Decision Help Requested

JLaw725

I'm 44 with stage 1, gleason 6. (5% in only 1 biopsy of 10) Was leaning toward DaVinci RP, but met with Radiation Oncologist today, and now I'm confused again. Still leaning toward the RP, but does anyone have any help they can offer in what made you choose either seeds or RP? Both Doctors are leaders in their field in Colorado (were recommended by doctor at Dana Farber in Boston) and actually work together. But both have their obvious preference to their specialty. I, like all of you, still have to make my own decision.

Pro's and Con's for both. Thoughts? Advice?

Thank you all for taking the time to respond.

Jim

tpelle

I had the option of seed implants but finally decided on surgery. Frankly, one of the books which helped my decision was "Seeds of Hope" by Dr. Mike Dorso a doctor in Northern California who decided on seeds. The hell he went through making the decision seemed overwhelming and will either help you go for seeds or stay with your first decision. I have heard from a friend of his that he is happy with his decision now several years later. It's a fast read. Check

http://www.prostatepointers.org/prostate/prof/mdorso/


which will give you quite a bit of his writing on line. Then you can order the book if you want more.

Best of luck in your decision making.

rogermoore

Hi Jlaw,

The decision you will be making will affect the rest of your life. Don't rush into this and be totally comfortable with whichever decision you do make.

I chose RP and have been extremely fortunate in the results. The primary reasons I selected RP was:

1. I Wanted to be totally free (if possible) of the disease. I didn't want to risk one cancer cell remaining in my body.

2. Had I elected to have implants, and one of the cells escaped the treatment and resurfaced, surgery would then be extremely difficult or impossible.

Good luck,
Roger

MarvS

Hi Jim - I was 39 when I was diagnosed with similar situation; I'm 44 now. To make a long story short, I chose EBRT combined with seeds. Why?! I belonged to a support group and was scared by stories of others who had RP and had to also get EBRT later beacause their PSA started rising again. Of course I have no idea what their situation was compared to mine, but I felt the duel approach offered me the best chance for success. It has been 3.5 years since treatment and my PSA is .09. Things are going well, with one problem - I have what they call a rare complication to the radiation (it is important to note that it was most likely the result of the EBRT and not the seeds). I now have an extremely small fibrotic bladder that will cause me to have surgery to substitute the bladder. The point of me telling you that is ONLY - be sure you fully understand the future impact of either procedure (e.g., no one told me of this potential complication). Also, I want to say that I would have chosen seeds alone, but I waited and my PSA rose all of a sudden so I went with the duel treatment. I am fully confident the seeds alone would have worked if I had done it at the right time. Anyway, my decision was based soley on the chance to kill the cancer, not on the complications that I knew could occur. Focus on that and I'm sure you will make the right decision. I had no one my age to confer with then, so feel free to stay in touch.

Photon

Hi Jim

I know decisions of this nature are difficult. I had Gleason 7&8s in all 10 cores and was age 62 so had to go for one of the more radical treatments - RRP and then EBRT when the psa wouldn't go away.

However in your case 44, 1 core out of 10, prostrate cancer being slow growing..I would have tried alternative therapys for 6 months....Essiac tea, no diary, organic food, off the booze. If you can get hold of a book called 'Your Life is Your Responsibility' by Prof Jane Plant. She had breast cancer and went through all the treatments for that disease and still had lumps. She then decided to do her own research into breast and prostate cancers and she cured herself. Both cancers are hormonal so the causes are similar.

All the treatments we have for prostate cancer have nasty morbidities it might be worth giving alternatives a try for a short period.

Hope this hasn't confused the situation more. All the best. Photon

william1

Hi J,
I, too, am faced with which treatment option to pursue. Our diagnosis is simular. Next week I'm scheduled to go to Emory University for another examination (second opinion) to verify my Gleason score and stage.
My urologist recommends r/p but made an appointment with the radiologist because he said he was obligated to inform me that radiation was also an option. He also advised to educate myself in order to be convinced my choice of treatment will be the best option for me. I respect his advice, but, how on earth does one possibly educate himself on the many options and side effects of the many treatment options available. It seems the more I read the more side effects I discover and the more confused I get. I guess the most important information I have discoverd thus far is to continue reserching this subject and to make a list of all the questions that I have so I can discuss them on my next visit.

At first look, r/p appears to be the most curable option if the cancer is confined within the prostate. After reading the discussions on this site it seems r/p is not as curative as I first thought. (Residual cancer cells can become a bummer) Radiation also sounds like a viable option. Again, read the many discussions on this site about the possible complications of this option.

Am I afraid,... darn right I am, but, on my next visit to the doctors office I'll carry my list of questions with me and when I leave I intend to be better informed. I owe this much to myself and family.
Best of luck and God Bless,
william

JLaw725

Thank you all for your thoughts. I really appreicate it.
I'll let you know what I do, and how I progress.
My thoughts and prayers with you all.

Jim

JohnW55

william1 said:

Hi J,
I, too, am faced with which treatment option to pursue. Our diagnosis is simular. Next week I'm scheduled to go to Emory University for another examination (second opinion) to verify my Gleason score and stage.
My urologist recommends r/p but made an appointment with the radiologist because he said he was obligated to inform me that radiation was also an option. He also advised to educate myself in order to be convinced my choice of treatment will be the best option for me. I respect his advice, but, how on earth does one possibly educate himself on the many options and side effects of the many treatment options available. It seems the more I read the more side effects I discover and the more confused I get. I guess the most important information I have discoverd thus far is to continue reserching this subject and to make a list of all the questions that I have so I can discuss them on my next visit.

At first look, r/p appears to be the most curable option if the cancer is confined within the prostate. After reading the discussions on this site it seems r/p is not as curative as I first thought. (Residual cancer cells can become a bummer) Radiation also sounds like a viable option. Again, read the many discussions on this site about the possible complications of this option.

Am I afraid,... darn right I am, but, on my next visit to the doctors office I'll carry my list of questions with me and when I leave I intend to be better informed. I owe this much to myself and family.
Best of luck and God Bless,
william

I had the rp on aug 18 with the da vichi. Something went wrong and the next morning they performed emergency surgury because I was bleeding to death, lots of damage. Be sure you choose a doctor who will use nerve sparing technique. Idid not and the after effects have been a nightmare. My Gleason scores were 8's and 9's, and after the surgury I was informed that the cancer had already come out of the capsule. Tell the doctors you want to know these things. They dont like to tell you everthing and can destroy your quality of life when it is unnessary. get many opinions and choose a doctor who can preserve as much of you as possible. My body is so damaged that I wish I never had the surgery so that I could have had a few years of quality life. Choose wisely my friend may the Lord guide your decision. I will pray for you.
John