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Posted 3/15/2011 8:57 PM (GMT 0)

I am a new member as I just received by PC diagnosis yesterday.

First, I would like to thank the creators and participants for the site.  I looked for a while yesterday to find someplace that felt comfortable to me and was happy when I found you folks.

My age is 62.  I have been blessed with excellent health-never been on any medications nor had any brushes with any diseases.  I am fit and walk several miles weekly to stay in shape.  My PSA is 5.9-Gleason index 6. 

My urologist was quite positive-saying that we caught the cancer early and that I would be fine.  He suggests brachytherapy because of my age and health.  He feels confident that my prognosis is excellent.

I would like to know from some of you whether you would concur.  Any experiences with this treatment would be greatly appreciated.  I am expecially interested in the side effects.

Thanks,

bachez

Posted 3/15/2011 9:14 PM (GMT 0)
Sounds like a good recommendation to me. I have had IMRT and seeds and didn't end up with incontinence or ED or urinary frequency issues. Of course I am only 8 months out from the procedures now so You'd have to find out from some of the other guys who have had a longer time span after they were treated on how they are faring. What a difference a few years of age make in what the urologist tells you though. I was 57 when diagnosed and all they wanted to tell me about was surgery because the urologist was the surgeon that would have done it.
Posted 3/15/2011 9:50 PM (GMT 0)
I think that you would find most Brachy patients on this forum have had no side affects such as incontinence or ED. I'm 2 years out and have zero side affects. I would also recommend Active Survelience (see post by Navy wife) if you meet the criteria.
Be sure to take your time and investigate all options.
JT
Posted 3/15/2011 11:20 PM (GMT 0)
welcome, bachez, glad you found us, and joined us.

Brachytherapy could very well be your best choice, you should have all treatment options including AS available to you. Take all the time you need to research and ask questions. Please keep us posted.

David in Riley
Posted 3/15/2011 11:34 PM (GMT 0)
Bachez, our stats are pretty similar and BT was my choice. I had some minor side effects but nothing that would have made me change my choice of treatment. I'm only 9 months out from treatment so I can't speak of long term side effects or results but my urologist seemed pretty sure that BT would be a good choice for me.
Posted 3/16/2011 3:57 AM (GMT 0)
If you have not read any books on the subject, you can learn a lot about PC and how it is treated by doing a little reading..Dr. Gerald Chodak's "Winning the battle Against Prostate Cancer is up to date and even handed..Dr Patrick Walsh's "Guide to Surviving Prostate Cancer " is even more comprehensive but Walsh is a surgeon so the book tends to lean in that direction...There are other books, most of them strongly biased towards the treatment (or lack of treatment) the author favors..There is a list of them in the permanent threads at the beginning of the forum. You can find most of them on eBay for a few bucks..Brachytherapy can be combined with external beam radiation for an even more effective one-two punch. God luck to you...
Posted 3/16/2011 11:36 AM (GMT 0)
I had brachy on Oct. 4. I would absolutely recommend it for anyone who is deemed a good candidate. I am only 5 months out, but my life is almost 100% of what is was before. I still have to be careful if I overdo it on coffee or beer. In those cases, I can have some leakage. Very minimal problem all things considered.

Posted 3/16/2011 12:33 PM (GMT 0)
Dear bachez, welcome to the forum but I'm sorry you have to be here.  From what info you have provided it sounds like brachy could be a good choice.  I am 2 1/2 years post brachy that I had at age 62.  The ONLY remaining side effect is the loss of about 1/2 of my ejaculate.  Other than that my side effects have been almost non-existent and my QOL excellent.  I have NO urinary or sexual issues nor have I ever had except for some frequency and urgency during the first couple of months post-brachy.

Feel free to copy and paste and read my "journey" at the bottom of my signature to get a more complete view of my experience.

Good luck and please keep us posted.

Tudpock (Jim)

Posted 3/16/2011 3:39 PM (GMT 0)
bachez - I would consider arranging for a "second opinion" on your biopsy slides, by an expert in prostate pathology. You can find the names and contact information for these experts on this board -- Bonkhoff, Oppenheimer, Bostwick, Epstein and a couple of others. This is easy to arrange through the office that did your biopsy. The reason to do this is prostate biopsy slides are notoriously difficult to read correctly. You will make a treatment decision based in part (maybe large part) on the reading, including the Gleason score, so you want to make sure it is right. Many times when an expert re-reads the slides, the outcome changes. Not always, of course. But it is worth knowing with highest possible degree of confidence what your cancer looks like before you decide on a treatment modality. Best wishes, Medved
Posted 3/16/2011 6:12 PM (GMT 0)
I would like to thank everyone for responding to me in such a  short time.

Getting all of this feedback within a day of posting is quite gratifying and very comforting. 

It seems most of you concur that brachytherapy would be a wise choice for me. 

Medved suggest getting a second opinion on my biopsy slides.  I am interested in whether others would agree. 

Again, keep the comments coming.

bachez

Posted 3/17/2011 4:10 AM (GMT 0)
A second opinion on the pathology is a very good thing to get done.

Get it from the best pathologist that you can.
Posted 3/17/2011 5:38 PM (GMT 0)
2nd opinion is always recommended. Get one from the experst listed above.
Posted 3/17/2011 5:52 PM (GMT 0)
Bachez,

I had a combo of BT and IGRT. BT was done as an outpatient...I was home the same day with no catheter. Had some burning, freqency, and urgency that went away after about 6 weeks. No incontinence, but some mild early ED which has improved (but with less ejacjuate). I'm 15 months out from BT and 12 months out from the last rad treatment and feel as good as I ever have. My PSA in December was 0.1.

For all the reasons above, I am admittedly biased toward BT as a treament option.

Regards,

Joe
Posted 3/17/2011 8:18 PM (GMT 0)

Medved and/or John T,

How do I find the contact information for the prostate pathology "experts" on this site?  It is not obvious to me.

bachez

Posted 3/17/2011 8:53 PM (GMT 0)
brachez,

Here's a link directly to the Bostwick 2nd Opinion Service page: https://www.bostwicklaboratories.com/global/services/laboratory-services/second-opinions.aspx

The others could be readily found using Google...their name, along with "pathology", for example, would be good starting points.

Bostwick is probably the leader in 2nd opinions...and probably considered the best in the industry along with Epstein.  I also used Bostwick.
Posted 3/17/2011 9:05 PM (GMT 0)
As you see, I am a surgery guy, but my younger brother had brachy and now at nearly seven years out he has no recurrence and reports that any ED issues are handled by Viagra. Your stats are similar to his, although he was 55 at treatment. so I would say that brachy is definitely a viable option for you
Posted 3/18/2011 12:30 AM (GMT 0)
Hello. Sorry you are going through this. I joined this board in Nov when my father was diagnosed. He is 62 as well with a Gleason 7 (4+3) and PSA in the 7's. I remember his first week of diagnosis he was pro radiation, however once you absorb your diagnosis I do recommend looking at the pros and cons of all treatments. He actually opted for Robotic Surgery. The biggest challenge to the decision was the fact that so many people support their choice and there are different choices and reasonings behind the choices. That is why it is important you meet with radiologists and surgeons in my opinion. I would also read some books. My father and mother liked Patrick Walsh's book and Dr. Ketan Badani's book Robotic Prostatectomy for Prostate Cancer — Is It For You?. My father liked the 2nd book better but he opted for surgery by Dr. Badani on 1/31. Good luck in your search! I remember when he was first diagnosed I panicked and ran to this website which was very helpful with opinions and resources but you need to couple this with actual appointments with doctors to form your decision.
Posted 3/18/2011 12:57 AM (GMT 0)
I am a DaVinci / IGRT guy, but only because mine was well advanced very early.

In the early 80's I had looked a lot at seed theraphy in general, and actually invested a tiny bit of money in the main company. One of the few investments I've ever made that returned anything. Even then the prospects were amazing. I had to be convinced by my friends in the medical community that I was too far along for that.

So yes, please consider all treatments before you make a decision.

Posted 3/18/2011 1:14 AM (GMT 0)

On this third day after diagnosis, I am starting to feel somewhat pressured from several different directions.

My next meeting with my urologist is 3/28 and as mentioned earlier, he thought my case was ideal for brachytherapy.  Many of you concur.  My sense is he would like a decision from me at this meeting and hence the pressure buildup.  I am advised that I should take all the time I need to make up my mind but I am a bit confused about what this means.  Since AS is an option, it would seem that waiting several months(perhaps to the fall of the year) would cause no harm. But, are we talking about months or perhaps a couple of years to decide?

I assume that I have time because my Gleason is 6.  Many responders have advised me to get a second opinion on my biopsy slides which would certainly slow things down a bit.  This seems like a wise thing to do. If this changed things, perhaps I am a 7-does the time frame for deciding on a treatment also change? Not knowing this answer increases the anxiety.  If a Gleason 7 should be the case, perhaps acting quickly with the brachy would be the best option as I could follow it up with a supplemental treatment.

Any info or thoughts would be appreciated.

bachez

Posted 3/18/2011 1:36 AM (GMT 0)
I can only speak from my perspective as the daughter of the patient, but I can tell you that I also felt this sense of urgency as did my father. I mean afterall, hearing the word Cancer brings out a sense of powerlessness. If you take that with reading about the side effects of different treatments that are not the best side effects to hear about, incontinence either bladder or bowel, ED, etc, it is all very overwhelming and understandably so. My attitude was you can't control the fact that you have cancer, but you can control how you treat it and how much information you can obtain. i felt power in information, that is personally how i think most of my family dealt with it. I think also it is typical to want an instant decision to almost calm yourself, to feel like you are taking power against cancer, and that is that. But again after you take some time, and I feel with a Gleason 6, you don't need a decision next week, you will find that even though you just want a decision to get start treating this beast, you will soon find that since there are possible side effects you need to acknowledge, you will want to explore all options. Dont feel intimidated by doctors. This is your body and your decision. The local dr that diagnosed by father met up a week later to discuss options etc. My advice is take power by purchasing 1 or 2 books that have been recommended and start reading. In the meantime while reading, set up a few appointments with some major doctors in your area. See if you can find one that does robotic (at least 300 or 400), the doctor my dad chose did over 1500. Then see if you can find one that does open radical and make appts now as you may wait a few weeks. Also find one radilogist and get an opinion there too. In terms of 2nd biopsy opinion we had one done right out of Columbia, where the doctor was that was doing the surgery. What city are you in or near? It may help others give you some Dr recs.

Post Edited (formypops) : 3/17/2011 7:47:47 PM (GMT-6)

Posted 3/18/2011 2:23 AM (GMT 0)
I am in Rhode Island
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