Asking For Input

I was diagnosed April 28, 2011.  I am going for a second opinion with Dr. Pow-Sang at Moffitt in Tampa on May 19, and with Dr Patel in Celebration, Fla on June 1.  I have read Dr. Walsh`s book, and a few others.  Asking for general input.  I am favoring robotic. I live in Clearwater, Fl.

Joe2011

AGE at time of diagnosis 63

PSA 3.9   (last year 3.5)

Biopsy:

2 of twelve cores

Left mid   Gleason               4+3=7  10% of core

Right Lateral Mid   Gleason 3+3=6   5% of core

No Perineural Invasion Identified

T1c

Thanks!

Not sure what you are asking for, but I will say a few things: first, you did a smart thing by reading the Walsh book; second, this website is a very useful place to get information, input, support - so coming here is a second smart thing you did; third, you are seeing two VERY experienced and well-regarded docs. So personally I don't have much to add. If I had to make one suggestion, it might be to also consult with a radiation oncologist -- you could at least consider the option of radiation before signing up for surgery, and it is hard to consider the radiation option in any serious way without talking to a radiation oncologist.
Best wishes, Medved

Thanks, Medved

I will research the radiation oncologist!

I have had some great support, both from many who have had surgery, and now with all my new supporters on HW. I have been reading posts for weeks, and found them very helpful.  I have spoke to patients of both surgeons I am considering, and both spoke highly of the.  So, encouragement and support is what we all need in a case like this

Joe

Hi Joe,

This is a stressful time for you, and like most of us at the time of diagnosis you must feel that there is a clock ticking and you need to make quick decisions about what to do next. This is true for many cancers but becuase prostate cancer is typically a slow growing cancer, a smart thing to do is simply to gather all the information to can and then make a considered decision. You have probably had this cancer for well over seven years so waiting a few months is not going to change much.

I think you have done all the right things in researching PCa through Walsh's book and then coming here.
One bit of input that I can provide is having an expert review of your pathology done. Very often the picture changes in some way once this expert review is done. In my husband's case he went from having no cancer to having cancer. In other cases people go from having cancer of lower aggressiveness to having cancer of higher aggressiveness. Or vice versa.

The reason why an expert review makes sense is that reading biopsy slides is a bit of an art. Very few people are good at it and the more you look at what these pathologists do, the more you realise that there are so many shades of gray in prostate cancer diagnosis and so many conditions that mimic prostate cancer that your average pathologist (who deals with hundreds and thousands of different conditions) just simply isn't experienced enough to see.

The process for doing this is quite simple. Experienced pathologists include Bostwick, Epstien and Dr Helmut Bonkhoff in Germany. Google them, contact them, get the forms and speak to your urologist who will organise for the slides to be sent across.

Having good data on what kind of prostate cancer resides in you will help you make good decisions.

Wishing you all the best,

Regards,
An

My husband also consulted with Dr. Pow-Sang at Moffitt and with Dr. Patel in Celebration.  In addition, he also consulted with a radiation oncologist locally. 

As you probably know already, your biopsy slides will be re-reviewed at Moffitt Cancer Center as part of your consultation, so you will have a second opinion done by the experts there.  We had a very positive experience at Moffitt - Dr. Pow-Sang reviewed all options with us, including robotic surgery, radiation, brachytherapy, active surveillance, etc.

Hubby chose to have robotic surgery done by Dr. Patel in Celebration.  He had a foley catheter for less than a week and was totally continent within 3 weeks, so no problems there.  He recovered very quickly and was totally satisfied with Dr. Patel and FL Hospital Celebration.

Feel free to email me if you have any specific questions about your upcoming appointments. 

Margie

Looks real promising, consider open also, Tactile feel is good for nerve sparing, and deciding the cuts. Hospital 48 hours 1 4" scar, plus little puka, { hole} fm pratt drain. But its all good, this will be the proverbial bump in the road for you, so stay positive. The mid tumor placing is real good news for a contained cancer.