new to this

met with RO yesterday. He says HT and 7 weeks of radiation should be started after surgery, no matter what the pathology. This differs some from surgeon who said that if there is LN involvement, only treatment option would be HT.

RO had his lab take another look at the biopsy slides - this makes the 3rd time. No change there, still G7, 12/12 cores.

Did find out that his relatively low PSA (6.3) is not necessarily a positive thing, given his volume of cancer. He may have a more aggressive cancer that doesn't produce much PSA.

Anyway, that's the update.

acsd --

Some people here have suggested that you consult with a medical oncologist, for an additional opinion. I think that is a good suggestion.

When you consult with so many different doctors, from different perspectives, there is a risk of information overload. But there is also a benefit to the different perspectives. I suspect, in your husband's situation, the benefit of consulting with a medical oncologist (in addition to your consults with a urologist and a radiation oncologist) will be worthwhile.

You mentioned that your husband is limited, for insurance reasons, to treatment within the State of Colorado. Given that, if I were in your situation I would consult with Dr. Michael Golde. You can see information about him here:


I apologize if this not appear as a link that you can click on. I am a computer moron. But you can past it into your browser.

I do not know Dr. Golde personally. But I have read things that he has written about prostate cancer, and he seems to be very experienced and knowledgeable. Maybe he can help your husband sort through the differing recommendations and make a decision that he (and you) feel comfortable with.

Best wishes, Medved
http://www.ucdenver.edu/academics/colleges/medicalschool/departments/medicine/MedicalOncology/faculty/Pages/MichaelGlode.aspx

Note: Edited to make link clickable...Jim

Post Edited By Moderator (Tudpock18) : 8/27/2013 12:55:42 PM (GMT-6)

thanks. I'll check out Dr. Glode.

To me, one of the advantages of the surgery route is that it provides more details - via pathology. Brachytherapy wouldn't provide any information on degree of spread to SV and LN.

ascd,
Wonderful thoughts here, and I can only say, as a wife...I was in your position twelve years ago. I thought "cancer" ...we only have a few years at most... I cried, and wrung my hands...and then found out many things....that I was ..WRONG! There are many many options today...Just hold each other, and tell your husband that you are with him ...in sickness and health, and somehow day by day you get through this stuff.. Things will work out...you will see. Di

More discussions with doctors, more confusion on treatment decision. We feel frustrated that there doesn't seem to be a "standard of treatment" based on staging, stats.

Husband starts on Casodex tomorrow, then Lupron in a week - getting started on HT while treatment decision is in process was something I learned from this forum, so thanks.

We're inclined to go the radiation/hormone route and skip surgery. It seems like the biggest argument for surgery in addition to radiation (which we KNOW is in his future) is that the situation will be fully understood via pathology. None of the doctors have been able to say that studies definitely show an increase in control rate with both surgery and rad/HT.

As usual, any input appreciated.

Redwing you posted "Grimm is a brachytherapist. His meta-study results favor brachytherapy. Not terribly surprising.
Good data is hard to find, and confirmation bias makes it doubly difficult."

First sentence is correct, but you do realize that Grimm was not the sole author to this ground breaking report? Good data is indeed hard to find, but this is good data - hard to argue with the facts as posted.  

Given the path of treatment you took I'm a little surprised at your first paragraph?

Hey Redwing / brother - no problem! I was just askin!

You've always got good stuff out here!

I've found that the best way to get a question answered by a surgeon is to tell the phone operator that it is a question for his nurse. It's not a question he/she will probably know the answer to but you will get him/her on the hook to track down the doctor and pry the information out of him.

Well, I registered on this site today after reading a lot of the comments. Obviously I too have prostate cancer. I am currently a 7 out of 10. Whatever that is. Due to a pituitary tumour God gave me in 1996, I have had to have hormone replacement therapy for some years. It is believed that my testosterone injections have caused my prostate to become cancerous. Haven't been peeing well for about 3 years and the sex "droop" has been a worry also. PSA testing has always been negative in the past. Apparently this is common for every 1 in 10 patients.

My doc informs me that because I still have to stay on the testosterone injections (every 12 weeks) it would only help to feed the cancerous cells in the prostate so I am scheduled to have the radical prostatectomy on 25 October 13.

I am 59 and during my life I realised that sex with my wife was the only thing I was ever any good at (my own thoughts). After reading your posts I look like losing that afetr the op too. Boy do I feel lucky (NOT).

My loving wife (40 years together) doesn't talk to me very much about it. I want to talk to her about it but am at a loss just what to say. We have tried but she ends up avoiding converstaion on the subject. I think she is just as worried as I am but keeping it to herself. I keep telling myself to remain positive and that someone else is always worse off but the old depression demon often sets in. Am I scared? You bet your "bippy" I am!

update:

Husband had DaVinci RRP on Sept. 13th. Actually went better than expected. No lymph node involvement (surgeon wasn't going to proceed if nodes were positive).

Pathology not great - but also better than expected, perhaps. no SV Involvement. Gleason 4-3 downgraded to 3-4. Bad news is small area of EPE. But surgeon sounds optimistic.

First night he was home from the hospital, I ended up calling ambulance in the middle of the night because he was doing so poorly. Severe pneumonia that kept him in the hospital for almost 2 weeks.

I have been following your journey. Pneumonia a little scary. Trust he is healing nicely at home now. Good luck. It is looking like my husband will be having surgery in January unless one last Pet scan and PSA test suggest radiation/HT is a better option.