Need Some Advice on PC

Greetings to all.  My name is Bill Palmer and I have been diagnosed with Prostate Cancer in Jan 09.  I had my first Biopsy in Sep 08 after a slight bump in my PSA. (2.2 to 2.65). My father was diagnosed with PC 12 years ago and had RP.  He is still going at age 73.  I however am 47 and while the prognosis is good I have had great relief from some of the stories on this board and downright fright from some others.

Anyway not happy to be joining this club but grateful as hell there is a club to turn too.

Thanks

Bill Palmer

Diagnosed 12 Jan 09.  1 core positive of 12 taken (no gleason as sample was too small)

1st Biopsy in Sep 08 had 1 core with ASAP of 12 taken.

Went to Virginia Mason in Seattle for a 2nd Op and had a mapping / saturation Biopsy in Aug 09.  2 cores of 24 positive with a gleason of 3 + 3 on both.  PSA is back down to 2.4 with free PSA of 21%.

Greetings, Bill.  Welcome to this site and to the club that no one wants to belong to.  You have many options and most importantly, you have lots of time to make a good decision.  You will hear from many here that have elected many different options and I am convinced that the option that is right for one guy is not right for another.  There is not such thing as the only "right" answer.  You have to find the one that is right for you.  I am convinced that your doctor - guided by you asking good questions that you will ask because of the detailed research you have done - is the right person to help you make the final decision.  By doctor, I tend to think of your primary urologist - not a surgeon or a radiation doc or a doc who does mainly seed implants or one of the other options. 

In my case, my urologist (who doesn't do surgery or radiation - he specializes in impotence) after doing my biopsy, sat down with my wife and I and went over options.  Based on his recommendation I chose surgery - mainly because of my age.  You are younger than I was.  However, there are younger guys who end up doing radiation or seeds and do well.  You have to find the option that is right for you. 

Bottom line for me - surgery has a big plus and a big minus.  The minus is you will most likely have more side effects (impotence, incontinence, no ejaculation).  The big plus for me is knowing where I stand and the fact the prostate with the cancer in it is gone.  Absolutely no guarantee that I won't have to have some followup treatment sometime, but all indications are that my cancer is gone.  I am one of the very, very fortunate ones that didn't really have to deal with incontinence (dry at day 3) nor deal with impotence (yes, I take a pill 2 times a week but no big deal). 

Find the right choice for you, make your decision and go with it.  Never look back - only forward.  As our friend Dale said on another thread just this morning, we all plan to be here debating the issues and supporting each other 10 years from now.  You have found a group of guys (and gals) who have been there, done that and are interested in helping you in any way we can.  Please keep us posted on how things are going.  David

Bill,
Welcome, you will get a lot of opinions on this site, that's why it's so good. With your stats you are the poster boy for all treatment options. The mapping biopsy gives you more confidence in your stats and reduces the uncertainty that you have agressive PC, your low PSA also confirm this.
There are a lot of studies on Active Survelience that show that 75% of PC in your range never show signs of progression in 7 years, and those that do are treated with no sign of matatsis in the future. Because of your young age the PC has a lot of time to grow, but with a good diet there is a high probability that you could go the rest of your life without being treated and if treated the cure rates are similar as if you were treated today. The key is to get a doctor that is experienced in AS.
Every other option is also available, similar cure rates and varing side affects ranging from severe to minor. Tudpuck and I are seeders and have had good results with minimal side affects; most of the others are surgery patients.
The Prostate Cancer Research Institute recommends "no immediate treatment" for your stats. Their web site has a lot of information on all treatment options.
Good luck on any treatment you choose as it is highly individual and you have to determine what is important to you. As long as your PSA doubling time remains greater than 3 years you have an excellent prognosis from any option. I estimate I went about 12 years from the time my PC was detectable to treatment and my doctor said I could have probably gone 10 more before it affected me; so you have plenty of time to research and get several opinions. Diet is extremely important in slowing or stopping progression so pay attention to it.
JohnT

Hi Bill! Welcome to Healingwell! Sorry you have to be here, but glad you found us.  My father had his RP done at VM in Seattle by Dr. Chris Porter and had a good experience.  The entire team was fantastic and while the outcome was not what we hoped, it by no means reflected the team at VM.  They operated like a well oiled machine and we were very happy with the expertise and the kindness they showed.  Good luck and I am happy to answer any additional questions!  Keep us posted!

Dear Bill:

Sorry you have to be here and I'm sure you will find advice/help for anything you want to ask.

I just want to tell you that I agree with JohnT and David completely.  At the very least find a doc with experience managing AS patients and, if your psyche can handle it, that could be a great option for you.

Tudpock