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Posted 12/11/2009 9:43 PM (GMT 0)
I really don't what all this says. Thanks to Opa N for telling me to go get a copy of the report.

I think i put it all as my signature.

Posted 12/11/2009 9:56 PM (GMT 0)
Well welcome to Hw.I am much like you I don't understand most of the stats and such so I will let the more experienced members chime in on that.But glad to have you aboard.

Zach
Posted 12/11/2009 11:17 PM (GMT 0)
Key....the left side is pretty high in percentage...do you know what the volume or size of your prostate is? I would think that some additional testing may be needed. The 100% mid and 88% apex to me would be of concern for cancer being close to the edge or already past the edge of the prostate. Additional testing will make things a little clearer on which treatment method would be best.

But that's my take on this...others will chime in with their thoughts as well.
Posted 12/11/2009 11:58 PM (GMT 0)
I don't see on this report anywhere about size or volume.
Posted 12/12/2009 12:12 AM (GMT 0)
Yeah, it will help to know prostate size in cc. if possible and/or tumor volume by % if known.

You are looking at 6/6 positive cores. The 2 that are 88% Gleason 7 would really concern me.

The PSA is not all that high, as far as a raw number, but then you are only 45 years old.

What is your own inclination for treatment at this point? Based on what is posted so far, I wouldn't want
to make a guess. Your age and Gleason would make you a good candidate for surgery, since
you would be expected to have more than 20 years life expectency.

Please keep us posted and stay in touch.

David in SC
Posted 12/12/2009 12:23 AM (GMT 0)
When i last met with urologist on 12/9 he said he wanted to do the da Vinci. I go back on 12/16. He said that he was going to start getting everything set up for surgery, that's what i want to have done as soon as possible. All i see is the tumor length & core length.
Posted 12/12/2009 12:53 AM (GMT 0)

Dear keysailfisher:

There is a ton of advice given to new members here.  At the top of the list from many, many of us...whatever the treatment we have chosen...is to get multiple opinions.  That is to talk with a surgeon, radiation oncologist and prostate oncologist.  Also, to read and research your situation.

By taking the approach you have indicated, i.e. "He said that he was going to start getting everything set up for surgery, that's what i want to have done as soon as possible.", it does not appear to me that you are taking the approach that many of us recommend.  Maybe you have done more research than indicated or maybe you have sought other opinions and not revealed that to us.  If so, I apologize.  If not, I don't believe you are becoming an informed patient to be able to make an informed decision about finding a cure for your cancer.

Respectfully,

Tudpock

Posted 12/12/2009 2:59 AM (GMT 0)
I agree with Tudpock (and others). But if you are not going to read some books, study your options, evaluate open versus laproscopic versus robotic surgery, and talk with a radiation oncologist and a medical oncologist in addition to your current urologist to compare treatment alternatives and the risks and benefits of each, then *at an absolute minimum* you should ask your urologist how many "da vinci" procedures he has done, and how many in the past year. In my opinion, if he has done fewer than a couple of hundred of them, or fewer than one a week in the past year, then I would not allow him to operate on me. You should know that, with prostate surgery, there is a demonstrated correlation between experience and skill of the surgeon and outcomes. In other words, your continence, ability to achieve an erection, and potentially your life could depend on the skill of your surgeon. I wish you the best.
Posted 12/12/2009 3:06 AM (GMT 0)
Key,
The indication is that you have a very large tumor on one side. What you don't know is if the tumor has extra capsular extension or if the tumor is located in a spot that would make surgery difficult. A color doppler ultrasound or an MRIS could give you more information. There are a lot of cases in which surgery may not be the best option and you will wind up getting radiation. It's much better to know before they start cutting than after.
JohnT
Posted 12/12/2009 3:13 AM (GMT 0)
I've done alot of research and surgery seems to be the best option for my age. My surgeon is very skilled with the da Vinci.

Frank L.. Tortora, MD


      
Frank L.. Tortora, MD

 
 

Dr. Tortora graduated Cum Laude from Yale University and from medical school at Emory University. His internship and residency were served at UNC Hospital in Chapel Hill NC. He is still affiliated with the UNC School of Medicine as a Clinical Associate Professor in the departments of Surgery and Family Practice. Dr. Tortora is a Diplomate of Urology. Dr. Tortora is sought after nationally by developers of new urological techniques and treatments and is considered an expert for panel discussion in his field. He has helped develop medical and surgical techniques to aid the treatment of male sexual dysfunction. His past appointments include President of the Medical Staff of Western Wake Hospital where he still maintains a close administrative association.

Posted 12/12/2009 3:26 AM (GMT 0)

I agree with John.  This would be a good place for a color doppler.

These aren't available everywhere, so you may have to travel a little to get one.

Second opinions are a good idea for cases like this that show a high core percentage, and particulary from a radiation oncologist or a prostate cancer oncologist.  You will find many men on here who say the surgeon recommends surgey and the radiation guy recommends radiation.  Hopefully a prostate oncologist is a more neutral person.

Just be sure you take the time to understand your cancer, your treatment options, potential side effects, and 5 and 10 year prognosis rates.

Good luck.  Oh, and take a deep breath.  This is not a death sentence.  Statistically you have a high percentage chance of a long life.

Goodlife

Posted 12/12/2009 5:03 AM (GMT 0)
Key - It sounds like you do really have a well qualified surgeon and for that reason I think you are very fortunate. I'm sure he is so well secure in his abilities that he would welcome the opportunity to help refer you to other prostate specialists for additional opinions. I know it is important to "get this taken care of" but it is equally important to "get this taken care of" when fully informed of other options. Please accept my apologies if I have overstepped protocol here but I agree with most of the guys on this thread who are urging you to get more info.
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