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PROSTVA+Surgery+Waiting vs. Radiation????

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Prostate Cancer
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Posted 4/29/2015 1:06 PM (GMT 0)
Hi All,

My hubby and I are coming to decision time soon: Surgery or Radiation (w/ Zelefsky).

Here's the twist. We went down to the NIH Monday and met with Dr. Gulley (who is the one doing PROSTVAC) and Dr. Pinto, and they encouraged us to enroll in a clinical trial looking at PROSTVAC vaccines prior to surgery. If we enrolled, we would start on the vaccine and do the surgery in July.

Here's the thing that's making me SCARED -- my hubby's MRI is suspicious of ece. Some have read it as suspicious (MSKCC), others not (UPenn, Johns Hopkins). When we expressed worry about this to Gulley and Pinto, they said that waiting until July would be well within any concerns regarding danger.

Do you guys think that? The ece is making me very jumpy and scared, though being in the hands of Gulley, Pinto, and the NIH would be really reassuring if we go the surgery route.

Thoughts?

Warmly,

Mary
Posted 4/29/2015 1:28 PM (GMT 0)
Hi Mary,

Believe me, I understand how scared you are about waiting a few extra weeks but PCa is a very slow growing cancer and you should have nothing to worry about. I don't know when your husband had his biopsy but it gives his body that much more time to heal from it before his surgery.

My surgeon believes I had it for 10 years before my surgery judging by the size of the tumor.

I had my surgery in July and it was as good a month to have it than others so set the date. I sure felt better just knowing I had a date for the surgery.

Once the date is set, have your hubby start working out, walking and preparing for "the fight". He wants to be in the best shape he can. If he needs to loose a few pounds, that would be a good time to start. I read somewhere that surgeons didn't like to perform surgery on someone
who was over weight so I loss 10 lbs. before having it.

Good luck to you both

Bill from Florida cool
Posted 4/29/2015 1:57 PM (GMT 0)
Hi Bigmac,

Thank you for your response. With suspicion for ece, I'm just so scared!!!!!

Warmly,

Mary
Posted 4/29/2015 4:44 PM (GMT 0)
Hi pjr,

I tend to agree with BigMac post above and can only add that hubby had the Prostvac vaccine (different trial) over a year ago with NCI and Gulley and Madan watching over and they are awesome. The Prostvac for Jim has been a great bonus treatment with very minimal side effects.

Marie (and Jim)
Posted 4/29/2015 4:49 PM (GMT 0)
Mary, I'm trying hard not to let my biases get into my answer but they undoubtedly will.

You probably have time to do the trial and wait until July for the surgery. However, I've gotta say, if there is the possibility of ECE then I would bet on Dr. Zelefsky who will target the radiation properly to try to eradicate any little buggers that may be in escape mode. Or the surgeon may cut wide with non-nerve sparing and the consequent likely side effects. Any impact from the Prostvac is entirely a crap shoot, IMHO.

Again, I am biased but that's the way I see it.

Jim
Posted 4/29/2015 5:02 PM (GMT 0)
You've got time to make a decision. July isn't that far away in PC terms.

Andrew
Posted 4/29/2015 5:35 PM (GMT 0)
I agree with Jim - when ECE becomes clinically apparent - and MSKCC is among the best at reading them - there is almost certainly going to be more found after pathology. I also agree that Prostvac is nice, but there's really not much evidence to support its use with surgery (which the clinical trial may or may not provide). I think radiation is a safer bet - a small amount of ECE is easily within the margins of every kind of radiation. Perhaps they will want to go a bit wider in the planned target volume, which isn't really a big deal.

- Allen
Posted 4/29/2015 7:06 PM (GMT 0)
You guys are awesome. Did you know that? I hope so! There's one very worried wife here who is deeply indebted. Again, you are the most awesome. TY!

Yours,

mbo
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