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66 yr old just found out and trying to make the best choice of treatments

gadan1
Posts: 19
Joined: Oct 2009

Tried to do this Saturday, but did not post. I'm 66, found out Wed I have Prostate Cancer. Early detection i guess, I"m 66 minor stroke 4 yrs ago, type 2 diabetes, and all that goes with it. Actually feel pretty good and in decent health. My PSA was 5.2 , Gleason 3+4, and Stge T1C. I understand there was 1 of 12 positive in the biopsy. My Urologist told me the 3 choices, and kind of suggested the seed option. While there he gave me a name and number to set up a consult. I went through with it, but now i'm having second thoughts. My wife and I after reading so much stuff over the weekend, now are leaning toward removal, but I just don't want to make the wrong choice. I would greatly appreciate any thoughts on what little information i have provided, but any help is better than none. Thanks

rebelyeller
Posts: 2
Joined: Nov 2009

2ndBase, if I might ask, how did they know your cancer had already spread? My Gleason is 8 with 11 of 12 positive and psa is 6.7. I had a bone scan and ct yesterday but don't see my urologist until next Friday to find out the results. At that time we are to begin planning a treatment and at this point I'm still trying to weigh through all of this info. My father had same issue 34 years ago, took radiation, and had a relapse to the bones 3 or 4 years later and died 6 years after the initial diagnosis.

I'm pleased for you and please do not ignore any signs of a difference in your body behavior. We believe my father ignored a pain that cropped up, because he had always been in "perfect" health.

Don

muttsrule
Posts: 52
Joined: Sep 2009

Hey, gadan1. What were the three choices your urologist gave? I can just recommend a couple of research sources, which somebody may have already suggested: 1) "100 Questions and Answers about Prostate Cancer," 2nd ed. 2) "Dr. Patrick Walsh's Guide to Surviving Prostate Cancer," 2nd ed. Get this through Johns Hopkins (if I leave this site to get the reference for you, I'll lose my connection here). Google for Johns Hopkins prostate or some such phrase. I'll check in here with the url later, in any case. Both offer good insights on choosing treatment.

finbar
Posts: 26
Joined: Aug 2009

I'm 17 years older than you with a similar Gleason score and with Type 2 diabetes under control. My urologist gave me the bad news, said the cutoff age for surgery was 74 and promptly gave me a Lupron hormone shot. Then he recommended a radiologist who proceeded to outline a treatment program for me that included two years of Lupron, 26 weeks of radiation plus the insertion of multiple radiation seeds. I asked many questions about side effects
and was seriouly disheartened to hear the long list. Seeking a second opinion, I met with a top surgeon urologist, experienced in radical prostectomy who said I'd be a candidate for surgery with my cardiologist's approval. I took some tests and was cleared. I then spoke to a number of the surgeon's patients who were very satisfied with their outcomes but seemed to
side-step questions about their libido. Not fully satisfied, I learned of robotic prosectectomy thru the internet and sought further information from doctor friends.
Determined to have the canceer excised from my body, I traveled to NYC to meet with Dr. Ash Tewari at Cornell NY Presbyterian Hospital. Dr. Tewari has done, not hundreds, but thousands of robotic pros. A 1-1/2 inch scar is testimony to a remarkable procedure - in one day and out the next with three three-month intervals of PSA testing of near zeros. The experience is vitally important in not only removing all cancerous tissue but in avoiding injury to surrounding organs and tissue. And added to this is the capability of implementing nerve-sparing techniques. I must add that the Lupron gave me a number of problems. Thank GD I avoided that treatment.

HIFUgal
Posts: 58
Joined: Sep 2009

HIFU High Intensity Focused Ultrasound. It's been in use in Europe for 18 years, the rest of the world for 6 years.

My husband had HIFU last year and no discomfort and no side effects, we've sent in 9 other guys who all report no problems too. We are all very happy! The major decision is to find a doctor who has done many procedures as it's a percise treatment. Dr. Scionti has been treating men with prostate cancer with HIFU for 5 or 6 years. He is also the doc who teaches other urologists around the world. He is the most caring doctor that I've ever met.

It cost $25,000. and treatment must be out of the USA, Nassau or Puerto Vallarta. He brings his entire medical team with him each weekend. Go to HifuCareCenter.com or NYHifucenter.com HIFU is in clinical trials here in the USA. It's the best money we've ever spent!

gadan1
Posts: 19
Joined: Oct 2009

I am in process of having my medical records sent to Emory University Hospital for review. I hoped to have them reviewed by Dr. Marshall but he is on medical leave. Does anyone have any experience with Emory's Cancer Center and can they suggest a surgeon or do you know anything about Dr. Peter Nieh, MD, Associate Professor of Urology, Director of Uro-oncology Center? Thanks

bigxbadxjohn
Posts: 15
Joined: Oct 2009

Hello

I faced pretty much the same decisions that you are faced with now ten years ago. I was 57 years old and in otherwise good health. My PSA was in the 5's and Gleason was 7.

At that time, robotic surgery was not available so I chose the open surgery. It was an excellent choice for me. Today I remain 100% percent cancer free. The side affects have been totally manageable. I think it is very rewarding to return to a "cancer free" status if possible.

For that reason, I would strongly consider the robotic option today. Just make certain the surgeon has performed many successful robotic prostate surgeries.

If you are near a Cleveland Clinic, where you live, that could be a good place to inquire. Their Urology/Oncology continuously enjoys top ratings in the U.S. News comparison reports.

Best wishes to you,

John

abear1952
Posts: 5
Joined: Nov 2009

I am three weeks post op of having the seed implants. I am 57. I found out about 4 months ago that I had prostate cancer much like yours. My Gleason was 6 and my Psa topped out at 5.6. I too had only one 10% spot in one of 12 biopsy's. I was not in any hurry to make a decision as I wanted to make the best one. After several months of research and worry and lamenting and a second opinion, I finally made the choice to go with the seed implants. I did not like all the other options due to the severe side effects and recovery time. I was finally scheduled for the procedure and am very happy with my decision. I went in on Friday and was home the next day. Although I am having some expected complications, I was aware of what to expect. I am having some difficulty in urinating and am on Flomax to help with the swelling. My scrotum was black from bruising and the injection site was a bit sore for a few days. Now, three weeks after I am having some uncomfortable sensations of pressure pushing from the inside of my rectum. I assume it's from them swelling. I am told that these symptoms will subside eventually. All in all, I am back to normal day to day activities and have had no other problems. I would make the same choice again. Good luck with your decision and best to you.

abear1952
Posts: 5
Joined: Nov 2009

http://www.prostate-cancer.com/brachytherapy/side-effects/brachytherapy-side-effects.html

Check out this website Gadan1. Don't be in too big of a hurry to make a decision. Read, study and ask questions. My doctor said that in the 15 years that he has been doing this procedure that he has had no patients to experience a reoccurance of cancer. My first urologist want to cut on me and I didn't want that. I then went Vanderbilt Medical Center in Nashville for a second opinion. After that I settled in on the Brachytherapy option. Every thing that i heard and read about this procedure just reinforced my decision to go for it. I hope this helps you my friend and I truly wish you will. Oh, if it is any concern to you......Within one week postop I experience my first erection. I have masturbated several time and I am able to prodcuce ejaculate, although it's not like it once was, but at least it's still there. It could deminish with upcoming months but it could stay where it is. At least I am have erections and orgasams. The possibility of not is so much greater with the other surgical options. Again, best wishes!

Dick

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