Choosing Cyberkife, awaiting insurance OK

Swingshiftworker said:

You Made The Best Choice!
IMHO, you made the best choice for the treatment of low risk PCa. It is, as you have said, really a "no brainer." CK is the most precise method of treating CK currently available and is definitely not TOO aggressive, given its effectiveness and the lower risk of significant side effects associated w/its use.

I had CK in Sept 2010 at UCSF (but made the decision to go w/CK in April 2010 only 3 months after I was diagnosed w/PCa). Had to wait until July 2010 in order to switch from Kaiser to Blue Shield on order to get CK and then had to wait 3 months to get a place in the machine.

No urinary or bladder irritation and no ED. The reason my PCa was discovered in the first place because of my complaints about of urinary frequency which I thought were just due to BPH (an enlarged prostate). The frequency was not increased or decreased by the treatment and I still have to pee with some frequency. So, there's really been no change in that regard.

The only noticeable effect of the treatment has been reduced ejaculate volume, which is to be expected with all forms of radiation treatment. Still have some but very little ejaculate. Don't know if there's still any fertile sperm in it, but the limited ejaculate makes impregnating anyone extremely unlikely. So, if you want to have an more kids of your own, you should bank your sperm before treatment.

I was rated at Stage T1c and Gleason 6 (3+3). Only 1 core (less of 0.6 mm involved). My PSA was only at 4.5 before the biopsy in Jan 2010, spiked to 29.7 after the biopsy and fell to 5.9 in June 2010 before the treatment. Didn't take (but should have taken) another PSA test just before the treatment to get a more accurate baseline. My PSA has continued to vacillate following treatment from a high of 12.30 in Dec 2010 to a low of 3.03 in Mar 2011 then back to 5.07 in June 2011 then back down to 3.56 in Sept 2011. Needless to say the variability and relatively high continuing level of my PSA scores is disconcerting.

There are studies that indicate that a reassessment to determine if the treatment has failed is mandated if the PSA level does not drop to between 1-1.5 two years following treatment. That'll be in Sept 2012 for me and, if my PSA level does not drop to that level by then, I'll be asking for an endorectal MRI and a MRSI (magnetic resonance spectroscopic imaging screening to determine the then current status (and location, if any) of the PCa.

Others, like Kongo, have had much better success w/their PSA testing and have achieved PSA scores below 1 within 3-6 months following treatment. Hopefully, you'll have the same experience as they have but don't be surprised if you don't.

Good luck!

robert1 said:

The World of Choices
Hello jackie:

Given your low risk staging, you have the world of choices at your disposal. I assume you checked out PBT, IMRT and Brachytherapy also. CK is documented as a solid choice for true low risk patients. Impressive cure rate stats with relatively low side effects.

Good luck!

Swingshiftworker said:

Damage to Ejaculatory Duct?
Other than infection, blood in the ejaculate is the most common problem following a trans-rectal prostate biopsy. The bleeding usually resolves itself, as it did in my case and fortunately didn't have any infection -- the cirpo they gave me to take before and after the procedure worked.

Wasn't aware of this before but a quick Google search also revealed that a biopsy can also damage the ejaculatory duct thereby reducing ejaculate. Didn't have that problem myself but this may be the problem you are experiencing which "should" also resolve itself before treatment.

See the following for a brief discussion of the issue:http://www.medicalnewstoday.com/releases/112975.php

I did not experience any pain or discomfort following my biopsy but others have reported otherwise. So, some "strains" around the base of your penis (near where the prostate is located) would not be unusual. After all, the urologist just poked 12 holes through your rectum and into your prostate.

However, you should not be experiencing any significant pain or bleeding; pain is often associated w/infection. Listen to your body and, if anything, unusual is happening return to the doctor (or emergency room) ASAP to get an assessment of the problem.

Good luck!

hopeful and optimistic said:

Active Surveilance for delayed treatment
Based on your biopsy results, I would consider active surveillance as a treatment option. It may be that you have an indolent cancer, that is not likely to spread, so an ative treatment may not be necessary. I suggest that you see a doctor that specializes in this treatment option, preferably at a major center of excellence. I have been doing this for since, 3/09. You may click my name to see what I have done.
As far as PSA which is an indicator only, I wonder if you have any other data points that you can provide?

Also I wonder what the size of your prostate is? There is ratio psa/prostate size the lower the better.....0.15 or better.

I also suggest that you have an endorectal MRI (combined with a spectroscopy) to see if there is extra capular extension, stage your cancer, see if there is an indication of cancer in one lobe or two and how much cancer.

Did you have a second opinion from an independent expert pathologist on your biopsy slides...........this is of the upmost importance....it is CRITICAL.