Advice on Agressive Cancer

tv778

Last month I was diagnosed with prostate cancer. Since 2003 my PSA has risen from a 3.8 to a 6.1 and I have a gleason score of 8. My biopsy showed cancer in all of the six samples taken. My urologist recommended a laparoscopy prostatectomy with possible removal of the lymph nodes depending on what they find. (with possible radiation and hormone treatment after) When I went for a second opinion, a radiation oncologist felt he could cure the cancer with a combination of radiation and hormone therapy for two years. Since both may involve radiation and hormone treatments anyway, I am not sure which is better. I of course want to decide on the best solution with the best outcome, but it seems the more research and consultations I receive, the less certain I feel. I was suppose to undergo surgery in a about a week. Any advice or personal insights? Any feedback would be helpful. Thank you.

william1

TV,

I,too, am scheduled for surgery. Mine will be on Feb 08 in Atlanta. You're right it's time to get serious.

Whether to have surgery or radiation is a decision you'll have to live with. My best advise is to research till you drop. There are several studies on various treament options. Read as many as you can before making your final decision. You should be absolutly comfortable with your choice.

I'd certainly ask the radiation oncologist for the stats on his curative claims. Although every case is unique, look for cases simular to yours.
Does your urologist feel hormone treatment and prostatectomy is a curative treatment?

All of us who have chosen surgery have done so believing it offered the best option for a curative treatment.

Continue to research and make a treatment decision
based on factual information you feel completely comfortable with.

Remember the Serenity Prayer!

Good Luck'
william1

rogermoore

tv,

I'm sorry to hear of your diagnosis last month. It is really good that you have located and taken the steps to visit this site. You will find a lot of information and support from the people that visit this page.

I am a 5 yr survivor of a Radical Prostatectomy I had at the age of 58. After considerable research and contemplation of the various available treatments, at that time, I elected to go the surgical route. The logic I used was that I wanted to be completely (hopefully) rid of the cancer. With the other alternatives the Doctors treated the cancer in your body, with the intent of eliminating it. The real catch came if the alternative treatments (Chemo, Radiation, Hormone, etc) failed, the surgical option had then been eliminated. Yes, following surgery the Dr. may consider further treatment might be necessary, however at that time you would know that at least a large portion of the cancer (the origin) had been removed by surgery.

With the nerve-sparing technique having been practiced for several years now, and the Laproscopic and Robotic becoming pretty common-place, some of the side-effects have become less frequent.

Please feel free to e-mail me from this site for any personal questions you would prefer not made public. For other questions regarding all treatments post them on this site and I am sure you will receive responses.

By all means be comfortable with the decision you make, as it will affect you for the rest of your life. Once you make your decison select the surgeon, or Doctor you feel very confident in and comfortable with.

Best of luck,

Roger

bsimmons

It's a tough call. Surgeons want to operate, rad oncs want to irradiate. And you don't know what's best. You probably never will know. I was diagnosed Christmas 2004 at age 48. Chose the nerve-sparing RRP because surgery doesn't seem to generally be an option after RT. I chose the open over the laparoscopic because my urologist had >20 yrs experience with the open and only >1 yr with the robot. He prefers the open, because he can feel things by hand that he cannot with the robot.

In any case, it turned out that the cancer had already spread locally. I had surgery in March, discovered recurrence in June, started hormone therapy (Lupron) in July, and had RT Aug-Oct. My rad onc treated it very aggressively, as if I had never had surgery. I have two months of hormone therapy to go. My PSA is now <0.1, so I'm good to go, until the next PSA test, anyway.

I have no regrets about the choices we made ("we" because my wife was involved in every step); I do wish I didn't have to deal with some of the side effects, but mainly I am glad the cancer was discovered no later than it was, and that I received the excellent care that I did.

Good luck, bws

Photon

I had exactly the same histology and PSA as you - diagnosed in February 04. I went throught the same process as you listening to my Urologist and Oncologist and then wondering what to do. Let me say now there is no right answer.
My family are doctors but renal specialists at a University hospital and they did some research for me and found that a new study that showed for the first time that the operation provided the best chance of survival. So I had my retro pubic RP with all its morbidities - non nerve sparing, incontinence for 3 months. By the way although 61 I was physically very fit and was back at work after 5 weeks. I since have had salvage RT because my psa has stayed around 0.3 but has not significantly moved since March 2004 even after RT.

The only thing about surgery is that it cuts the cancer out which gives one a sense of well being that it is no longer in your body.

All the best in your decision because only you can make that.

JohnW55

MY situation was nearly identical to yours. PSA jumped from 1.7 to 6.5 in 2years.
cancer in all my cores with gleasons of 8 and 9. Had laparoscopic Aug 18 with no nerve sparing(big Mistake) Then emergency open for post op bleeding on the 19th. They tore something with the robot. MY advice, go for the open surgury, INSIST on nerve sparing. this operation is going to change your life, quality of life is important. My doc convinced me it was too risky to spare my nerves, that was a mistake. Also docs wont tell you they can transplant a nerve fro some part of your leg to replace erectile nerves. BUT THIS MUST be done at the time of the surgery. I wish you the best. Talk to some more doctors. It is your body that they are going to change, forever. John