Hello just diagnosed and very frightened

Steve1961 said:

Thanks Thanks

thanks and sorry jusr kicking myself for skipping a year I would have been stage 1 rather than 2  that’s all thanks I will just pray that it was still contained .... that’s all I can do for now 

You and I are tracking pretty much the same as what I've read from you.  I even skipped a year in my PSA screening.   I was born in 1961 as well.   PSA originaly high when I was 51, five years ago.   I most likely had my 3+4 for a couple years prior to that,   So 7 years I'm thinking at least.   I did have surgery, and my PCa was contained.  I tell you this because there is a good chance it is contained for you as well.  Also a 3T MRI eluded to that prior.    My MRI was prior to my biopsy, used to help locate it.   I'm not sure if the insurance companies care if the MRI is prior or post PCa detection.   Maybe others know, you should ask.

Heed the advice of those here.   Take some time now to research your options and pick the one that's right for you after you have learned of them. Don't get too focused on surgery immediately.  Really look at options equally now.  It may seem like it's taking forever to make a decision, but when you look back in a year, a couple months to research will seem like a blink of an eye in retrospect.   Everything you are doing now is in a heightened state, you can slow it down.  Tell yourself over and over, "I will be fine".   Because you will be.

Take care - Dan

Welcome to the club no one wants to join. Similar to Max, I was dealing with a recurring Staph infection in my prostate. It was very large, like a hot soft giant blob in my business, and completely shut down my plumbing. There was no pain, which is why PC is a silent killer, you don't know you have it. The only sensation I felt, even when the prostate was at its largest, was a glowing heat emanating from the prostate into the surrounding nerve tissue... and typically accompanying UTI urethra pain. After a barrage of antibiotics, we got it down to 250cc during the biopsy, and with daily Flomax and Cialis, was able to keep the plumbing open enough to knock out a small stream. Further treatment got it down to 197cc by the time of my surgery. The biopsy was Gleason 6 3+3, and normally a candidate for AS. But, I was in danger of the Staph infection eventually becoming resistant to the antibiotics if I continued to try and keep the prostate size down to around 200cc by treating the recurring infection with the antibios over and over again.

My point in all this is your prostate may seem big now at 55cc, but with BPH, PCa, acute or chronic prostatitis, pathogenic infection, or a combination of all these, 55cc may not be the maximum yet and you are only 56 years old, you may still have a lot of prostate fun and games ahead.

So yes I had my prostate removed, but like the guys said, the PCa had not escaped the capsule and Gleason score was low. 

But like they are saying, whether you and your doctor settle on the three types of treatment, MAKE SURE you get the best oncologist and/or robotic surgeon available. There are unfortunate cases on here that experienced side effects that others who had the same procedure did not, and if you read far enough back into the archives there is one element that the worst side effect cases usually have in common... an inexperienced oncologist or surgeon that struggled with the learning curve of the particular procedure. One patient had his colon burned by off target radiation and now has no bowel control, others have permanent incontinence from surgery. Not trying to scare you here, just trying to make sure you look out for your own best interest, and that means getting experienced professionals, not "the next guy up". Yes, everyone has to learn from the beginning, but why should you be their practice dummy.

I myself had a great surgeon... But I went through 5 different urologists at different clinics. This particular surgeon was recommended to me by a friend, and he has many years of experience under his belt. My giant infected cancerous prostate was taken out, and I have not had a UTI since, the incontinence is about 95% better, and the ED is almost cured completely. BUT, in case no one mentioned this yet, if you do get the surgery, you will lose 1 to 2" of length. When the prostate is surgically removed, a corresponding section of your urethra goes with it, then the remaining is pulled up and reattached, causing your tool to retract an inch or two. If you were 6" before, you will be 4 -5" after surgery. In your case, only 50cc, you will probably only lose an inch. I

Just some things I thought you should know.

Steve1961 said:

Thank u

Thanks for the advice let’s have a virtual beer one night 

Sure thing....

"Robotic radiosurgery, also branded as CyberKnife Robotic Radiosurgery, is not robotic surgery. Developed by Accuray, a radiation oncology company, FDA-approved CyberKnife involves no cutting at all, but rather is radiation for the treatment of cancer. Through a series of 1-5 procedures on different days, the patient receives targeted radiation to the cancerous area. This is a minimally invasive procedure believed to limit the radiation exposure to the surrounding non-cancerous tissue through its precise ability to hone in on the cancerous prostate. A recent multi-center study of low-risk prostate cancer patients showed a 93 percent non-recurrence rate after 5 years, though the procedure is relatively new and data is limited.

In Dr. Samadi’s opinion, this type of radiosurgery has two significant limitations. First, it relies on pre-surgery CT scan data to determine the size, shape and location of the tumor. “We just don’t learn enough from those pre-surgery scans,” stressed Dr. Samadi. “What we think is low-risk, very localized prostate cancer could be more invasive, and could therefore be missed by this type of treatment.” Further, Dr. Samadi clarifies, this is radiation and though the hope is that the cancer will never return, treatment options may be limited if it does. “It’s considerably more challenging to perform robotic prostatectomy surgery after radiation, so if the cancer comes back treatment options can be more limited.”

During a robotic radical prostatectomy procedure, the surgeon uses finely controlled robotic tools consisting of high-resolution cameras and micro-surgical instruments to remove the cancerous prostate. Though minimally invasive, the surgeon is still able to clearly see the entire surgical field. Blood loss is minimal, vision is 3D and is enhanced 10x and the dexterity of the instruments allows an experienced surgeon to guide it in all directions with full rotation. For Dr. Samadi, robotics is the perfect blend of old and new. “I see robotic surgery as a great marriage of the benefits of traditional, open surgery and state-of-the-art technology,” said Dr. Samadi whose patients have a 97 percent cure rate. “Essentially, I can see and do everything I used to see with traditional surgery without risking the same traumas to the patient.”

http://www.roboticoncology.com/press-release/cyberknife-and-robotic-prostate-surgery-the-winner/

After SBRT the prostate size shrinks in size due to atrophy. This was true of my friend who had SBRT five years ago. At that time his prostate was very large, if I remember correctly it was about 85cc. He is doing just fine now, and his pee stream is comparable to a fire hose stream.

Now a days radiation is very precise and effective; there is no need to do radiation after surgery since radiation alone will do the job, there is no need for surgery which is only localized in addition to radiation, since men can incur significant side effects which are cummulative. The radiation perimeter, in cases where there is a chance that the cancer is  outside the capsule, can be extended. Eventhough surgery, although difficult, can be performed after radiation,there  is no need for surgery after radiation since there are other treatments such as hormone for failed radiation treatments. Radiation cure rates are comparable to surgery cure rates with less side effects.

You quote Dr. Samadi's ( a urologist who is biased) of 5 years ago. At that time if my memory is working, Dr. Samadi and Dr. Katz who does SBRT (cyberknife delivery) worked in the same hospital in New York...I think that they did not, to say the least,  get along at that time.

I researched this in a limited way with keywords "CK shrinks prostate" and I can't find any other instance where CK effectively did shrink the prostate through atrophy. Yes, your friend's prostate may have shrunk, but if this were a common effect of CK, it seems like it would be heralded as a positive effect of CK technology. I strongly suggest it be researched further into the archives of other medical forums and university websites to see if it does have that effect, before anyone makes their treatment decision.

If it did harmlessly shrink the prostate, then why isn't CK being used to address severe BPH symptoms regardless of cancer presence?

In the case of RP, there is no question it resolves BPH and prostatitis issues.