Treatment Decsion Time

Surgery, though not my desire, at the end of the road seemed to make the most sense.  I would have gone ANYWHERE in the country that afforded me the best outcome.  The fact that there was a premier surgeon here in Chicago at both Northwestern and Univ of Chicago meant I didn't have to travel.

We are fortunate to have good insurance that covered almost any option, so that played into it too.  I think financial consideration should be added to the list, as it seems many have to consider the impact on their financial stability as well.

One alternative strategy not in the mainstream camp . . .

http://www.compassionateoncology.org/pdfs/THB06208.pdf

Steve

http://www.prostate-cancer.com/index.html = list each treatment except Proton

http://www.proton-therapy.org/ gives info and location of all 5

Again, you have come to a great site for support but only YOU can decide your treatment and regardless of what it is I support you 100 percent

Blessings

Richard aka smilingoldcoot

For your info, I am now 62 and have been on TAB for nearly 1-year, during which time my PSA has reduced from 19.2 to 0.018.

Unfortunately, nothing is a free ride and there are several possible side effects of TAB, the "Big 3" of which are (1) Loss of libido (effective castration), (2) ED, and (3) hot flashes.

There are also a number of other possible side effects such as weight gain, muscle loss, loss of bone density, depression, emotional stability, fatique, muzzy feeling, and others.

For myself, the main effects have been (1) and (2) above, plus a muzzy head and at one stage a loss of emotional stability. I have not been bothered by hot flashes, which I understand in some people can be quite debilitating.

However, the side effects are most probably reversible after stopping the hormone therapy, or can be treated with medication. Not so for the standard treatments.

There are also reports linking hormone therapy to an increase in metatices.

For the original ASCO abstract which caught my attention, please see . . .

http://www.asco.org/ASCO/Abstracts+%26+Virtual+Meeting/Abstracts?&vmview=abst_detail_view&confid=37&abstractid=20271

Also, in my case, I considered the probability that the PCa had spread outside the prostate. MRI and bone scans are not sufficiently sensitive to detect this with any degree of certainty unless there's a good amount of cancer to detect. I prefer to consider the probability of the spread of cancer using the following link . . .

http://www.prostatecalculator.org/

To me, there's not much point in doing a radical prostatectomy, brachy, or RT, if the cancer has already spread. Hormone therapy kills cancer cells wherever they are.

Hormone therapy is not a cure for PCa but a therapy to try to keep it under control, like diabetes or high blood pressure. Many men diagnosed with PCa would prefer to attempt a cure for the disease with the standard treatments, and I understand where they are coming from.

Wishing you all the best, whatever you decide to do.

Steve

read these posts again and i so felt the anxiety of that struggle for you.  my wife said that she asked the nurse in the OR prep room to come in and sedate me because she was afraid i wouldn't go through with it, because as i was lying waiting i was getting more anxious and saying i should be doing Proton Therapy.  today, i still wonder how things would be had i done Proton Therapy, which from my research seemed the most logical other choice vs. surgery.

my surgery had the desired outcome mostly.  i'm continent, though it's not "perfect".  i have ED issues which at 42 is a tougher thing to deal with.  and i still worry about recurrence though i had a very good post op pathology. 

at the end of the day, life is just different.  but it's life.  and for that i remain grateful.  i long for the day when there is a vaccine or cure for cancer.  i also hope it comes sooner than later, but also know that it will be painful to know if it comes in my lifetime that had it only come sooner, i might still have a quality of life that i had before cancer.

but then i look at my kids and i remind myself our how lucky i am to have found it when i did and to be facing the possibility of a total cure.  even with side effects, it would be a wonderful thing to regain confidence in my health.

i hope you find peace with your decision.