Cancer Section

stoniphi's picture
stoniphi
Posts: 54
Joined: Mar 2015

Tc3 from an 11/12 biopsy, MRI, bone scan, 12/12 bad cores, PSA=11.1, G=7(4+3), 2 projections,1 vesicle contaminated. DaVinci RP 12/12, ADT 1/13 - present, ~80 Grey of external beam Cyberknife radation over 40 sessions 6/1/12 - 8/1/12. Age 64.

 

"Graduate" advanced degree black belt (North American Taekwondo Association), 7 mile a day 7 days a week runner, weight training, yoga, pro chef grade dietician/cook...general health nut. Buddhist, married.

 

The radiation side effects are supposed to max out by 3 years after treatment termination, then they go away somewhat over a period of decades. Yes, getting the chemo hurts, the pump is a bore, loosing 4 cm of dick was initially uncomfortable, better now.

 

The most noticible radiation side effects were/are a burning sensation on urination, somewhat explosive bowel movements, and slightly more painful  hemorhoids. There are also 'radiation shits' pretty much as my radiation oncologist warned me of, with cramping & straining for tiny results. Lots of mucous discharge.

 

It took me a few days to recover enough in hospital to be ready to go. It took the hospital a couple more to get me out. I walked laps around the cancer ward floor (as directed) with a catheter and a pole with my IV hookup. I quit counting after I got past 100 laps/day. I then went home to my couch and my bottle of Captain Morgan rum for 1 week until they took out the catheter. The next morning I walked 6 miles. Within 2 weeks I was slowly running 6 miles a day. For the last 2 months I have been back up to my normal 7 miles a day, though I am slower due to the Eligard.

 

No, gaining belly fat, loosing muscle mass, sudden washes of nausea, hot flashes, mood swings and all of the other bothersome side effect of the chemo are not much fun, but they will go away as the stuff starts to clear my system in 3 - 5 months.

 

I hope to regain my sexual desire and function despite having had a portion of my nerves removed due to perinueral invasion of those. I believe that I have improved my chances of living a much longer life due to my choices. This based on my personal circumstances.

 

Surgery hurt.

EBRT gives some uncomfortable side effects that may take years to show up.

ADT for 2 + years is a stone cold drag.....

...but allowing the PCa to metasticize when there is a very good chance it will do that would mean giving up my life as I know it, to me. In short, my attachment to life is greater than my attachment to penis length, ED or fear of pain.

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3329
Joined: May 2012

Uh-Oh,

In reference to hopeful and optimisitc's article above on Cyberknife assessments:

Be aware that CyberKnife is a form of hypofractionated radiation, which simply means Image Guided (IGRT or IMRT) radiation delivered in fewer (but larger) individual doses.  IGRT and IMRT typically take 30 to 40 treatments (daily visits) to deliver 76 or more Gray (abbreviated "Gr") of radiation, where as Cyberknife can be done in one week or so. The radiation oncologist with whom I discussed RT proposed that I get IGRT over 38 sessions, for 76 Gray, for instance (2 Gray per treatment).  He told my wife and I that he is not a CyberKnife fan, for reasons that he mentioned to us. 

Everything I have read in Journal articles says there is essentially parity, or equivalence, in IMRT/IGRT, and Cyberknife.  Both are excellent choices, with excellent outcomes.  I am in no way "against" CyberKnife, just sharing what I have come across.

Dr. Peter Scardino, head of Surgery at Sloan-Kettering Cancer Center, is seemingly not a Cyberknife fan. He writes in his Dr Peter Scardino's Prostate Book (Revised ed, 2010) the following:

Cyberknife is a commercially produced, proprietary (private) technology, meaning it is a particular company's brand of IMRT.  It is not, as the name implies, a surgical proceedure, and no knife is involved. The company that developed and is aggressively marketing this device uses it to administer hypofractionated radiation doses, meaning the therapy is delivered in a few weeks instead of the standard eight or nine weeks. Knowledgeable radiotherapists prefer standard IMRT to the CyberKnife variation for prostate cancer therapy.   (Page 335)

 

.

 

Swingshiftworker
Posts: 1013
Joined: Mar 2010

Scardino's comment was made in 2010 -- 5 years ago -- and IMO his opinion is severely outdated and does not take into account recent studies of CK's effectiveness.

While CK and IMRT/IGRT both deliver radiation in hypofractionated doses (CK in fewer and higher doses than IMRT/IGRT) the greatest advtange of CK is the superior mapping technology used to reduce the potential for any collateral tissue damage caused by radiation delivery.  The radiation levels used in CK was based on the delivery of radiation via HDR BT -- high dose rate brachytherapy.  CK's techonolgy allows 3D mapping and radiation delivery to the sub-mm level which almost entirely reduces the possibility of such damage which in turn substantialy reduces the possibility of ED, incontience, etc, which are more likely with HDR BT and IMRT/IGRT because of their mapping/delivery limitations.

Bottom line, even prior studies indicate that survival rates are not better w/CK than w/surgery or IMRT/IGRT, the quality of life benefits of using CK (substantially reduced likelihoold of ED, incontinence, etc. over other methods) is reason enough to choose CK over the other technologies.

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3329
Joined: May 2012

Most commonly, IGRT is fractionated, but not hypofractionated.  My radiation oncologist offered me "Calipso" radiation delivery, which is a Varian product, a competitor to CK. You and I discussed these two some time ago, if I recall correctly.  Calipso claims to be "4-D," with delivery acaccuracy about the same as CK.  Obviously, both are great products. I'm delighted it worked well for you, and many others, both in PCa, lung, and brain cancers, and any other cancers that thy are now commonly utilized against.

 

hopeful and opt...
Posts: 2226
Joined: Apr 2009

 

SBRT delivers radiation in hypofractionated doses, Cyberknife is one of the delivery systems for SBRT.. There are other delivery systems such as Novalis. So there are delivery systems from various companies that deliver SBRT. The results of these delivery systems are comparable. Basically these delivery systems must be very precise, to avoid damage. SBRT was first done  about 9 or 10 years ago by C. King while he was at Stanford. At that time of development,  he used the Cyberknife system.He now uses the Novalis system. As indicated in the above study by Katz that now shows 7 years of results, SBRT using Cyberknife  is very successful. There are other studies that also include results of other SBRT delivery systems that provide similar results. For the most part there are four or five sessions of delivery of hypofractioned radiation that are delivered. SBRT achieves comparable results to IMRT,in a shorter more convenient time,  since SBRT is hypofractioned, Eventhough there is more radiation given in each SBRT session,  there is also less total radiation  that are delivered to each patient when compared with total amount of radiation by IMRT type systems, which may very well  be a long term benefit. Of course more time is required to measure this.

There are variations of IMRT with various names that delivers fractionated radiation over approximately eight weeks or so with approximately 40 sessions. As I understand, although  IMRT is very precise, it is not as precise as SBRT.

stoniphi's picture
stoniphi
Posts: 54
Joined: Mar 2015

...was a machine head that revolved 359 degrees around a table upon which I lay. A cast of my lower body was attached to the table and the machine head revolved around me. They tatooed 3 blue dots on me (front and both sides at waist level) which were targeted by green lasers when I laid down in my body cast. I wore my own sweat pants and a T shirt. No metal allowed in pockets. There was a Cartesian grid in red lasers as well, projected from above onto the table. I was told there were 11 separate x - ray generators that acted in harmony with each other and a system of shades and reflectors with varying intensity. I took a close look at the shade setup inside the machine head. It was exactly what they said it was and appeared to be quite capable of targeting a 3 - D space smaller than a millimeter in diameter deep in your body up to maybe 10 centimeters wide. The computer system that ran things was very main - frame large and current, everything was top - notch equipment. They started out with a 3 dimensional image of my internal layout and I was adjusted to exactly the same position every day. I got to pee right before they set me up so I was comfortable. I laid down and shut my eyes, the table slid under the machine head, it fired up went around me once then shut down. They slid the table back out and I opened my eyes. Done for that 2 Gy session, usually there and back home in about an hour.

 

I was aware the the number 1 side effect of the radiation treatment is ED. Numbers 2 and 3 are the urinary and bowel difficulties I have previously mentioned. Others are also possible, but less likely. You will wait 3 years to discover what all the side effects of the radation will be. Your relationship with those side effects will continue pretty much as long as you do after you receive the radiation treatment.

 

It is said that a cut will heal relatively quickly while a burn takes a very long time by comparison. Surgery is the cut here and radiation is the burn.

Being a relatively scheduled person, I just scheduled the daily treatments into my days for 2 months, enjoyed the short ride and meeting my fellow patients. Some were afraid, I was not, so I tasked myself to cheering everyone else up as best I could. That worked out well for all of us.

 

There is so very much more to life than the size of your penis and/or having/not having ED. A year or 2 invested in oneself is not such a long time. If it is a cost, then there is a commensurate profit as well, our task is to find and appreciate that profit. While it is important to know of the possible hazards of any of these treatments, it is not beneficial to dwell on them too much.

 

 

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3329
Joined: May 2012

Stoniphi,

I have found that I agree with virtually everything you write, especially as regards attitude and keeping the "big picture."  I will be 60 next year, and cannot fathom the concern many men my age or older have with "penis length" and such. Who are we kidding ?  Me -- no one !

stoniphi's picture
stoniphi
Posts: 54
Joined: Mar 2015

It took me along time to decide to particpate in this forum. I thought I should try and bring some cheer and perspective to what can be a very frightening and sad expereince. Being alive is so much fun that the treatment side effects and such should not bring us down too much. Laughing

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3329
Joined: May 2012

Stoniphi,

I love the Uncle Fester pic  !

My current pic is from the same era of vintage TV: Voyage to the Bottom of the Sea.  The show began in 1961, or around the time the nuclear Navy was beginning in real life.   I like it, having been a sub sailor for many years myself. 

I am very glad you made the decision to join here,

max

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