New Poll: What was your primary treatment for your Prostate Cancer?

english alf - now that i got your "denial" joke, ha ha, denial for me isn't my style in anything or anypart of my life, i take things on head first, gather in the facts, learn to understand my situation, then make hard fast decisions and stick to them. always been my mode of operation.

david

thanks, mag. we've been on similar paths, but you are 2 years ahead of me

gunner, will give you credit, for a different type of surgery than normally offered. why and how did you end up with that route? very curious.

greg...that's an interesting combination you used

URO recommended AS or Brachy. Hubby decided on LDR brachy. It's scheduled in April.

As of now, 73% chose surgery, in one type or the other, so based on raw numbers, we are seeing surgery 3 to 1 over any other choice of primary treatment. This is in line with other numbers I have seen on line while searching on this subject, that surgery is still overwhelmingly the number one treatment for prostate cancer. It still doesn't make it better, or take away from any of the other treatment choices, but numbers are numbers.

david

This ran long. Sorry. Feel free to skip it.

I voted previously but didn't comment on the thought process leading up to my decision.

Bear in mind that my diagnosis changed drastically with my post-op pathology report. Prior to surgery (after four 12 core biopsies with a few extra cores on the right apex which looked sketchy on ultrasound) I was a very-low volume GS7 (3+4).

I looked into a number options and narrowed the field down to four: robotic surgery; brachytherapy; HIFU; and active surveillance. Brachytherapy was attractive since I would get to keep all my parts but my prostate was much too big. This wasn't an absolute impediment. If I had really wanted brachy I could have done six months of HT to shrink it down to a manageable size. Any of the three active treatment choices would have offered a good chance of a cure (based on what I knew then) and since I was concerned about sexual quality of life issues, and since HT can have lasting sexual consequences, especially for older guys, that more than offset the attractions of brachytherapy.

I also thought about doing AS for a while to wait to see if the Sonablate HIFU machine would get approved in the US. A local doctor in my area has been doing trials with that machine and is getting good results. But there is an upper-limit on prostate size for HIFU, too, so once again it would have involved HT treatment first.

As for AS I was a borderline candidate. The second read of my one positive biopsy core had bumped it from GS6 to GS7 but both pathologists remarked that there was so little cancer there that they almost missed it. They described it was 3 to 5 percent of the core. My uro never felt anything definite on the DRE. He said he could feel "a little firmness" on the right side but that it wouldn't have worried him if he hadn't seen the shadowy area on the ultrasound.

What made AS finally unappealing was that in 2007 I had spent three days in the hospital with a prostate infection. It had left my prostate scarified and inflamed. (My negative biopsies mentioned inflammation.) This always introduced and element of uncertainty into PSA monitoring since the inflammation could affect my PSA and mask the contributions of PC. This meant lots of biopsies (which I had never really learned to like) and that, combined with occasional pelvic floor pain from the inflammation my prostate, was starting to make Mr prostate seem like a high-maintenance organ and I decided it could go.

As it turns out, continuing to wait would have been a bad, bad idea. It makes it complicated for me to advise GS6 guys to consider AS. I am convinced, statistically, that on average most of them would be better off. But at the back of my mind is that little voice that tells me that if the guy I am talking to is a statistical anomaly like me (remember, before the second opinion I was a single core 3-5 percent GS6) then I am giving him bad advice.

Such a small but ornery group.

Should be a movie called "Attack of the Killer Seedmen".

David, I know I and others have made this point already, but I did want to say again in perhaps a slightly different way that we need to be careful of how we interpret the results of this survey.

As in all analysis we need to understand the data set that feeds what we are studying, and in this case I believe what this survey is telling us is something we probably already know - that the majority of folks out here went the surgery route and are here because of what is involved with that approach - being more "invasive" than perhaps others. And let me get this out of the way right away, more invasive - but NOT better or worse, so please don't anyone start up that nonsense again!

I continue to follow this thread as I believe it is a good one and I enjoy seeing everyone's posts here - let's just keep in mind what makes up the input data.

Robotic for me...55 at the time July 2011...bald and white.  I did look at radiation and met with Doc thinking I would but changed my mind after interview..So I looked at both options and took a month or more to decide....

open surgery for me, been in the zero club every since.

Mika

I clicked on seed radiation, although I actually had HDR brachy (just finished!) so no seeds were involved. But I thought that was best answer in the spirit of your accompanying post.

I want to thank everyone's participation in this particular survey. I think its been great, and shows a pretty good mix of treatment methods being used by our family here at HW.

Still tracking down a source I had read some time ago, that showed that surgery (in particular robotic) is still the number one primary treatment choice for PC nationwide, despite the advances and uses of non-surgical approaches.

This is just an educated guess on my part, but I would expect that those proceeding with true AS, is very low. Which is a shame, in my opinion. And I don't include men that are in denial and simply ignore AS or any treatment, out of fear or whatever other reason there is in there mind.

I remember an old saying, that I always thought stood well. Ignorance is simply not knowing something. Stupidity is knowing something, then either denying it or ignoring it. I feel that any man with a verified PC diagnosis needs to do something, starting with at least AS - with a proper patient/doctor relationship while on AS - and doing all the things that true AS requires. All known cancers are worth keeping a close eye on, in my opinion.

david