newly diagnosed- which way do we go?

nybob

I'm 54 and have been diagnosed with early stage cancer. PSA is 3.7, Gleason score of 6 with one of eight biopsy samples having 26% cancer cells. My urologist referred me to Dr. Louis Potters at NY Prostate Institute for seed implant radiation. I am not a fan of surgury(ie RP) but am interested in hearing thought process of anyone who has been down this path.

RLR64

My husband was diagnosed last March with prostate cancer in both lobes of the prostate. His Gleason score was a 7 (4+3) and he had the DaVinci, Robotic surgery in June. His surgery went well, the Urologist spared both nerves, he was totally able to control his urine in two weeks and regained sexual functioning in about two months. It was a God-send to us and he didn't have to be off work long, either. Everyone has to do the research and make his own decision but this surgery worked well for my husband as far as regaining functioning and not missing much work, etc. I understand it also offers a magnified, 3D view of the organs, cancer etc. as they do the surgery. The robotic arms they use to perform the surgery are very precise and able to manuveur much better than human hands and there is less blood loss (almost none) and easier recovery. I wish you a short recovery time and great health no matter which way you chose to go!

kalar7856

Hi nybob,

I was 45 and had a PSA of 3.5 and a Gleason of 6. One of eight of my biopsy samples showed cancer as well. I know guys who have had up to 70% cancer TOTAL in the prostate and did well with the RP.

I opted for a RP and am so glad I did.

The seed implants damage the lining of your colon and after 10 years you can experience tears and other problems. You are too young for radiation in my humble opinion. Did your doctor tell you if the surgery doesn't get it all you can still do radiation? If you do the radiation first, surgery is no longer a treatment option?

I had total urine control immediately and normal sexual function after 3 months.

For the record I thought the biopsy was worse than the surgery. ..smile..

Best wishes,
Kalar7856

fcatroneo

I agree with Kalar. I am 60 years old and had my RP on 12/27/07. I have no problems with incontinence or ED. You are young and should consider RP or Robotics. What is very important is the experience of your doctor. My doctor (at Emory Hospital in Atlanta) has performed over 4,000 PC surgeries and still performs 4 every week. With that kind of experience, you should not worry. My PSA was 4.1 and a Gleason score of 6. With the right doctor, you will be cured of the disease. Good Luck

nybob

kalar7856 said:

Hi nybob,

I was 45 and had a PSA of 3.5 and a Gleason of 6. One of eight of my biopsy samples showed cancer as well. I know guys who have had up to 70% cancer TOTAL in the prostate and did well with the RP.

I opted for a RP and am so glad I did.

The seed implants damage the lining of your colon and after 10 years you can experience tears and other problems. You are too young for radiation in my humble opinion. Did your doctor tell you if the surgery doesn't get it all you can still do radiation? If you do the radiation first, surgery is no longer a treatment option?

I had total urine control immediately and normal sexual function after 3 months.

For the record I thought the biopsy was worse than the surgery. ..smile..

Best wishes,
Kalar7856

Hi kalar,
Thanks for the response. Did you have a traditional RP or was your procedure done laproscopically or robotic. Based on comments I reading on these chats, robotic seems to have successful outcomes. I live in NY and there are two or three top notch surgeons that specialize in the proceedure.I was also under the impression that surgery was an option after radiation, but have been corrected by my urologist that as you say it is not. That has changed my views on radiation as an option. I also had not heard about the long term effects of the seeds, although that is one of my concerns. Do you know someone who had these problems after having the seeds implanted? Thanks.

nybob

RLR64 said:

My husband was diagnosed last March with prostate cancer in both lobes of the prostate. His Gleason score was a 7 (4+3) and he had the DaVinci, Robotic surgery in June. His surgery went well, the Urologist spared both nerves, he was totally able to control his urine in two weeks and regained sexual functioning in about two months. It was a God-send to us and he didn't have to be off work long, either. Everyone has to do the research and make his own decision but this surgery worked well for my husband as far as regaining functioning and not missing much work, etc. I understand it also offers a magnified, 3D view of the organs, cancer etc. as they do the surgery. The robotic arms they use to perform the surgery are very precise and able to manuveur much better than human hands and there is less blood loss (almost none) and easier recovery. I wish you a short recovery time and great health no matter which way you chose to go!

Hi RLR64,
Thanks for the response. Where did your husband have his surgery performed and how experienced with the DAVinci system was the surgeon? what other tratments did you consider before deciding on surgery?

lardog

NYbob
Sorry to hear of you plite.
However you are in NY and the best surgeon in the country is at Presybeterian hospital in Manhatten Dr Tewari. Be ware of people making claims of how great their Doctor is and how many surguries they have done. Most surgeons will give you the gross amount of surgries however they may or may not be the chief surgeon. There are usually two to three surgeons in the operating room and most claim the surgery. I had robotic with Dr Tewari and will ot waste the print to alledge how many surgeries he has completed. I think you will be making the most important decision of your life regarding surgery. It's is not like buying a car and if you make a mistake you will only have the problem three to five years. I was 52 when diagnosed and now 53. Had surgery last July 2006 and would make the same decision today.
Spend some time and go and google robotic prostatectomy. You will find over 50 % of the articles about Dr Tewari, his teaching and his work. He personally does each and every surgery and from the time I have known him has done 6 to 9 surgeries a week. Look up the Da Vinci Robotic machine site, it will tell you where and what hospitals have the machine ad what doctors are certified. Then do you research on the doctors. Another words don't read or believe someone claim here it maybe as all polls slanted to what side.
At you age you are now a canidate for the seed in my opinion and the opinion of several Doctors that I spoke to. If you undergo radiation now other procedures will not be available to you in the future if the cancer comes back. Long term impontence and contiency is a problem years down the road. If you need any more info send me a private email and I will give you my email address of phone number. I am not a Doctor just a patient who did a lot or research. Best of Luck.
Lardog

rogermoore

nybob,

Like the majority of the others responding, I elected to have surgery because I wanted to be rid of the cancer, if possible. Also, the fact that once radiation had been done, the surgical option later had been eliminated. At the time of my surgery (2001) the primary method of surgery was conventional incision in the lower abdomen or perineal. Even with the surgery then, with about a 6" incision, recovery was very painless. More uncomfortable than painful. Regained full continence and sexual activity within a month following surgery.

Feel free to contact me via private e-mail with questions you don't want to post.

Best of luck with your decision,

Roger

Bamfam

NYBob-

Diagnosed in January. Elected for RC - in a few weeks. Went for a third opinion with Dr. James Eastham at Memorial Sloan. All three urologist recommended getting the prostate out. I chose RP with a guy who has done 1500+. Why?? It just seems to make sense to get the gland out. Also -- warning about radiation damage to surrounding organs didnt help. Especially bowel -- two family members had colon CA. Didnt pick robotics since they didnt have the same years and amount of data on cure rates.

Do your homework -- your numbers are good -- either way, you should be OK.

Bob

forbes

Sir: I am 62, Gleason 6 pre-op pathology, Gleason 7 post-op. Diagnosis first week Jan '07, surgery last week Jan '07. NY Hospital 1 night, walked one mile first day, and three miles every day thereafter. Not incontinent once! Minimal pain. At work after two weeks. All thanks to robotic laproscopic surgery and Dr. Ash Tewari at NY Hospital. Would do it all over again.

Tasch

nybob,
I am 45 and live on LI and was diagnosed last Aug.My PSA was 5.8 and 30% of the prostate tested positive.
Like lardog, I went to the BEST surgeon around-Dr Ash Tewari.
I think you owe it to yourself to give him a call and consult with him on it.Any Dr you speak with has probably been trained by Dr Tewari anyway, so why not go to the best?
I would be more than happy to give you my contact info and speak with you about it-if you like.
At 54, you are way to young to be dealing with seed implants.
I wish you the best in whatever choice you make.

Tasch

forbes

My advice: talk to Dr. Ash Tewari at NY Hospital. Tewari has performed over 1300 robotic laproscopic prostatectomies .

renobob

nybob said:

Hi kalar,
Thanks for the response. Did you have a traditional RP or was your procedure done laproscopically or robotic. Based on comments I reading on these chats, robotic seems to have successful outcomes. I live in NY and there are two or three top notch surgeons that specialize in the proceedure.I was also under the impression that surgery was an option after radiation, but have been corrected by my urologist that as you say it is not. That has changed my views on radiation as an option. I also had not heard about the long term effects of the seeds, although that is one of my concerns. Do you know someone who had these problems after having the seeds implanted? Thanks.

Hello nybob:
I had the radiation seed implants done one week ago on May 22. My 1 week follow up appt is today.
So far...so good! Everything normal, but...sore and much discoloration in the pubic area!