Still trying to decide

Hi Ger,

The very best possible advice anyone can give you if you go the route of surgery is to find a very experienced surgeon. There is a statistically significant difference in surgical outcomes that directly correlates to the experience curve of the practitioner, as documented in numerous medical journals. Start asking around, and people will come out of the woodwork with information and experiences and recommendations. You will undoubtedly be able to find someone very experienced in your area if you live in or near a major metropolitan area, although some men travel for miles to find the most experienced surgeon.

best wishes...

Hello Ger:

I didn't see you mention brachytherapy/radiation as an option.  Even if you finally opt for surgery you probably owe it to yourself to review all of the options so you can make an educated decision.  That means talking to a radiation oncologist in addition to surgeons.  Several of us on this forum have had very good experiences with brachy...you can read my journey via the link in my signature.

I did not realize you live in Florida.  One of the finest practioners of brachytherapy is the Dattoli Cancer Center in Sarasota.  Here is a link to their web site for your consideration.

http://www.dattoli.com/

Tudpock (Jim)

Ger,
With your stats, a Gleason 6, if confirmed by an expert pathologist, will respond equally to any treatment option with cure rates being exactly the same. Given those facts you should choose the treatment that has the least side affects and is the most convenient for you current lifestyle. As Tud mentioned Brachy is a fairly simple 1/2 day procedure with fairly benign side affects compared to other options. All the studies I have reviewed indicate that Proton has no advantage as to efficiency or side affects when compared to standart IMRT.
JohnT

Bob: good luck on the success of your "seeding". Sounds like the procedure went text book perfect for you. I hope your future PSA readings are all good for you.

David in SC

Ger42,  "Still Trying to Decide"  I understand completely, I'm there now too.

Age: 50 in good health other than PC

weight 170
height 5' 10''

No symptoms to speak of
PSA 10.4
Prostate no enlarged

Samples taken mid-April
6 out of 12 samples cancer
1) gleason score 3+4 involving 30% Right Base
2) gleason score 3+4 involving 40% Right _
3) gleason score 4+4 involving 50% Right Apex

Bone scan clean except a 1 mm spot on left scapula 
CT scan clean

Biopcy of Scapula was negative, Doctor says good/bad news, we want to watch it.

My urologist gave me the following options (not in any order): Study up and let us know which way you want to procees.

1) Surgery/external beam radiation (IMRB)

2) Hormone Therapy, Brachytherapy, IMRB 

Met with a radiologist and a robotic surgeon, each has their own path but I have not found any statistics to "know" the "Best" path for my situation, appers to be very subjective.    I did get a recommendation for surgery from a Doctor that I was e-mailing concerning a new Laser process and another from a taped 2008 Symposium I found online.  I just got off the phone with my urologist who said at my age, surgery is a good option with added external beam radiation.   The waiting list is long so I am now scheduled for July 16.   We have what appears to be a good facility here in Loveland, Colorado with experienced sergeons, still not 100% on my decision but typing through this is helping, ...... It must be raining in here, ... my glasses are a bit fogged!  Still hard to talk about/type about...

My wife of 30 years is "melting down" inside  and avoiding walking about it, we'll be working on that.  

I just found this forum , a lot hear to read for sure -

Thanks

Meryle 

Take your time!

Armed with a good medical dictionary (book format or online), go directly to the medical literature via PubMed if at all possible.  Look for prospective, randomized studies or as close to it as you can find.

Given our current state of knowledge, there are no clear or correct answers.

Zen9

I am also a new to HW and only speaking from experience from research I did when my father was dx 10 years ago and now with my BF. My father had a gleason 6 and seeds worked for him at 59. He has maintained a 0 PSA and no side effects for last 10 years. Being his daughter, it was hard to talk about ED and incontinence along the way but after BF was diagnosed, he talks more about it. He does not have side effects now but did have some blood in urine, had discomfort and was irritable. BF's situation is much worse, so he had to do surgery, HT and radiation. He has ED that is very depressing for him and rightfully so. We are only 6 months out so we are hoping for the best. There are many men here that had surgery and do not have the complications we had because of the severity of PC spreading. Thankfully, you are able to consider various treatments! There is so much information out there and many treatments available. Second and third opinions are the way to go! Every doctor will sell their speciality and its up to us to make the decision that is right for us at the time we need to make it. I wish you the best and know you will have a good outcome!

I have a consolation June 16th with the urologist my Dr neighbor recommended. He has been doing DaVinci surgery since 2003. He recommended seeds for my neighbor's grandfather. Neighbor says he will give me an unbiassed opinion. If I opt for surgery I might use him he has had more experience than my current doctor.
AS for my wife I could not have a better women at my side. She has been supportive since day 1. She is wiling to come to any appointment I ask her to attend.

I have an acquaintance who has the same urologist as I do, and he is under AS. His PSA was as high as 9 three years ago and has now increased to 12. Still no problems.
I should add that he is already 74 years old.