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Any surgery guys wish they had done radiation instead?

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Posted 4/8/2011 10:56 AM (GMT 0)
As far as the 'you can't do surgery if the radiation fails' thing, that is not quite true. Before my 'seeding' I learned that while it can be much more difficult afterwards, a skilled surgeon can still remove the prostate. Could be that one reason many won't do it is because the added difficulty may screw up their success statistics.
Posted 4/8/2011 1:23 PM (GMT 0)
Dear I Used to Be a Fish,

Hi. My Husband had a robotic prostatectomy at Penn in Philly on 3/04/2011
He is 50 and is without pads and we are resuming intercourse He did use An oral medication but his Dr wants him to try doing without it

Maybe I missed your original post. Did you give your husband's age? My husband researched other treatments including some that are really in trials. After consulting with some family members and friends including a surgeon,and oncologist, we were very encouraged to have surgery. When a man is as young as my husband, he has a better chance of maintaining continence and sexual function. More importantly, the urologist I spoke to said that if he has a recurrence, it is better to have had surgery BEFORE radiation as the tissues become more brittle and do not respond as well.

Whatever you do, make sure your surgeon has done over 600 robotic prostatectomies.There is one or two who have developed a technique that allows the surgeon to get closer to the sometimes hard to reach apex. One of them is in Florida and And another is at Cornell

Again, the treatment he chooses should be based on his age, prior health conditions and stage The problem with staging is that you do not get full picture of the pathology unless the surrounding tissues are biopsied

I know John Hopkins does a Friday clinic where a panel of oncologists, surgeons an radiologists will discuss your case and advise

Get the ver best medical treatment your insurance ,time and pocketbook can afford and remember that this cancer can be treated and result in a high cure rate.

I wish you both the best
Posted 4/8/2011 1:45 PM (GMT 0)
Diamond3,

Your guy deserves to wear a red cape with a big S on it. That's a fantastic recovery, my surgery was on 03/03/11, wish I was at that stage. Best of luck without the meds.
Posted 4/8/2011 2:06 PM (GMT 0)
Dear Viper,

Well you know my husband has a really hot wife.....only kidding

First of all, he is 7 years younger than you and he runs to the bathroom A LOT
Secondly,he gets up through the night to go to the bathroom ..now he knows what his menopausal wife goes through.
Finally, while he had a really good nerve spearing procedure, he has a positive margin
One last thing , his Urologist was really surprised but his surgeon mentioned something about his having a long urethra

I wasn't bragging, I just wanted I Used To Be A Fish that there are often good outcomes

You know, everyone heals in different ways It is really way early for you. Hang in there.
Posted 4/8/2011 2:36 PM (GMT 0)
Hang in there? No pun intended, LOL.
It's great to hear good results.

Thanks diamond3.
Posted 4/8/2011 2:57 PM (GMT 0)
I had surgery in January of 2010. My urologist advised me to be patient in terms of recovery....he said it can take up to 2 years. I was dry and pad free at 8 weeks post op. ED was a bit slower, first signs of things starting to work was about 6 months post op, able to achieve full erections with medication at 10 months, and at 15 months able to achieve full erections without the aids of meds. PSA is undetectable. I am cautious of saying never say never, and I don't want to jinks myself, but now at 46 years old I am looking at this event as a bump in my life that is hopefully behind me and that I will never have to look back at.

In other words no regrets whats no ever.

Posted 4/8/2011 3:16 PM (GMT 0)

normek said...
I had surgery in January of 2010. My urologist advised me to be patient in terms of recovery....he said it can take up to 2 years. I was dry and pad free at 8 weeks post op. ED was a bit slower, first signs of things starting to work was about 6 months post op, able to achieve full erections with medication at 10 months, and at 15 months able to achieve full erections without the aids of meds. PSA is undetectable. I am cautious of saying never say never, and I don't want to jinks myself, but now at 46 years old I am looking at this event as a bump in my life that is hopefully behind me and that I will never have to look back at.


In other words no regrets whats no ever.

Must be great to be able to experience such progress over a somewhat short timeframe. It's the kind of news that can help anyone who has questions about their own progress.


I cannot see it as a bump in the road yet. Some days I do, but then at times it hits me hard that I just went through a tough stretch out of the blue.

I was watching the Big C last night where the main character with terminal cancer finally has a few very gut wrenching scenes where she has to face her own mortality and it really got to me. It's like I was transported back to the week I was told I had cancer. I hope I can comfortably put it all behind me within a few years. ONm the other hand, this might be our reality and it's just added perspective on life, self and loved ones.
Posted 4/8/2011 7:37 PM (GMT 0)
Fish,

I started out thinking I was going to have surgery. My uro, much to his credit, urged me to explore all options...including BT since he was also experienced with the acutal seed insertion. I learned as much as I could and spent a lot of time here on HW. In the end, I opted for a combination of seeds followed by radiation. The tipping point for me was the issue of incontinence. A member of my extended family had PC surgery 3 years ago and still wears pads. I have avoided the issue with BT and have had only mild side effects.

Making the decision for a G6 may be the most stressful part. Once you are past that you can start moving ahead. Best wishes,

Joe
Posted 4/8/2011 7:52 PM (GMT 0)
Joe, if you don't mind, what are your mild side effects?
Posted 4/9/2011 4:28 AM (GMT 0)
No regret. Will not go for AS, however, I should have taken a more serious look at radiation.
Posted 4/9/2011 10:24 AM (GMT 0)
Ex Fish

My doctors told me my treatment had a lot to do with my age I was 49 at the time same age as your husband. They gave me all the info of all the treatment options but they recommended the robotic surgery. They said that if I had radiation I could still have the surgery but the side effects would be worse. I read every thing they gave and talked with some people. I decided on the surgery. I have not regretted it I have had second thoughts from time to time but not big regrets. I don't have ED with a little coxing he gets up and performs, orgasms aren't what they used to be but it's improving.  I'm down to one pad a day. I barely leak.  I can LIVE with this.

Viperguy

Your being too hard on yourself I know you have a lot on your plate. I'm sorry you lost your job. As for your surgery your expecting too much too soon. I was waking up to wet PJ's at a month out myself and yes it got me down. I'm now 6 months out and almost can go pad free. You got to get a positive attitude it makes a difference. And like one guy alluded too make the little guy know your still thinking about him. Everything needs exercise after surgery.  

Posted 4/9/2011 4:11 PM (GMT 0)
Post op day four. Had robotic surgery at ny presbyterian.I just turned 50 and found out I had Pca gleason 3+3=6 .take your time do research every case is different. I wanted to go seed therapy but my prostrate volume was 50 grams aka to large and not a great candidate for that treatment.I would have needed 6 months of hormone therapy to shrink it.I didn't want to wait that long. They say any treatment can be right as long as you get highly skilled drs who perform well in their trade. I think I made the right decision,but it's always in the back of my mind that maybe I didnt.good luck with everything fish stay positive
Posted 4/9/2011 4:32 PM (GMT 0)
G6,

Immediately after BT...urgency, frequency, burning sensation. 15 months later....less ejaculate than before and slightly more frequent urination than before BT.

I believe from an earlier post you may be in the NE Florida area. Please feel free to contact me at the email address in my profile.

Joe
Posted 4/12/2011 5:38 AM (GMT 0)
I have no regrets. Had nerve sparing over three years ago. I am continent and

have erections anytime without meds. My "size" is back to normal also. Orgasms are

as great as ever. Except for the dry orgasms all is the same. I had a great surgeon and a very

loving and sexy wife that "nursed" me back to health.

It is a decision you must make and many here believe their decision was the best.

I am just sharing what worked for me.

Posted 4/12/2011 7:56 AM (GMT 0)
No regrets.
Also there is the matter of the possible difference in pre-op(biospy) pathology and post op pathology.

Before surgery I was only a Gleason 6, after surgery I was a 7, and more importantly I was stage 3 as there was seminal vesicle invasion. Now had I opted for RT as my first treatment, then the cancer in the seminal vesicles could or would have been missed, or might just not have received enough dose for the RT to be effective.
As it was, when I did need RT after surgery the targetting of the prostate bed took into account what was known about where the PCa had actually spread to.

Alf
Posted 4/12/2011 11:04 AM (GMT 0)
No regrets here. I was given options, in fact Dana Farber in Boston and another leading uro surgeon in Atlanta told me they would only do or advise HT & RT because of the nodule felt on DRE and they thought cancer would also be in SV. They both gave me a prognosis of 5-6 years. I also had 2 uro surgeons tell me they thought RP would be a choice also. I did weeks or research and did not make up my mind until for sure until the day of surgery. In fact I saw a Radiation Oncologist one day and had surgery the next. After surgery they found the gleason to be the same, but instead of cancer being on one side as biopsy suggested, it was on both sides and I had 40% gland involvement. I was told that with that tumor volume, the RT would not have gotten it all. I have been completely dry post 2 weeks catheter removal. Although I can get erections without medication, I cannot no sustain without, and that is ok with me except the cost of cialis and viagra. That was not a big concern with me going into surgery as much as the continence, I would much rather be a live steer than a dead bull. This was 4.5 years ago and I may die before that 5-6 years, but it won't be from Prostate cancer. I have no regrets. My only advice is to RESEARCH all your options and find the best possible person in that field.
Posted 4/12/2011 11:52 AM (GMT 0)
no regrets whatsoever. Cancer was contained, no issue whatsoever with urinary issues and having sex as frequently as before surgery with full erections. All this right after surgery. Wouldn't have done it any other way.
Posted 4/12/2011 12:34 PM (GMT 0)
One more thing to add:

For me I also had enlarge prostate (BPH) and had frequent urination at night (2-3 times), slow stream, could not completely empty, dripping after urination, waking up with lower back pain every morning, surgery cured them all. Now, I do not have to get up to urinate at night, empty in seconds and no more lower back pain.

I never ask but am curious to find out if radiation also cures the symptoms of BPH? I would think radiation should offer the same benefit as it kills off prostate cells but like to hear from the radiation folks.
Posted 4/12/2011 12:43 PM (GMT 0)
i had a tiny prostate but had same issues with weak stream, sense of urgency when nothing was there, dripping at the urinal for 20 seconds when I thought I was done. Surgery has also fixed all of these for me. I pee liek a 10 year old again.

One urologist told me those symptoms had nothing to do with my prostate cancer, that they were spasms. I found that hard to believe.
Posted 4/12/2011 5:11 PM (GMT 0)
 Well there  you have it a hundred different views. Sounds terrible it's not really because for one they have hundred different life experiences. They are not trying to mess with you. You have to do your research and make your decision. I made mine I can't make yours. It's tough

 

Post Edited (p_elliott) : 4/12/2011 11:14:11 AM (GMT-6)

Posted 4/13/2011 2:26 PM (GMT 0)
I feel like I did the right thing. By having surgery first it leave more treatment options avialble in case I need them. Also, they biopsy the prostate after they remove it. That makes you a lot more certain of the results of the cancer treatment.
Posted 4/13/2011 4:17 PM (GMT 0)
Newporter,
I had a 60mm prostate before seeds and IMRT. Had all the BPH symptoms, slow stream and getting up at night. Seems that radiation cleared up those problems. Don't know if it will last, but so far so good.
JT
Posted 4/13/2011 9:29 PM (GMT 0)

The only regret I have is using Trimix. Whether it was due to the needles themselves or the paraverine in the trimix, I developed fibrosis. I first really noticed the fibrosis about the same time I had the one and only usable erection with Viagra. I can't help wonder if I would be having usable erections now, at least with Viagra, if I hadn't used the Trimix.

Posted 4/14/2011 5:17 AM (GMT 0)
John T,

Thank you for your reply. I am very happy you confirmed that radiation would also cure the symptoms of BPH.

From what I have observed, the field of radiation treatment for prostate cancer is progressing very rapidly and it would not surprise me that the current "cure rates" are equal to surgery. If the side effects are less, it might indeed surpass surgery in popularity in the future.
Posted 4/14/2011 9:11 AM (GMT 0)
dear ebook - you may need permission to post your request since this is a patient to patient support group site - please write to the owner/moderators for clarification.
thank you.
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