Prostate Cancer Support Group

I went to see another Ur today to get a second opinion. He specializes in Robotic Surgery. He actually gave me an hour of his time to discuss all the options available to me. From what he told me I am not a good candidate for A.S. He suggested that with the amount of cancer showing on the right side of the prostate that I get the the darn thing removed. My scores are as follows 3+4=7, DRE is normal, PSA 8.1, T1c.MRI looks good. I asked him about seeds or radiation treatment but he seems to think with my age being relatively young 53, that I don't want to worry about this thing coming back in 10 years. i was told with all my numbers plugged in that I have a 91 percent chance of the cancer being removed with the prostate. The only problem I have is that he has only done done 80 of these procedures. My original Ur has done over 1000 conventional open surgery's. It has been one month since the biopsy and he suggested that I should make a decision with in 2 weeks as it takes a month to schedule surgery. Any input greatly appreciated...

This is a tough choice, I know; we all had to make it. I can' tell you what to do but only give you my perspective. I was diagnosed at 52, my Gleason was 3+3, PSA 5.6 and not as severe as yours. I based my choice on robotic surgery for my 53rd birthday present. I saw my dad get diagnosed at 60 when it had already escaped and even with surgery and some radiation, it got him 12 years later. It was 1984 when he was diagnosed and medicine has progressed significantly. I did not want to follow in his footsteps.

I considered my opinions and did my homework. I would have gone with AS if I was over 70, but I am not. Also, if my diagnosis was more severe and I was over 70, I would of either gone for radiation or seeds. That choice would of been based on my life expectancy as my reading told me that I would have complications from the radiation 15-20 years down the road. Noting that I am your age, I had to look at my life expectancy and I am planing to be healthy to 100. So although, I new the issues with ED and UI were real, which by the way at 5 months I am still dealing with, I am glad for myself I choose to have it removed. My PSA now is undetectable and I am doing my rehabilitation and Kegels: I have hope especially because of my age but there are no guarantees.

I suggest you read some of the books recommended on this site, in particular Saving your Sex Life and Winning the Battle Against Prostate Cancer - Get the Treatment That is Right For You.

As far as which Doc to choose. The books tell you to go with the one with the most experience; I would ask if I could talk to some of their previous patients. The one who has done few could be very good too, asking others may provide that answer.

Your ID is sobersince00; I wonder, if you have had issues with drinking whether that has compromised your health in any way that may affect your recovery. I know, it is allot to think about.

I wish you peace in finding your choice and path. This is a good forum, read as many posts as you can; they are full of valuable insights that are not available in books.

Post edited by: paperplane, at: 02/23/2012 10:07 PM

I think Paperplane hit most of the right notes.

I might add book called Decision or The Decision. Written by young Uro who had surgery. The book has some charts that might help you in your choice. This man also has web site. It is a little off the wall, but after so many "clinical" sites it was refreshing.

A factor to consider is any future treatment. I understand that radiation after surgery is "easier" and more common than surgery after radiation. This is to the best of MY understanding. ( I could be mistaken )

While time is important, it is no excuse to RUSH into anything.You don't want ANY remorse about your choice of treatment. I would want to know if waiting another 2 weeks ( or a month ) would change anything other than the date of surgery. If the cancer is that virulent you should already be in the hospital. Please keep in mind this is just my opinion.

I think I may have shared with you to not get overwhelmed by the information you will learn. After a while you should start to gravitate towards a treatment. This is a good time to practice "take what you need and leave the rest"

You continue to ask questions and gather information. You are doing the RIGHT thing, keep at it!

kapm

I believe, Mr. K., that surgery is actually NOT a viable option after radiation, whereas radiation after surgery is a possibility. I have read that in various places and, in fact, made my decision partly on that.

I concur with Mark, I learned that as well. Radiation causes too much damage to allow for surgery.

I also agree with K, don't panic and rush into anything. You need to be comfortable with your choice for it is a life game changer.

Thanks guys for all your input. Decisions, decisions. I just don't want to make the wrong one based on fear but then again I don't want this thing growing inside of me while I wait. I appreciate each and everyone of you. You have been through what I am going through. Somedays I just want to bury my head in the sand and pretend this thing is all a bad dream but my family wont let me do this. They are very persistent and mean well. So difficult for me to stay in the present when things are not going my way. All thought is of the past or future...

Hang in there Bro, one step at a time!

I have read some good advice so far on this page. My (I had robotic at 49) advice if you choose robotic is to find someone with more than 80 under his belt. The robotic is only as good as the doctor controlling it. My doctor had over 2000 under his belt with what so far have been good results. Keep the faith and hang in there.

If the doctor thinks the position of your cancer in the prostate is such that he can get good clear margins using the robotic method, then I would accept that advice. In our case, the doc, who was skilled in both methods, said the cancer was too close to the top edge, and he could manipulate and feel better if he went open, and because there was one GLeason score that was an 8. So we took his advice, he got clear margines, saved one nerve bundle, and so far, 17 months post op, PSA is undetectible.

They want you to wait six weeks after the biopsy to heal before doing the surgery anyway, so you're not outside the common window for making a decision.

Don't get rushed. You must feel at peace with your decision, because the time to analyze and agonize over it is now, not afterwards. Afterwards, you have to tell yourself, and believe, that you made the best decision you could with the information you had, and the feelings you have about the whole thing.

Easy does it, friend; if you force it, you'll make yourself crazy.

Keep writing and reading. Oh, one thing the book The Decision said was, after you do your research and make a decision, then set that decision aside, and trust in your doctor. It's out of your hands then. So allow yourself some worry free time also.

I think you might find this useful in comparing the two approaches.

http://myprostatedoc.blogspot.com/2011/03/truth-about-da- vinci-surgery.html

Prostate Doc

Myprostatedoc.blogspot.com