Salty_clark's Journey

I just ran across this forum as I was researching on the net my condition and decided to join. My situation is that I had a DRE with a small lump found. My uro performed a biopsy on 11 March 2008 and the pathology report came back with a gleason 8 (4+4) on the right and a 7 (4+3) on the left. 23 core samples with 3 of 12 on right positive and 1 of 11 on left positive. My PSA is 3.8. Had a bone scan and CT scan of pelvic and abdominal regions and they were negative. I have decided to have robot assisted surgery on 30 April 2008. The surgeon is Dr Randy Fagin who has done over 1200 of these specific surgeries. He is located in Austin Texas...I am in El Paso Texas and will travel there for the surgery and spend about 9 days to complete the time to remove the catheter before returning home. I am apprehensive about the outcome with respect to positive margins. Everything I read seems to point toward a post-op pathology report of positive margins. I will not speak directly with Dr Fagin until the day before the surgery so I don't know his thoughts about my chances. I thought about radiation and dismissed it for the time being...I just feel like I have to get the thing taken out of me and then if necessary go for the radiation. I am 75 now and am approaching my 76th year in May. I have lived a long life with many adventures and misadventures as I am a retired Army officer and I am looking for a way to extend my life a bit more as I suppose most other folks on this forum are doing also. Would appreciate hearing from any others that are experiencing any similar circumstances especially with aggressive gleason scores and a relatively low PSA. Post edited to add title to thread…  :) Post Edited By Moderator (bluebird) : 4/7/2008 8:50:43 PM (GMT-6)

Welcome Salty_clark
Sorry you had to come but you are at the right place for helpful and informative advice and suggestions. The most common and sensible piece of advice I have come across is to temporarily put aside your initial (and completely understandable ) reaction of "get this out of me now." Those with PCa have time to research the condition carefully (there is much information here covering all forms of treatment) before deciding on their final course of treatment. You will find that members here on the forum are anxious to help and a source of great advice, answering virtually any question you can think of. They will greatly help put your mind at ease. Another valuable resource as Diana has suggested is located at (www.yananow.net) particularly the treatment chart section. I wish you well with your treatment.
Bill

Hi, Salty. We went in with better numbers (to Dr. Fagin) in August 06. Our path report came back as somewhat of a shock - a major upgrade. The point is, you really won't know one way or the other until after surgery when you get the path report. That's also the good news, because you'll know pretty much where you stand and what, if any, the next steps will be.

In our case, Dr. Fagin recommended no further action, with some "suspected" cell leakage plus bladder neck involvement and a 30%-50% chance of return. He is extremely knowledgeable in statistics (and skill) and we trust him implicitly. To date, we are still "undetectable" so his recommendation is paying off. With each 6-month Zero our percentages rise considerably for staying clear for many years to come.

Yes, it's an apprehensive time, this waiting before surgery (or any treatment). And you may question your decision up until the last minute, even though you know it's the right one for you. You'll be in great hands - get the first step out of the way and then you may not have to worry about a next step.

Thanks all for the responses and encouragement...I appreciate your kind words. My wife and I are approaching this with reason based on what I have found though my research. I can understand how some men can elect to go with other forms of treatment but for me I feel the very best option is the surgery with Dr Fagin. I have always been somewhat of a man of action who wants to get things done yesterday if at all possible. The thing about it is I have to know and the best possible speedy way to know is through surgery and the post-op path report. This is one of the most difficult decisions a man can face and, as I have reasoned, I can follow up with radiation if the path report is unfavorable. I have a life-long friend who was diagnosed about two months before me and he elected radiation treatment. He received about 6 weeks of external beam and just underwent seeding this past week. His doctors told him that he was to old for surgery or, at least, that is what he told me.
Again thanks so much for your kind words and encouragement. I will keep you informed.

Salty

Thanks Frank1205 for your response. I plan to keep all of you informed as the month progresses toward my surgery date of 30 April. I just got a call from my cardiologist giving me report on my chemical stress test I had on Thursday past. Everything is fine and he cleared me for surgery and will fax a letter to that effect to my surgeon, Dr Fagin in Austin. I needed clearance because I had a 4-bypass surgery back in 1995. So, everything is falling into place. I will be posting periodically to let you guys know how things are going leading up to the surgery and as I can after the surgery.

Salty

Richard (smilingoldcoot) Thanks for your kind words. I hope and pray that everything goes well with your Proton treatment. Please keep me informed of your progress and stay positive..

Keep smiling...and I am smiling with you.

Salty

Welcome salty!

A treatment decision is very personal.  I'm glad you are on a good track for your particular situation.  Don't be afraid to confirm your treatment decision with others.  After I made my initial decision to have surgery, I had conversations with 3-4 other health care professionals to obtain other views.  All the information was very helpful.

Please consider using the "Control Panel" above to create your own signature file as others have done.  This will help all forum members respond to you a little better when you are posting on other topics. 

I'm so glad you joined the forum and hope you find this a place of support and comfort as I have done.

Kind regards,

Tommorow Tuesday 4/8/08. I go and see the Doctor to let him know I have made up my mind to have the da Vinci treatment. I join the community a couple of weeks ago. I had asked what to expect from this point on and have been reading a lot of the messages in the chat room, which have been answering a lot of my questions. I guess I need to wait untill after the surgery to see what's up on my end, and then go from there. The community has given me a ample list of questions for the doctor. Thanks everyone.

  Hey ~ Salty & Loved Ones,   Gentle Hugs and Warm Thoughts   We know ~ we can “all” make “Your Journey” smoother just by being here for you!   This is truly a great forum!!! ~ You have joined!  You are now part our forum family ~ a group of wonderful individuals who are so willing to share...   It helps “all of us” ~ to help you ~ if we know where you are on your path. So ~ Please stay with us and take our hand when you need it!   Keep posting.... OKAY!!       KNOWLEDGE     IS     POWER   ...   and   POWER conquers   fear   YOU MAKE THE DECISIONS… YOU HAVE OPTIONS… ~ and ~ Your decision will be the right decision for you!!!     Thank you for letting us know the specifics… …this helps all of us to know where you are and it's great to know that you plan to stay with us and share your journey with all of us.  I took the liberty to place a title on your thread.. it was showing (No Subject). If you wish to change it do so by clicking on your 1st post in this thread... then click on the pencil..  you can then change the title.   Buddy & I invite you to visit our personal thread listed in our signature below … We would like to help in making a portion of your journey a little smoother.. so pull from us what fits your needs.   Make sure you visit the links in your Welcome Message… there is so much information to help you through this!   This path is best traveled with friends.   The stepping-stones ahead will be smoother if you stay close to all of us. http://i206.photobucket.com/albums/bb179/mamabluebird1955/Stepping-StonestoHealingWell.jpg   Keeping you close in thoughts and prayers ~ as you travel this new path with new friends.   In Friendship ~ Lee & Buddy  

KrisP...Hey you should have waited a week..we could have met in Austin. Great that you already had a consult with Dr Fagin...I would have liked to have done that but circumstances and distance precluded me from making the trip until the 29th of April. I feel very confident as you do about his abilities and am looking forward to the event. Perhaps if you hang around long enough we can chat in Austin. I am planning to spend about 9 days there.
Good Luck and wish you the best in the future.

Salty

Age 75
DRE nodule 15 Jan 08
PSA 3.8 18 Jan 08
DX 11 Mar 08
4+4 on the right 4+3 on the left
3 positive of 12 on the right and 1 of 11 on the left, all less that 5%.
bone and CT scans 18 Mar 08 = Clear
Robotic Surgery scheduled 30 April 08 w/Dr. Randy Fagin, Austin, TX

Hi Salty,

Welcome to HealingWell, the site that no one really wants to belong to but since you're here I'm sure you've found out there are some knowledgeable and interesting people represented here. You asked in your initial post for members who have high gleason scores and also low psa's to reply to your message.....well I fit that bill. I had a dre with positive results a fairly low psa on biopsy 4.57 and a high gleason score of 8. I had 24 core samples taken on biopsy with about 12 of them positive to some degree. I initially was uncertain as to what course of attack I was going to pursue....I explored brachytherapy and had almost decided on that when I read of some possibly major problems 4-5 years down the road that turned me from that. In the end I decided on DaVinci surgery as it seem the least invasive of the surgeries and also that is was much safer and that the surgeon could see the surgical field much clearer. I was fortunate that I found an experienced Davinci doctor within a hundred miles from my home. I eventually had a failed surgery as I had a positive margin and a seminal vesicle involved and a Gleason score upgraded to a 9. I was started on Lupron almost immediately after the surgery and scheduled for IMRT radiation as soon as I was fairly continent. I have since completed my Rad therapy and have almost a year of Lupron under my belt. My psa is presently undetectable. I became continent about 5 months after surgery but as both nerve bundles were taken I'm not having much success in the ED department. My Doc tells me that he expects after my 2 years of Lupron that I should regain some sexual function. I feel fortunate that I had the Davinci surgery, as had I selected Brachytherapy, I wouldn't have known of the spread of the cancer into the seminals or about the positive margin. At least I was able to receive some adjuvant treatment in addition to the surgery. Again welcome, probably be talking to you again...jwb.

jtp...looks like you got it all mapped out...good for you...Keep us informed.

Salty

Age 75
DRE nodule 15 Jan 08
PSA 3.8 18 Jan 08
DX 11 Mar 08
4+4 on the right 4+3 on the left
3 positive of 12 on the right and 1 of 11 on the left, all less that 5%.
bone and CT scans 18 Mar 08 = Clear
Robotic Surgery scheduled 30 April 08 w/Dr. Randy Fagin, Austin, TX

Thanks TonyB

Your post-op report is very impressive. I can only hope that I can equal it.

Congratulations!!!

Salty

Age 75
DRE nodule 15 Jan 08
PSA 3.8 18 Jan 08
DX 11 Mar 08
4+4 on the right 4+3 on the left
3 positive of 12 on the right and 1 of 11 on the left, all less that 5%.
bone and CT scans 18 Mar 08 = Clear
Robotic Surgery scheduled 30 April 08 w/Dr. Randy Fagin, Austin, TX