Hello just diagnosed and very frightened

Steve1961 said:

surgury

yes oncologist recvommended surgury...he said at my age its better to take it out and be done with it..was told they reccomond radiation for older people late 60s 70s because the surgury at that age is kinda rough..gand usually its so slow growing radiation is better for them...anyway yes i have decided on ssurgury..just need tips on finding the right surgeon.. i was told he should have performed at least 500 of these  and read ever review  what else should i know about the surgeon...is robotic the wasyto go or is the old way good as well...thast all...just asking asking..like i said Stanford and UCSF are the places i will be most likely deciding on...hope i am not being a pest...hopefully i can return the favor when i am done  and help other feel comfortable like all of you guys thanks

Be comfortable with the surgeon and talk to people that have used him or know of him.

Dont be afraid to talk to several and find the one you are comfortable with if that is the direction 

you want to go in. Relax and study and ask questions .In  this forum these gentlemen have alot

of knowlege because they have lived through it.

Have a Happy Holiday and Good Luck

Grinder said:

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.

grinder,

After radiation, the prostate has the texture of a used charcoal brickette -- think Kingsford on tailgating day.  My R.O. told me this himself.

Max Former Hodgkins Stage 3 said:

Urethera

CC,

My urology surgeon has a great map of the prostate and all of the associated plumbing on the wall in one of his exam rooms, and I have over the last two years asked him several questions about it.  He told me that the urethera actually does not run through the prostate gland. A section connects the bladder to the prostate, and then another section conncets the other end of the pprostate to the end of the penis.  But he said the passage through the prostate itself is pretty rigid and sort of like a superhighway entering into a cave bored through the side of a mountian.  This may explain why there was no stricture (restriction).

This is probably just more information than almost any layperson needs to know, and most pictures just describe the section through the galnd as in fact "urethera."   My doc has done well over 1,000 DaVincis and is a subspecialist in post-radiation salvage surgery, which is a fairly rare thing, so he must know of what he speaks.  He has taught urinary surgery at two medical schools also.

This is a highly detailed critique of the male ureathera and each of its many subdivisions:

https://emedicine.medscape.com/article/1972482-overview#a2

max

Thanks for your input Max, however can you check the link you provided? It wouldn't open for me - just a blank page.

CC52 said:

.

Thanks for your input Max, however can you check the link you provided? It wouldn't open for me - just a blank page.

I and a lot of other people here have been having trouble ove the last year getting links to open.

I used to just do a cut and paste and it worked great, but no more.  I manually used the editing options on the toolbar here and made the link a Hyperlink, but even that won't work.

You CAN read the link by typing in the address manually. If interested in the subject, it will be worth the few moment's effort required.

max

This is from these archives.

I am not suggesting CK is to blame, I am suggesting the improper administration of CK is to blame. And, similarly, the lesson here is that the best most experienced professional is necessary regardless of the procedure. Side effects are more prevalent when inexperienced professionals perform procedures.

The following is a response inre the side effects suffered from the procedure...

"ASTRO’s executive summary paper states: “Given that very high-dose fractions of radiation are delivered, the margin of error for SRS and SBRT is significantly smaller than that of conventional radiotherapy and therefore special attention and diligence is required. A SMALL ERROR IN TARGET LOCALIZATION FOR ANY 1 FRACTION RISKS UNDER TREATMENT OF PORTIONS OF THE TUMOR BY 20% OR MORE, AND INADVERTENT OVER DOSAGE OF ADJACENT NORMAL TISSUES COULD ESCALATE THE RISK OF SERIOUS INJURY TO A MUCH GREATER DEGREE THAN AN EQUIVALENT TREATMENT ERROR IN A COURSE OF RADIOTHERAPY WHERE A SUBSTANTIALLY LOWER DOSE PER FRACTION IS USED [IG/IMRT].”

"I have posted this info before and know it is not what you want to read but, without knowing more about your husband’s PCa history, stats, his clinical staging, the CK tx protocol used, dosing, the expertise & skill of his radiation team, including the radiation oncologist, the dosimetrist/physicist, the CK technician, etc., its difficult to know for certain whether your husband may have suffered permanent or temporary injury and/or collateral tissue damage from his CK/SBRT tx. I hope you find some answers soon, and that the symptoms are short term, treatable, and the pain resolves quickly. "

************* 

Note the words " the expertise & skill of his radiation team, including the radiation oncologist, the dosimetrist/physicist, the CK technician, etc. "

I can't help but point to one significant variable when it comes to side effects in ANY procedure... Skill and Expertise.

It is my contention that once CK is more widespread as RP is now, then less experienced and less skilled persons will administer the procedure, resulting in more side effects. 

Comparing the two procedure when SUCCESSFULLY done by expert skilled persons, they each have their advantages. If CK appears to be the recommended treatment for a particular patient's profile, then by all means, pursue that course of treatment. But the caveat remains, as it does for RP as well, get the best available. 

Once CK eclipses RP, don't be surprised if incidences of side effects increase dramatically, as the increased demand will exhaust the supply of competent professionals to administer the treatment. Then less skilled persons will be needed to meet the increased demand.

I continue to emphasize VARIABLES, which is necessary in any experiment. Everyone points to RP as the culprit, rather than consider the VARIABLES between successful treatment with RP versus unsuccessful treatment. The main variable continues to be the skill of the surgeon. In my case, everything went exactly as planned, just a little behind schedule. That is why I continue to be adamant that everyone gets the MOST SKILLED professional available, and not just condemn any particular procedure outright.

diagree,,,,,,,,,,the prostate is affected by the biopsy, and an MRI needs to wait.

Steve, you exhibit panic, and you need to calm down.....did you visit with a radiation oncologist...or are you simply trying to get the the prostate out as quickly as you can?

When I had my MRI they asked if I had had a biopsy and when I said yes, they asked how recently.  Apparently they want to wait for some period of time between the biopsy and MRI