turpT1a said...
I find it ironic that this "disagreement" between the surgery advocates and the radiation advocates has arisen over an initial diagnosis of a person who is G6 in 3 cores with less than 50% involvement. If the clinical diagnosis is correct (i.e. there is no higher Gleason tumors in the prostate), such a person would probably succeed under any treatment, including not undergoing any treatment at all. Several Active Surveillance programs, including Klotz's program at Sunnybrook Hospital in Toronto, would gladly enroll him as a patient.
Good points. In my own case, I was G6 in 3 cores with less than 50% involvement. But having three positive cores (even at 5% and 20%) kind of nudged me away from qualifying for AS. If only 2 positive cores, I may have done the AS.
On the other hand, the tumor was at the apex, so it eventually may have tried to break through.
But, back to your point, you are right about
the potential for success under any treatment. I was given the options of EBR and surgery. Mayo said both could cure me.
The tiebreaker was that I also had extremely severe BPH and radiation could not have cured my urination problems. So I went with the surgery and so far so good.
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.
Pathology showed Gleason 3 + 3, pT2c, N0, MX, R1
adenocarcinoma of the prostate.
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, 9/9/13 PSA <0.1. PSA tests now annual.
Firm erections now briefly happening in early mornings, 2 years post-op.
Post Edited (HighlanderCFH) : 2/20/2014 2:38:28 PM (GMT-7)