Welcome new guy glof1967

Have uro send biopsy slides to epstein or Bostwick for second opinion. Gleason grades ar subjective not objective. Your uro has you on a fast track for treatment, period. Tell him{ don't ask} you have time to consider all options including Active surveillance. If the the slides come back gl6 you should seriously consider Active Surveilance. {Google and learn about it on your on.} The 70% is arguably a moot point for decision making especially with a solid 6, which is hopefully what 2nd opinion will show. Your uro knows this!!{or should}. If you do not have the temperament for AS and want treatment for an immediate cure, seriously consider Brachytherapy{ google, if needed}. You personally should start reading/studying books written by experts in the field, so YOU know whassup. Its not a long study but you do need to know stuff. If not then you are at the whim of every bit of advice you get on internet forums,and uro's who can be woefully weak on "whassup". Being smart about the disease is really just a technique of dealing with the situation. Just like having complete faith in all your medicos and going along for the ride is. I make no value judgement for anyone but mysel, but do have opinions. On this issue the most informed patients are better off imo. Your Uro told you he thought you had the disease for a year. Did he imply or even mention that that was a " long time". If so, to me, thats a big red flag for him. one year with a gl6{ which is what he is hanging his hat on} is glacially slow with PCA. those are my thoughts . Good luck in your journey. My gut instinct from info gathered is that you have indolent cancer which if it ever hurts you would be in 10 years or so and probably never. Remember what I said about getting smart about the disease. If and when you do, you will be able to point/counterpoint what I just said, what others here have said and yes what your medicos have said. Get those slides to an pca experienced pathologist for a second opinion.

We discussed the SE's of surgery. Not pleasant but manageable. Age plays a significant factor in recovery so that is in my favor the dr said.

I had a similar consultation, with the head of urology at a major medical facility in the Midwest. When I asked him why he was suggesting surgery he told me "because at your young age, and excellent level of physical fitness, you stand a good chance of dealing with the side effects of surgery." My reply - "Really; and if I don't do so well with the side effects then at my young age I've got a long and miserable life ahead of me, right?" I got the deer in the headlight look followed by what was clearly a how dare you challenge me look, at which point I simply got up and left.

In my opinion - the age card no longer holds up given the advancements of LDR and HDR BT. Potential side effects from all of the treatment options, but I would encourage all in this stage of their journey to simply do your research before rushing into a decision where there is simply no "do-overs."

golf1967,

Dr. Patrick Walsh's Guide to Surviving Prostate Cancer!

Buy this book and start reading.

You have a favorable diagnosis and pretty much every treatment will cure you, so I agree that it's all about the SEs, as well as individual personality. You do have the luxury of time so I would use that to learn as much as you can.

BTW, I see you're in LA. I live in the South Bay...if you ever want to meet or chat, you can e-mail by clicking on the envelope icon under my name.

Golf, since you are in LA, I would recommend seeing the Prostate Oncology Specialists in Marina Del Rey. Let them be the gate keepers to radiation/surgery (not likely) or systemic treatment options. Also, since you had one dropping PSA, they may have you wait it out.

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Age 63

PSA 2.9 12/02, age 51
BX/DX, 9/03, G6, 4 of 12 cores
Brachytherapy 9/03
PSA nadir 1.1 5/08
PSA 1.8, 12/08
BX/DX, 2/09, G8, 1 of 12 cores
Hyperthermic, Hormone (one Lupron), IMRT (10) spring 2009
PSA nadir < 0.1 10/09 - 01/12
PSA 0.2 4/12
PSA 2.9 5/14
C11 Acetate PT/CT, found 2.0 cm lymph node 5/14
Lupron/Casodex 5/14
Nadir <0.01
2/15 SBRT to node
3/15 PSA 0.02, T=0

Island time, If a urologist gets a hit of 100% on 2 cores because he got "lucky" and bingoed a small tumor of gl 6, it is moot be cause of the grade and because a 100% of zero is zero. This math also means that 70% of a tiny core needle even 2 of them is very tiny compared to the volume of the whole prostate. Theorectically a person could have a ten core biopsy with a 100% pca in all ten, take out the prostate and discover via postop pathology that the total volume of cancer is 1%. which was the total volume of the ten core needles. It could take 10 years for that puppy to grow to a point that the cancer needed treatment. that would be 10 years w/o S/E's. AS is not an option to give the cancer time to grow its an option to not have s/e's. Via a good A/S program the patient may never develop a cancer that needs treatment and then he might and when he is 66 like myself when diagnosed, [ mine was inactive non surveillance}he can get the treatment and like my self get it treated then. Yeh I had some heavy upgrade on the grade, but i lived some 20 years with out S/E . the upgrade would have been caught by the biopsy and then treatment could have been reconsidered. Again misinformation and understanding of the terms, the variables etc is always chasing the fear of patients who just don't know. Believe me the medicos, sell there product and the hi % core needles help that sell. Im sure the other practitioners have there own techniques. I am not slamming anyone. If I was I would need to slam the the whole present paradigm of the planet. Which in a way I do. But bad always is attached to good and I have learned to discern the paradigm and be come quite adept at spiritual alchemy. ps self edit by context and self discernment if needed...

Hey everyone.

I am having robotic surgery tomorrow. Not an easy decision to make. I did speak with a radiologist about it. He told me the pros and cons. He also said surgery was probably a better option based on our discussion. I think the type of person you are plays into this decision. I am at peace with my decision and glad I took the advice to speak with a radiologist. I was leaning toward surgery but had lingering doubts. My discussion with him gave me peace of mind.

I want to thank you all for you advice thus far. I am positive I will come looking for advice in the days, weeks, and months to follow.

No worries Peter. My recliner is the only place I sit in the living room. I have sat on the couch maybe 5 times in the last 10 years. The TV is perfectly situated for my recliner and the remote is always with me...until I fall asleep then my wife gets the remote.

Thanks.

Good luck golf, slay the beast, we'lol see you on the other side

Hey everyone. Just checking in.

Well I am in day 3 post RALP and feel pretty good. The walking helps a lot. I was able to walk a few hours after surgery so that was a good thing. Pretty much just ate fruit and drank a lot of water for the first couple of days.

Learned something on day 1 post RALP. Cold weather affected me a lot more then usual. Usually I am fine going outside in 65 degree weather in just pants and a shirt. Not now. I was shaking uncontrollably. I have been in cold weather and felt that way but not 65 degrees. Live and learn.

Milestone yesterday. A funny as this sounds, I finally had a bowel movement and what a relief. Been taking those for granted all my life. Not anymore.

Now I am looking forward to the cath being removed on Thur.

Until later my friends.

Golf, welcome to the other side, glad you are feeling well. Keep us posted and ask questions when you need to.

PRETTY GOOD path report? I would call it a perfect path report. Congrats, man, party time.

I need some advice. I am wearing these diapers and they are causing me to sweat a lot from head to toe at night when I sleep. I have the ac set to 72 and still sweating. Anyone else have this issue?