Got Biopsied Today- was (No Subject)

In some ways I have been hard on you and your situation, for that I apologize. You probably don't have to go very far from home to get competent care. Talk to several doctors -- a good doctor will recognize that you need to explore your options (my surgeon actually recommended another surgeon who had more experience than he did.) Overall more information about PC is better. You might want to see an oncologist rather than a surgeon since your stats suggest that you have many choices.

The "problem" is that there are many good choices for treatment and that will mean that you need to consider what is important to you. To the extent that this group can, we will at least talk about alternatives and the individual choices that we have made.

It is great to hear that you are collecting information so you can consider your options! With a positive DRE on the left it is not surprising that he warned you about nerve loss. My surgeon warned me that he might have to take the right hand nerves but ended up sparing both sides (your results may differ) My doctor also went over many things that could happen during and after surgery -- from puncturing the rectum (rare) to loosing about an inch in length from my penis (common,sigh) I think he wanted me mentally prepared for what might be and also did not want to "over promise" about surgical results.

Keep us informed

If the PC is confined to the prostate then either surgery or radiation has the same cure rate. From what I have read Proton Radiation has the least amount of side affects of all the treatments and by far the best patient reviews.
JohnT

crewa2,

Sorry you had to join us but welcome. for me it was a personal desision. I wanted all of the cancer out of my body as soon as possible with the least lasting side effects. So I chose surgery. Radiation can always be used after surgery but surgery cannot be used after radiation. What ever choice you make just be sure it is the best for you. Good luck and best wishes for you brother.

Crewa2: So sorry about the news.. We were all hoping that it would be negative. I do agree with the other about Run from the quick trip to the islands. Sounds fishey to me. Get your pathology report and get a second or third opinion. Explore you options. I cholse surgery based on my family history and the Dr. advised that it was my best shot a cure. Being a gleason 7. I am 10 months our and I am still happyt with my decision. I still have some frustrations in healing. Know that most of us on this board have active e-mails in our profile. You can e-mail questions if you wish and you can always request a phone call.

This is a jurney where brotherhood is very supportive.

Best of luck

Jeff

I'm sorry to hear that your news is not all good. You should know that over 90% of capsular penetrations are less than 1/10 mm -- that is to say microscopic. That said, I only got news of the capsular penetrations on the post-surgical pathology. This clearly worries my surgeon, so in spite of my current PSA of 0.0 it worries me too.

So now you have the question that no one can accurately answer -- why do surgery if you are going to have to do radiation anyway (maybe)? The worst part of PC is that you have to keep thinking about it.

Let me say something about my personal decision which only explains what I did not what you should do. I grew up in the atom bomb era when radiation=death. Also, at my age I figured that I wouldn't be a candidate for surgery for a lot longer.

I guess that a part of the issue is what do you need to get flying again. Can you fly with incontinence or do you have to be dry? I could go back to work wearing pads, I don't know if I could have handled the fatigue of radiation

Whatever you decide, know that it is a reasonable choice and that we are here for you.

Thanks for the support everyone

Yes Idaho, all of my DRE's have come back positive with a nodule on the left side, in addition, on the last DRE he felt a very small bump on the right side also.

Geezer, they tell me that the FAA wants me to be continent before retuning to flying. How would they know, I don't know?

The surgery vs. radiation conflict continues. I have a consultation with the proton beam people in JAX on Monday.
The oncologist recommended getting treatment started within the next 6 weeks due to the change in my diagnoses.

If your last DRE was by a different doctor then the bump on the right may not mean anything. My internist found a lump on DRE, my first uro did too but said it was only because my records said there was one, my second uro said he felt nothing but staged me as if there was one because he said it was more conservative.

about the FAA. After reading about all the automated maintenance messages that an Airbus sends, perhaps they can check the records to see how often the cockpit seats need to be cleaned ;) (of course it could just be short runways in bad weather)

Crewe,
To answer that question, and assuming you end up choosing surgery as a primary treatment, your doctor and others would have to review your post surgery pathology report to see if, any, escape from the prostate was detected, and doing the pathology on the seminal vessels, lymph nodes removed, etc.

I am not trying to rush you to surgery or any other treatment, that is your call to make. You have circumstances that on the surfaces that any lengthy period of waiting and watching might work against you. You definitely want to contain the cancer as much as possible, and that's where the biggest gamble comes into play for you and any of us that has to make a decision about treatment.

Whether you wait weeks or months, of course its your call. My dr. knew with my stats, that it would be a close call ultimately when to start a treatment choice. And that's assuming in my case, that my pathology didn't upgrade the gleason or staging. I went with my dr's hunch and had surgery 8-9 weeks after my 3rd and final biopsy.

David in SC

I met with the people at the Jacksonville proton center yesterday. They were a great bunch of people and the doctor was very laid back and informative. After his DRE, he was much more optimistic than the doctors at Moffitt. He said he would stage it as a slight T2 almost borderline T1. He was not too concerned by the MRI report of probable capsular penetration. He felt that I would probably have favorable results with surgery or radiation. He did not at all try to sway me either way and really laid it out in simple and no BS terms.

So today I call the robotic surgeon I have seen to inform him of the latest MRI results, gleason score and my concern of the possibility that surgery may leave a positive margin behind. He immediately becomes angry that I went to see the people at Moffitt and calls them a bunch of idiots for suggesting radiation. He screams at me on the telephone "mark my words, in ten years you will be very sorry". Needless to say, my short list is one guy shorter.

On the other hand, what if he is right. I mean these guys are the experts, and I'm getting conflicting information. I don't know, I'm really confused right now.

I have one more appointment with a robot surgeon tomorrow and then I think it's time to make some decisions. At this point the PBT is looking like my choice.

Thanks to all for listening, counseling and support

Hi Crew,
I was told that I had to wait 6 weeks after the biopsy before I could have my robot surgery. Even though they were going to be taking it out!
This two week rush job seems fishy. "Act today, don't delay If you call within the next 10 minutes will you'll also get a free Kinsu knife set." It's not my business but I don't like it.
Good luck,
Jeff