Newly Diagnosed

111575

First, I would like to thank everyone who contributes to this site. As a newly diagnosed prostate cancer member the discussions on this site have been very helpful.

I received the news of my cancer on July 24 and have been researching info on prostate cancer for the last two weeks. I feel like I'm on information overload and I'm running out of time re selecting the appropriate treatment and surgeon.

My clinical staging info is as follows: PSA 5.5; 7 out of 12 cores were cancerous (2/3 were in the right mid section (30%) and 3/3 in the right apex section (70%) section); Gleason score 7 (3+4);perineural invasion; MRI's and bone scan show no signs of cancer. I'm 53 years old and in good shape. No prior experience with cancer and no family history of prostate cancer.

The surgeon I'm working with says I'm a candidate for radical surgery and he only performs the perineal procedure which he maintains is better than the retropubic procedure because there is less blood and it provides better results re urinary incontinence (easier to see all the moving parts necessary to be reconnected). I asked him why the retropubic is performed more than perineal and he said it was because the perineal is more difficult to learn than the retropubic and therefore there are less doctors who opt to specialized in it.

I was also told that since a large part of my lower right apex was cancerous (70%) that it was likely that I would have to have the nerves removed on that side but I might still be able to keep the left side nerves.

If anyone has any comments/observations re the following questions I would greatly appreciate it:

(1) pro's and con's of perineal versus retropubic (probably robotic)??

(2) Any experience with Dr. Uzzo at Fox Chase Cancer Center?? I'm looking for a second opinion.

(3) What, if anything, can I take from the fact that I have perineural invasion re trying to predict whether or not the cancer has spread beyond the prostate capsule??

(4)Does anyone have experience with sural nerve grafing?? Any advice??

(5) Is there anything else (I'm saying my prayers) that I should be considering or following up on??

Thank you all so very much.

shipjim

Hi, I was diagnosed in Jan 2006, had Da Vinci Robotic in Feb 2006, was playing golf in about a month.

The surgery you described was one I looked at and it looked like it HURT!!! So did the other so I used the Robot cause I'm chicken.

Went in at 8am, was walking around by 3pm and drove home the next day. Pain never made it to 2 on 10 scale.

I was 3+3 and had no nerve or lymph gland involvement. I was 58 and healthy and had/have a great attitude. Am now virtually continant, except for lifting or sneezing (eating beans is bad too). Do your Kegel excercises starting now.
Still have problem with impotency but am using the Osbon Pump to stimulate blood flow plus viagra. Still early I'm told my so many to wait a year on that.

Biggest problem I've had this year is achilles tendon surgery in May, now that was depressing but it too is better, I just returned from a 3 week fly fishing trip in Colorado. Just wore extra pads and carried them in my cargo pants pockets.

As long as you wake up on the top side of the earth, it ain't all bad.

Stay in touch, jim jacobs

111575

shipjim said:

Hi, I was diagnosed in Jan 2006, had Da Vinci Robotic in Feb 2006, was playing golf in about a month.

The surgery you described was one I looked at and it looked like it HURT!!! So did the other so I used the Robot cause I'm chicken.

Went in at 8am, was walking around by 3pm and drove home the next day. Pain never made it to 2 on 10 scale.

I was 3+3 and had no nerve or lymph gland involvement. I was 58 and healthy and had/have a great attitude. Am now virtually continant, except for lifting or sneezing (eating beans is bad too). Do your Kegel excercises starting now.
Still have problem with impotency but am using the Osbon Pump to stimulate blood flow plus viagra. Still early I'm told my so many to wait a year on that.

Biggest problem I've had this year is achilles tendon surgery in May, now that was depressing but it too is better, I just returned from a 3 week fly fishing trip in Colorado. Just wore extra pads and carried them in my cargo pants pockets.

As long as you wake up on the top side of the earth, it ain't all bad.

Stay in touch, jim jacobs

Jim, do you know how many Da Vinci procedures your doctor performed before you??

Thanks for the info.

George

stuart

Since you were at Fox Chase I assume you live around Philadelphia...I live in Philly and treated at Abington Memorial Hospital...I did get an opinion at Fox Chase...I opted for treatment via radiation...My urologist at Abington is Joseph Izes, M.D. and my radiologist is David Horvick, M.D....While you may go with surgery you may explore radiation just to learn about another approach...Dr. Horvick previously worked at Fox Chase...I was diagnosed five years ago...At the time my cancer was considered aggressive...If you ever want to talk you can leave me an e mail...

shipjim

Sorry for the delayed reply, my doc does 25/month so about 550 in the last few years. Vannatuki (sp) clinic at the Ford Hospital in Detroit is one of the best, the doc I think is Mani Menon has done thousands of these, he recommended my doc. Proficiency in this starts at about 50 operations. jj

mullet

just had it done last weak im up and around fishing some .pacing but still theres more work to be done

rocco0123

stuart said:

Since you were at Fox Chase I assume you live around Philadelphia...I live in Philly and treated at Abington Memorial Hospital...I did get an opinion at Fox Chase...I opted for treatment via radiation...My urologist at Abington is Joseph Izes, M.D. and my radiologist is David Horvick, M.D....While you may go with surgery you may explore radiation just to learn about another approach...Dr. Horvick previously worked at Fox Chase...I was diagnosed five years ago...At the time my cancer was considered aggressive...If you ever want to talk you can leave me an e mail...

Stuart, I too have seen 2 urologists in the area who both recommend radical prostatectomy. I have an appointment with Dr. Horvick tomorrow so I'm anxious to see what he says. Either way, it's a tough decision. I'm wondering why you decided on radiation vs surgery and how things are going for you. Thanks in advance....