Hi there,
Sorry to see you were forced to join "The Club."
First off, did your doctor perform a DRE (digital rectal exam)? I'm guessing the answer is yes. Did the doctor say anything about
BPH (enlarged prostate)? I'm again guessing the answer is yes.
If so, your enlarging prostate is squeezing on the urethra (which runs through the center of the prostate) and causing the dribbling problems. Such a condition also causes it to stop & start, spray like a garden hose, have to go frequently, etc. I was on Flomax for a couple years but it eventually lost its effectiveness as my prostate kept growing & growing.
As with you, I was diagnosed with a Gleason 6 through a biopsy that showed 3 out of 20 cores with cancer, which you can see at the bottom with my signature.
My uro at home said that if I had fewer than 3 positive cores he would favor AS. But with 3 cores positive, he believed in "aggressive" treatment and recommended da Vinci.
My comments that follow may offer somewhat of a parallel to your situation. It so happens that I am also a regular patient (for annual physicals) at Mayo Clinic in Minnesota -- and my next annual check-up was only a month away. So I opted to take my information to them for a second opinion.
The first thing they demanded of me (and something YOU should also do) is to provide them with my original biopsy slides so they could perform their own analysis. One of us suggested that you have a second opinion on your biopsy and this is a GREAT suggestion.
Mayo's lab ended up agreeing with the original diagnosis. So I was scheduled to meet with one of their radiation oncologists and also one of their urologist/surgeons. The radiation oncologist was very upbeat and told me I had a highly curable case (sounds similar to yours) and that radiation could cure me.
HOWEVER, he also told me that the radiation would only cure the cancer and could NOT solve my urination problem with the BPH. I was having TERRIBLE urination problems -- taking 15-20 minutes for what used to take 15-20 seconds. So the Mayo radiation oncologist actually recommended that I make a date with "Mr da Vinci."
I met with one of their surgeons and ultimately returned a couple months later to have the operation there instead of at home.
I'm not far from being 2 years out from the surgery and have been 100% continent since about
5-6 weeks following the surgery. My prostate was over 98 grams in size -- almost FOUR TIMES the normal size. My surgeon performed a cystoscopy on me the day before the surgery and said my prostate was beginning to twist and deform and that it eventually may have begun to encroach into the bladder. He then assured me that the surgery was really my only "logical" way to go.
So, if you are facing BPH (and it sounds like you are), you might consider the surgery to kill both birds with one stone -- get the cancer out of you and also solve your urination problems at the same time. Today I rarely get up in the middle of the night to urinate. Often I go the entire night without having to go at all -- and this is after drinking lots of fluids during the late evenings.
One more thing that I'd like to caution you about
. It is IMPORTANT to understand that a biopsy report is only an educated GUESS on the exact nature of the cancer within a prostate. Between 20 and 28% of the time, post-op pathology reveals that there was a HIGHER Gleason grade of cancer that was missed by the biopsy needle. To be fair, there is also a smaller percentage of times when the Gleason grade is actually downgraded after surgery.
In any event, I just want you to be aware that AS is, to a 20-28% extent, a roll of the dice in hopes that the biopsy report is accurate. But plenty of guys have posted that their Gleason grade proved to be more aggressive than reported by the biopsy.
In any case, it still seems like you have plenty of time to consider everything. You should meet with a radiation oncologist and ask him/her about
what I said, and also ask any other questions that come to mind. Do the same thing with the urologist/surgeon.
In this manner, you can learn the pros and cons of both types of treatment and make an informed decision based on what you feel most comfortable with & confident in.
Good luck!!
Chuck
Resident of Highland, Indiana just outside of Chicago, IL.
July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA Sept. 2011 was 5.7.
Local urologist DRE revealed significant BPH, but no lumps.
PCa Dx Aug. 2011 at age of 61.
Biopsy revealed adenocarcinoma in 3 of 20 cores (one 5%, two 20%). T2C.
Gleason score 3+3=6.
CT of abdomen, bone scan both negative.
DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
My surgeon was Dr. Matthew Tollefson, who I highly recommend.
Final pathology shows tumor confined to prostate.
5 lymph nodes, seminal vesicles, extraprostatic soft tissue all negative.
1.0 x 0.6 x 0.6 cm mass involving right posterior inferior,
right posterior apex & left mid posterior prostate.
Right posterior apex margin involved by tumor over a 0.2 cm length, doctor says this is insignificant.
Prostate 98.3 grams, tumor 2 grams. Prostate size 5.0 x 4.7 x 4.5 cm.
Abdominal drain removed the morning after surgery.
Catheter out in 7 days. No incontinence, occasional minor dripping.
Post-op exams 2/13/12, 9/10/12, PSA <0.1. PSA tests now annual.
Semi-firm erections now happening 14 months post-op & VERY slowly getting a bit stronger.
Post Edited (HighlanderCFH) : 8/12/2013 11:34:53 PM (GMT-6)