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50 Year Old Husband Just Diagnosed with Prostate Cancer

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Posted 2/2/2011 1:05 PM (GMT 0)
As our guru on PCa Dr. Stephen Strum, a real expert in PCa (btw). There is a place in PCa for all the various treatments or non-treatments (A.S./W.W.)....from what I have seen in 9 years almost of internet various forums, books, support groups and more....this is the reality of PCa, there are more choices than even listed in this thread.

Some guys have done different things and not necessarily insane either. Each case is somewhat unique or can be uniquely treated. I know a guy here in Michigan whom only did ADT3 for 13 months, then proscar for maintenance, he is at year 15 now, rebiopsied 3 times, one this year and nothing found even via Dr. Fred Lee with color doppler ultrasound guided rebiopsies. Maybe not cured either, but he has 15 yrs. of good living and could still do any treatment offered for PCa. So is he an idiot for not rushing into the normal pathways. His psa was 11.0 he had two positive cores found back then 2+3=5's, today would be gleason 6. I have his phone number and email, fyi.  He has absolutely no regrets in his decision....Dr. Leibowitz has website info on this type of protocol...and yes it may not be for everyone, just as Dr. Strum mentions anyway.

Posted 2/2/2011 3:51 PM (GMT 0)
I would also suggest that you at least research brachytherapy, both High Dose temporary and Low Dose seeds. The very prominent centers doing this including Datolli in Florida, Critz RCOG in Atlanta, Demanes cetmc at UCLA, and Martinez in Michigan report that they use brachytherapy for people as young as age 40.

Radiation therapy is used for other cancers at ages younger than age 50 as a standard course. I would guess that your urologist would order salvage radiation therapy if the surgery fails even though the patient is age 50. I wouldn't throw out this very successful treatment option without first having a very serious discussion with a top notch rad-onc.
Posted 2/2/2011 4:30 PM (GMT 0)
I forgot to mention that Univ. of Penn/Phila. now provides proton beam therapy..........so there's one more center on the east coast if you don't live near Boston or Jacksonville, FL. Several of the guys in my PCa support group have been treated there already

Arnie in DE

Posted 2/2/2011 7:30 PM (GMT 0)
A large study published last year by Sloan Kettering I believe in January or February dealt with radiation or IMRT vs. surgery survival rates. The study was conducted and authored by both radiation oncologist and surgical urologist. As one observer pointed out they had their arguments before they published the study. The studied showed little difference within the margin of error between the 10 year survival rates for radiation vs surgery. The study noted there is little data beyond ten years to draw any effective conclusion for men who’s life expectancy was greater then 10 years.

However the study did show a higher instance of metastatic diseases in patients treated with radiation that were unrelated to prostate cancer. Once a patient developed a metastatic disease their average survival time was 3 years.

Medicine works off of gold standards that are result of long term data collection and patient outcomes. People live much longer and are generally in better health because of careful study clinicians have performed. For me personally, surgery is a very rational decision because there just isn’t enough ten year data.
Posted 2/2/2011 9:09 PM (GMT 0)
From another wife who knows exactly how you feel right now - BREATHE, and rest assured your guy is, according to his biop results, at a fairly early stage, although G6 on both sides. Many docs and studies say you can wait 3 months before making a decision as to treatment. It is a terribly gray area for decision making, and that will be stressful. You and your husband have found this site before you've made a treatment decision, and that's a good start!
The advice to read Walsh's book is another good step to take. It caused me to get a second read on my husband's biop slides from JHopkins. You both will get through this, just keep communication open between you and make sure your advice is formed from solid medical readings and/or consults.
Posted 2/2/2011 9:12 PM (GMT 0)
bill88:

I don't know that anyone is questioning whether your decision is logical but you need to be careful with statements like you made where you infer that surgery is the ONLY rational treatment for another specific individual.

There are a ton of studies, many of which have been posted and debated on this web site.  Many of them are contradictory, even within the same study.  None of us have been able to find any long term, controlled, randomized comparison studies...probably because they don't exist.

I invite you to look over some of the older posts where this radiaion vs. surgery topic has been discussed many times, quoting many studies. 

I guess it's not clear to me whether or not you have had treatment; I'm inferring not.  If not, you might want to take the time to consult with radiation oncologists and prostate oncologists as well as surgeons before making a final decision.  A number of us on this site would postulate that radiation is a very logical choice in a number of cases.  Maybe not yours and I can't guess on that.

Tudpock (Jim)

Posted 2/2/2011 9:47 PM (GMT 0)
Diamonds
You are among friends and people with extended knowledge on this topic. My humble advice is to gain as much information on your husband's condition as possible and don't be in a hurry. I know when I heard the word cancer everything went into overdrive, and the selection I made was not the selection I should have made. I am one of those who trusted his uro surgeon knowing he had performed only 75 robotic prostatectomies. There were complications that I feel could have been overcome with a more experienced surgeon. My surgeon even admitted to me he had not seen my anatomical condition before. He even called the surgeon that trained him for advice. There is no substitute for experience when performing this type surgery. I would recommed buying the book "Surviving Prostate Cancer" by Dr Patrick Walsh from Johns Hopkins. I wish for you and your husband the best of good health.
TTaylor
Posted 3/11/2011 8:47 PM (GMT 0)
Any suggestions for the amount of fluid intake the days following my catheter removal?
Posted 3/11/2011 9:33 PM (GMT 0)
Welcome Diamond and husband,
I am relatively new here and have not the expertise that most if not all of the good people here have. I wish I would have found this site before I had my surgery. The decision for me was simple but the support would have been greatly welcomed and comforting.
You can always come here just to vent if needed. I've done that a couple times myself. Who knows, some times some one will say some thing to make you smile and that can change your whole day!
Good Luck and keep us posted, we're rooting for ya!
Posted 3/11/2011 9:38 PM (GMT 0)
Diamond
There are guys here who are engineers and who love data .Give them your age and weight and they will have it figured to the drop what the water intake and voiding should be. Now you've opened Pandora's box on this one. Duck and cover!
Posted 3/11/2011 9:54 PM (GMT 0)
Age 50, weight 160
Posted 3/11/2011 10:55 PM (GMT 0)
Diamond,
I see the cath is out ,how is the incontinence doing? It can be a very frustrating time for men,at least it is for me. Mine cath was in for 13 days. I am now down to 4 or 5 pads a day.
I just drink the same amount of fluids I did before, maybe a little more. Do not cut down on fluids to try and slow down or stop leakage. Urine should not be dark yellow. That could lead to urinary tract infections and other nasty stuff.
Posted 3/12/2011 1:01 AM (GMT 0)
I've had my catheter out for a week and a half now.  I am still trying to drink as much water as possible.  I had some blood in the urine and wanted to try to clear out as much of the sediment and crap as possible.  I think it is possible to not drink enough.  I don't think it is possible to drink too much. 
Posted 3/12/2011 1:45 AM (GMT 0)
Incontinence? It's been about 8 hours, not sure yet what to make of things. Some urine is ending up in the toilet, some isn't. I seem to be able to stop and start the stream. I haven't gotten a full bladder feeling yet. We'll see what tomorrow holds in store.
Posted 3/12/2011 1:59 AM (GMT 0)
Diamonds3

Day and night are different -

If you make it through the night without a significant leak, that's great. A very good sign.

Daytime - even if you don't leak much at night, daytime can be a challenge.

I held everything at night for a few nights, but there are the nights every few weeks where I flood, so I still use a pad at night. During the day - wet was the norm for several months.

It sounds like you are already ahead of me - I'll be hoping for the best for you.

Posted 3/12/2011 4:01 AM (GMT 0)
Man, I didn't make a stream for like 5 days or so!
Posted 3/12/2011 2:08 PM (GMT 0)
I got up 2X during the night to use the bathroom. It's funny, I almost never got up in the middle of the night pre-surgery. When I woke up in the morning I had a full bladder. I thought I was dry until I weighed my pad, 7 grams heavier. We'll see how it goes today, we have a wine and cheese party to go to. I guess it's better than a beef and BEER.
Posted 3/13/2011 2:26 AM (GMT 0)
Today, like last Saturday, my bladder took control. It seems like during the week I'm doin pretty good but when the weekend comes,not so much.During the week maybe 4 to 5 pads a day, weekend 6 to 8,I don't get it. The only thing I'm doing different is, in order to get out of my tiny town,I've been shopping with the wife. Oh wait, never mind! That probably explains it !
We are going to her stores and not my stores...hardware,sporting goods& and motor cycle shops.
Posted 3/13/2011 1:19 PM (GMT 0)
Diamonds,

I am also getting up in the middle of the night more frequently than I was presurgery. I think that previously I just ignored the urge. Since the surgery, I'm more concious of it an not inclined to be taking any chances. I hope that as you and I become more confident in our control, this will be less of an issue.
Posted 3/13/2011 1:39 PM (GMT 0)
Hello Diamonds!  I started to read this thread and just had to find out how things have turned out for you.  It seems midstream (pardon the pun) your wife left and you are now posting.  Is that correct?

I just wanted to stop by and wish you the very best.  There are some wonderful people here, as I am sure you have discovered.  Just thought I would mention that it took my husband FOUR months before he was completely pad free.  Kegals were very important for him.

Take care and good luck to all of you here!

Best regards,

Aimzee

Posted 3/13/2011 4:47 PM (GMT 0)
yes, I (husband) seemed to take over this userid. Things are going well; we meet with the surgeon on March 15, 2011 to get the final pathology report. The issue for me right now seems to be the increasing pain at the incision near my belly button. I mentioned it to my uro when he removed my catheter last week and he said to make sure to mention it to the surgeon. I have not lifted anything heavy and the only exercise I've been doing is walking about 2 miles a day.
Posted 3/13/2011 5:07 PM (GMT 0)

Diamonds husband:

If I remember correctly,  that particular incision caused me the most grief in healing,  but it did heal with time. Pressure from pants , shorts, belt etc always seemed to aggravate the area.

Posted 3/13/2011 10:12 PM (GMT 0)
Diamonds: With your husband'w weight at 160 lbs Converted to kilos is 72. So he should consume around 72 ml of fluid each hour. That is equal to 58 ounces of fluid per day. That is a general recommendation for average temp and humidity levels. Don't go crazy with fluids or drink too little because that is even worse. Your body and kidneys need fluid. Hope that helps.
Mike S.
Posted 3/15/2011 9:57 PM (GMT 0)
My wife and I feel very fortunate with the favorable final pathology report that we received today:
Prostate Size: 22 grams
Gleason: 7 (3 + 4)
% of Tumor involved: 10%
Extraprostatic Extension: None
Seminal Vesicle Invasion: None
Margins: +, invasive apical, posterior
Lymph-Vascular Invasion: None
Perineural Invasion: None
Grade: T2C
Lymph Nodes: 6 removed, all clear

As my Gleason was upgraded to 3 + 4 I need to have my PSA checked every 3 months starting in 6 weeks.
Posted 3/15/2011 10:33 PM (GMT 0)

Diamonds, I see in your signature that after your biopsy, your Gleason score was given as 3+3, and you then apparently sent  your slides to Epstein for a second opinion.

Was it Epstein who upgraded the Gleason to 3+4, or was that done after the surgery based on the final pathology of the prostate? 

Did Epstein concur with the 3+3 Gleason score?

Congratulations to you and good luck.

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