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mikedayton62
Posts: 22
Joined: Sep 2016

I received my diagnosis last month (on my birthday of all days). PSA = 12, Gleason = 6 in 1 of 12 biopsy samples. The urologist said that there is an 8mm tumor completely contained within the prostate. He recommended three alternative treatments:

1. Robot Assisted Laproscopic Prostatectomy (total removal of the prostate). He said his partner does these, and has a lot of experience.

2. External Radiation - Eight weeks, five days per week of targeted radiation treatments.

3. Internal radiation ("seeds").

 

I'm 54 years old and otherwise in good health. I would appreciate if anyone could provide advice or tell of their experiences with any one of these treatments. My urologist told us that all three have similar chances of successfully eliminating the cancer, and he expects that I will likely not have a recurrence afterward.

A personal note - my wife lost her father to lung cancer in 2007 - on my birthday. To spare her more grief, I might need to get a new birthday. haha

VascodaGama's picture
VascodaGama
Posts: 3191
Joined: Nov 2010

Mike,

Thanks for the update. I am glad for your positive atitude in spite of the worsen pathologist report. I hope they managed to remove the whole cancer and that you are now cured. Upgrading results is common in surgeries. The biopsy can miss those cancer spots and different pathologists may judge differently when classifying grades. The critical finding is the tertiary Gleason grade 5. I wonder about other findings such as the seminal vesicles and the lymph nodes.

As a note to your wife's concern on the difference in the reports; one should think that the biopsy examines just a fraction of the whole gland. For instance, a 12 needle biopsy draws about 0.2 cc of tissue (2cm x 1mmD x 12) which is less than 1/30th of a normal sized gland (25 to 30cc). Your gland weighing 57 grams (=57 cc) means that it was larger than normal (or that they have included the weigh of the seminal vesicles).

Best wishes for full recovery.

VG

 

mikedayton62
Posts: 22
Joined: Sep 2016

Laughing

mikedayton62
Posts: 22
Joined: Sep 2016

The seminal vesicles were removed and the pathologist found no cancer in them. No lymph nodes were removed, so i assume that means the surgeon saw no need to remove them.

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3427
Joined: May 2012

Mike,

Removal of the seminal vesicles is nearly universal today in RP. It is good that they were clear.  Removal of sentintal lymph nodes for biopsy is at the disgression of the surgeon.  My surgeon removed none either, but my specifics were considerably milder than yours.  But all negative margins, a negative set of seminal vesicles, and presumably negative for signs of perineural invasion all strongly suggest no escape anyway.  It is possible that the gland was tested negative for positive margins before the surgeon closed (immediate biopsy is common in cancer surgeries).

My pelvic region was TOTALLY NUMB for at least a month, and slowly regained feeling.  At first I thought that there was no way I would ever have normal sensation, but it came back gradually but steadily.  Do not let the numbness scare you.  I was having sex after several months with TRIMIX self-injections, later with Cialias, and today require no Cialias.  It sounds also like you are well on the way to continence.  Some guys move faster, some slower. Be aware that there are a wide variety of pad thicknesses available for any degree of problem.

Wishing you an "undetectable" first PSA.  Understand that the PSA will show some numbers to the right of the decimal, but if they are under the threshold value, then it is clinically "undetectable." It sounds overall like your result will indeed by undetectable. Labs and cancer centers differ a little on the definition of undetectable, and your doctor will of course explain all of this to you. 

max

DaVinci, December 2014

mikedayton62
Posts: 22
Joined: Sep 2016

I'm about 12 weeks post-RALP. My first PSA, a month after surgery, was 0.02. Next PSA scheduled for early March.

ED still 100%, incontinence improving.

VascodaGama's picture
VascodaGama
Posts: 3191
Joined: Nov 2010

At my surgery the surgeon used PSA=0.06 as the threshold to judge success. Remission is taken as PSA<0.05 by most doctors. Yours is way bellow that. Congratulations.

ED is of concern. You need to be active to avoid atrophy.

Best,

VG

Laxdad
Posts: 2
Joined: Jan 2017

mike

i am a first time participant in any forum.   I had surgery a year ago.  It's been an interesting journey. I read the posts in the blog, I am on a similar path, just a little further along.  I was diagnosed at 55, I had robotic surgery by an excellent surgeon, my post numbers are very good.  at 55 the downside of allowing the cancer to spread was too great.  My wife and I both agreed robotic was the way to go.

It just so happens that I sent my doctor a video today, in the 12 months since surgery I have run over 1300 miles, done 5000 push-ups and 10k sit-up.  I have worked hard not to let surgery slow me.  That does not mean it has not been a challenge, I just figured the more I pushed the better the recovery.  

I could define the past year in quarters. First quarter sucked, no way around it.  My goal was to run 4 miles, 4 weeks post surgery. I was slow but steady But I got there.  The incontinence was a hassle but got progressively better.  I started off wearing pads all the time.  ED in Q1 was concerning.  I was told to be patient by the doctor and he was right.  That doesn't stop you from wondering if "it" will ever work again.  By Q2 my running mileage and speed were up, I was using smaller pads, and "things started moving down there".  My doctors prescribed cialis since day 1.  They figure anything that increases the blood flow is a good thing.  I could not argue the logic.  

At 12 months, I wear a thin liner for exercise or heavy lifting. The pace of Improvement in the incontinence is slower but this was expected As I have come a long way since Q1.  It's still getting better all the time.  ED is improving, sex life is not back to normal but getting there.  I run 5-7 miles a day, hike mountains and feel that life is almost back to what it was.  Be patient, set goals for each quarter, and don't back off.  

I hope this helps

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