Can't make a decision

Mikey, if the 1955 is your birthyear after your name, you are just 3 younger then me, same as my wife. Compared to other people's specs, you have a fair amount of cancer in each of your cores like I did, that really concerned my urologist. I am no doctor or expert, just one of the gang here, fighting my own battle, but on your specs, psa, age, general health, etc, I would be inclined to have surgery, and if you can get good robotic in your area, why not. In my area, only one place to get the robotic, and the only qualified surgeon had less then 25 behind him, and he is in my dr/surgeon's practice. I ended up with a very deep and narrow prostate bed, and my own surgeon said had he started robotic, it would have had to been aborted to an open. So there are a lot of factors. I know other's reading this post will think I am a broken record, but I stand by the knowledge that surgery first, with radiation as a salvage is far safer then radiation first, with surgery as a salvage. Many, if not most, surgeons will agree with that statement. Just my opinion, that I factored into my own personal decision.

BTW, congrats on your grandaughter. That's wonderful. I have two grandchildren, girl - 6, boy -3.

That will add to you and your wife's life and enjoyment I am sure. Mine got to visit me once when I was in the hospital, it was a nice touch. In fact, they just left my house.

Again, if you didn't feel scared, I wouldn't believe you. The Big C is frightening to any reasonable person, male or female, whether you are the victim or the spouse, so don't be concerned about that.

SO many here will help you on any aspect of your decision, your treatment, and your recovery, so don't be afraid to ask anything.

David in SC

Hey PWS, All I will say is the most improtant thing especially for us 40's guys is to rid our bodies of the cancer. From what I have seen it seems most of the time the PCa is more agressive in us youngins than the older guys. You take what time you need and find the treatment that is right for you. Just remember, even with complications this disease can be beat and we can live normal lives agian. My journey was long and hard but I am in the light agian.
Wish you well,
KW

My 2 Cents as well for you ..

Mikey , i think your train of thought is correct , you are young and in good health , so recovaring from  a DaVinci will be  faster and easier for you , as well as getting back to full continance and potency shortly after ... as Skapod wrote i also advise looking at Mt. Siani in NYC an Dr. Samedi  .. as he has a good track record  even just by the ones on this bpoard that used  him .... would be closer too than another country...

good luck and keep us posted..

GB

mikey1955 said...
Thanks Dave and to all others!
At this point I am looking at surgery first...as all the other options, including radiation, make excellent secondary or salvage options...again...IMHO.

Thanks for your support all...no final decision yet.

PS: Holding my 15 minute old grandaughter was a thrill beyond words. My mother said this is part of the circle of life. I hope to stay in the circle a long time...with all of you here...

Mikey

I've been reading this thread with interest since I'm in the same boat researching treatment options. I think the most important step is to have your cancer properly staged before deciding on any option. A low gleason and low psa indicate that the cancer is most likely confined within the prostate; surgery is an excellent option. A high psa that cannot be explained by the tumor size alone or the location of the tumor close to the wall indicate a high probability that a positive surgical margin won't be obtained. Nomograms can help in determining the best options.
I've heard a lot of people comment that they chose surgery because if it didn't work they could always use radiation later. My thought is that now you would be faced with living the reat of your life with the effects of two treatments rather than just one.
As to proton treatment, both my docs say that this was state of the art in the 90's and IMRT is more effective with fewer side affects.
The Uros I talked to recommended surgery, but didn't take into acccount my high PSA or tumor location when making their recommendation. My prostate oncoligist was more through in looking at everything before recommending IMRT and hormone therapy. It's important to take your time and get a lot of different opinions.

JohnT

Mahalo,
You asked me a question a few days back, and my apology - the holidays kept me away from HW. I was initially sent by my GP to a Urologist with a good reputation and he was a seed man (brachy). After doing the biopsy he told me he thought the seeds would take care of it. I was leaning that direction because I wanted the least invasion in my life - at this point I knew nothing about PC. But, I started reading etc. and the more I read and looked at my biopsy (which was high intermediate). I had 8 of 10 cores with some cancer - all but one core was a gleason 6, and the one core was a gleason 7. I also had shown perineural invasion on the interior wall of the prostate. After reading I started questioning the good doctor more and more about my chances of being cancer free. He basically told me that statistically I had just better than a 50% chance the cancer was contained to the prostate, but he said he believed the seeds would cover beyond the prostate any cancer immediately outside. I actually thought this was a plus because he stated the surgeon could not tell at the time of removal if he had gotten it all. The slant I got from the doctor was that even at the worst situation he could keep me alive indefinitely (using a combination of drugs) and he showed me a lot of stats. All of that was good and true, but the more I read the more I wanted to be assured that if was possible to be cancer free rather than just staying alive through constant doctor visits and drugs.

The clincher came for me in these areas. I read and understood that if the seeds do not get the cancer, surgery is not much of a later option, nor is additional radiation. If the seeds don't get it, then the back-up is harmone therapy. On the other hand, the advantages to surgery is that once the prostate is taken you will know much more definitively if the cancer has spread outside of the prostate and have a better opportunity for salvage radiation treatment. Meanwhile, while I was learning this the doctor came up with the sudden notion (at least it seemed that way to me) that I should have 8 months of Lupron in conjunction with the seeds, and not only that (since I seemed so concerned to be cured) he felt it would be best for me to have external beam radiation before the seeds - he called all this the blue plate special - shoot all the guns. Well, I received a 4 month Lupron shot. So my treatment direction that started with seeds only had advanced to external beam, seeds, and harmones. In the meantime I had heard about Dr. Fagin (a young but seasoned DiVinci doctor) and visited him. All it took was one visit with him and my mind was immediately made up. I would have DiVinci - so I did.

Now, I still am not completely back where I was with either IC, or ED, but I am making significant advances and I would do the same thing again. My PC could come back, but at least I have the peace of mind of knowing my pathology report, and the percentages are in my favor that I will never have PC show up again. Had I gone the other route, I would still be wondering and would have all this time been continuing under the influence of Lupron - it is liveable, but having been under its influence for 6 months I don't want it unless necessary. They say surgery is the "gold standard" and I believe in my situation it was indeed. If your cancer is early and you are strongly confident of your doctor and the cancer's confinement to the prostate, seeds may be your best route. These are tough decisions. I wish you the best in your decision making.

thank you for the clarification Skapod,

I had a partner  until 3 years ago , not  so sure a LOVING one   (as i have discovered ) but that is for a differrent book, an i always like to hear succsss stories like yours , and you are absolutley correct , the main goal here is to get rid of the cancer and live a long meaningful life post surgery, and the rest is a bonus , being a very sexually active man pre surgery  (as i am sure your husband been as well ) it is hard for a man to accept anything less than a healthy sex life for  the years to come , even though i can not agree more that relationship (the good ones that last forever ) can not be based ONLY on sex.. there  are other sides to LOVING someone , and reindship is  surely on top of the list... i am thrilled that you look at your partner that way , just makes life even more worth living for every day ...and the rest is gravy..

i can not say i do not enjoy life , of course we can never get back to the same way we were before , and just the fact i can enjoy and watch my 2 boys growing (i have a 13 and 11 year olds) worth every minute of it ...one day i might find a worthy partner as well that i think can stay besides me for a long time .. mean while , i am practicing ...hahaha

have a great HAPPY  new year !!!

Keep  us posted ..

GB

skapod said...
GB, just want to clear something up and not make everyone think I'm bragging, he is by no means an adult film star or what he was before, we are just happy to see that blood is flowing. He still has a long way to go, but we are encouraged with the progress he has made. I will tell all of you what I told him, what matters most to me is that he is by my side. A relationship based on sex has no substance. He is the best friend I've ever had and I want to spend the rest of my life enjoying his company. Erections do not define a man and love making can be done in many different ways.

I hope you all have the support of a loving partner to get you through this very difficult time.

Happy New Year to you all.

Glabers, and any others, VED is vacuum erection device. It's used to bring blood circulation back to the penis and abdominal area for quickwer healing and for (possibly) quicker urinary continence. Many here are using it and can fill you in on the details. Go to Osbon.com for info.
Bob

Hi again Glabers,

Here is couple of links to sites that carry  the  Auguatsa products   (one is the MFG itself) and the other is even cheaper by ADW

i use that exact pump and it is comparable to the Obson  (which i have used  as well befoe hand)

http://www.vitalitymedical.com/Product/Augusta-Medical-Elite-Custom-Manual-Operation-Vacuum-Erection-Device-Rx-15020.html

ADW

http://www.americandiabeteswholesale.com/-strse-532/Augusta-Medical-Vitality-Manual/Detail.bok

Good Luck

Tom, Welcome to HW and the other side. Hope your recovery is progressing ok. Hope you stay with us and share your Journey.

Hello Tom,

Welcome here and for being on the other side. I thought you gave some good sound advice. I see you are in NC, I am just outside of Greenville, SC, almost neighbors. Hope you continue to have a good recovery.

David in SC