RP or Seeds

mec1971

I learned several weeks ago that I have PC. My PSA is low, 1.34; Gleason score is 3+3=6 and not palpable. I am 50 years old. I have been wrestling with the decision between seed implants or rp. My concern with seed implants is the lack of long term data. I seems that at my age, rp is the best method to 'cure' my cancer such that I can live a long healthy life. Any comments will be appreciated. Thanks to those who respond!

M

Rwharrington

Well, I'm certainly no doctor, and that's your best resource, but I'm 48 and was diagnosed with PC one month after my 48th birtday. I did a lot of research into prostate cancer, and treatment alternatives. Based on my reading I had decided to go with a radical prostatectomy even before my doctor recommended it. The factors I considered were: my psa score was low (2.4, after 7 consecutive years of 1.2), and a Gleason score of 6. I have a history of pc in the family, and had been tested since my 40th birthday - so for me, the psa doubled after 7 consistent years. If this was my first psa test,I wouldn't be so quick to go for treatment because the "danger" psa level is 4.0. I also understand (perhaps incorrectly) that if you have seed implants and the cancer recurs, surgery is no longer an option - or at least a very risky option. None of the material I read however, elaborated on just why. The general recommendation for a man with a 20 year life expectancy or greater and pc that is most likely confined to the gland and in good health is rp.
I had rp in March of this year, and am doing very well. I'm dry, (no erection yet though), but am happy with my decision.
It's not an easy decision, but in the end, you have to go with what you believe is best for you. For "youngsters" with pc like you and I, I personally believe the worst decision is "watch and wait" because we have the best chance for long term survival.

rogermoore

M,

I'm surprised you discovered PC with such a low PSA count. You must have had other symptoms,or is there a history in your family? In any case, if you have not already done so, I would recommend a second opinion.

Two and one-half years ago (at age 58) I was diagnosed and underwent surgery. I elected that route because of the desire to be assured (as much as possible) that once the procedure was completed I would be rid of the cancer. My surgeon also informed me that if I elected the "seed" route, and the cancer recurred, surgery would no longer be an option.

From what I have heard on this page I was extremely fortunate during my recovery. I suffered nominal leakage for a few weeks and erections began recurring within two weeks following removal of the catheter. Sexual activity was resumed within one month following surgery. I have not been required to resort to any assisting drugs or devices since surgery.

If you have any questions please don't hesitate to contact me via the e-mail address on my web page.

Good luck with your decision.

Roger

warren612

I was 52 when I discovered PC. Every male in my family, except my younger brother has had it. My PSA was 3.2 and my Gleason was 5. I talked to 6 Dr.'s in all. Maybe a little overkill. But the one that convinced me to have surgery was the radiation oncologist. He said because of my young age I would need 42 days of direct beem radiation, then have the seeds put in. With so many years left in my life they need to be sure they get rid of it. All that radiation scared the hell out of me. I said to him what happens if it comes back? He said not much chance of successfull surgery. He said take a piece of bread , put a piece of cheese in it, now take the cheese out. Pretty easy. Now he said take the two pieces of bread, put a piece of cheese in it, put it in a microvave for 20 seconds, now try and remove the cheese. Pretty much impossible. That made me decide on surgery. I am happy with my decission. It's been 15 months. It took me 7 months to dry up and I used Viagra for a while, that didn't work to well for me. I had my Dr. give me an injection which gave me an erection and after that it works fine. Get some 2nd and 3rd opinions, talk to guys who have had the sugery and that may help you with your decision. Good luck. If you want to discuss more e-mail me at william.f.warren@comcast.net

Sailor1988

I know what you're going thru. Here's my (our) story to give you an idea of the factors that went into our decision, with the hope it might be of some help to you as you make yours. On November 20th, I was one year post op from a radical retro-pubic prostatectomy. It was on my 60th birthday that we got the news; PSA was 10.9, Gleeson 3+3=6 and not palpable. We had conferences with 3 different doctors and looking at all available information, it appeared that the cancer was probably confined to the gland. Based on that, we wanted to have the cancer completely gone, so my wife and I decided to go with the surgery. We were well aware, before hand, that we could face incontinence and impotence, so it was important to us that we make the decision together.

At this point in our recovery I have a little leakage when doing very heavy lifting and normally wear a small pad for safety when away from home. A small inconvenience but certainly manageable. Erections are slowly improving, though Viagra isn't as effective as hoped, so tomorrow we'll be trying Levetra to see how that works.

The bottom line is that even with the problems we're facing, we would do nothing differently to have the peace of mind that the cancer seems to be gone (PSA's .002 so far).

As mentioned in another post, it's a difficult decision, so you have to go with what you ( and your partner) can live with.

The best of luck to you, whichever way you decide.

carmenf

My husband's surgery was conducted this week. He is 57. He elected surgery because of his relatively young age and his personality. He wanted it gone! and know it was gone. He has been pleasantly surprised how well the surgery went. He has had very little pain....more of a discomfort. He has had some swelling and bruising, but, again, just discomfort. The cathater is a nuisance and also uncomfortable. His PSA was also border line (4.6) and his Gleason was 6. Once removed they discovered the cancer to be more widespread than thought and it had already penetrated the prostate shell. So he will need radiation once he heals from the surgery. Hope our recent experience helps.