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Knowing what you know now would you go RP or BT

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Posted 3/26/2016 12:24 AM (GMT 0)
factor in cancer control, S/E recovery…ya know all dat kine junk. Remember you are on the honor system, tee hee.
Posted 3/26/2016 12:29 AM (GMT 0)
Meant BT not RT, but what ever.
Posted 3/26/2016 12:32 AM (GMT 0)
I did surgery because I just wanted it out. I was willing to risk the side effects to be cancer free. No regrets, especially since my surgery 4+ years ago I have been, cancer free, no incontinence, and no ED. Obviously, I feel very lucky.

Tom
Posted 3/26/2016 12:38 AM (GMT 0)
Would have gone radiation route.
Posted 3/26/2016 3:20 AM (GMT 0)
RT...................
Posted 3/26/2016 3:45 AM (GMT 0)
First of all, good to see you back...

For me, HDR brachy was the right decision. I went brachy since surgery had a 50-50 chance of not being successful and I wanted to eliminate the prospect of SRT. So far, the bet is paying off, both with "cure" and SEs. (I essentially have no SEs.) But, huge caveat here: while it was right for me, it may not have been the right choice for others. Clearly, Reltine hit his own personal trifecta--both with his results AND his goal of "getting it out." But personally, I have ZERO regrets going with brachy.

Non sequitur: I read a lot of analyses of data-driven political info. You may find an example, where the analysis says that based on polling there's an 80% chance of Candidate X winning Arkansas. So if candidate Y wins, is this a repudiation that the data-driven science didn't work? Or is it just the 20% chance on an upset coming home?
Posted 3/26/2016 4:14 AM (GMT 0)
Look at this forum and you will soon see where the recurrences are the highest and who is suffering from the most SEs. I vow to stand by any and all treatment decisions because guys who endured every treatment imaginable were there for me at my great time of need.

Nevertheless. reading through a few pages of threads will reveal the answers you are seeking.
Posted 3/26/2016 5:29 AM (GMT 0)
I hear you BT{couldn't resist initializing your tag} I agree with your thoughts completely. Oh I know the answer to my question and got it the same way you did. I put it out there for the newbies who are struggling with the decision.

Michael_T, thank you… I come and go for various reasons. The main one is when the inanities start affecting the sanities.
Posted 3/26/2016 5:30 AM (GMT 0)
Welcome back Sir Bozo. Thought you had picked up a wave that took you from HW permanently.
Posted 3/26/2016 5:48 AM (GMT 0)
Thanks CL…. Naw Im just a patient patient Oh and you don't need to call me sir I was an enlisted man…tho my Navy job description allowed me to command officers as to what to do, say and where to go. Pretty heady stuff for a apple cheeked 18 y/o. I got to like it and have been challenging authority ever since. I was here...just running silent and deep. Did you and Gary get to hawaii or is that still to happen. Big Island Hilo side is pretty wet generally march/april can be brutally so. My wife is from there…you can tell...she has web feet. I do like it there tho. Big Island is raw…like in….raw... and like all of hawaii, beautiful
Posted 3/26/2016 6:05 AM (GMT 0)
LOL dear Bozo. I was envisioning the knighted type. You know, where the queen accidentally chops off the red nose whilst tapping the shoulders with the sword. Never mind...My humor needs work....
Yup, we did get to Hilo. Really nice except for the frogs. Who knew little critters could be so loud! Our friends showed us the sights and we saw the volcano from an open door copter.
We were lucky that it didn't rain a whole lot. Only one night in Waikiki be for heading home. We aren't big city types, so that was enough.
Gary rallied and had a good time. But his PSA is back over 1,000 with not much left to try. He just got 3 liters of ascite fluid drained from his abdomen. That sure helped him feel better.
Um, a little OT here, but thank you for asking. Which Island are you on?
Thought about you while watching surfer dudes.
Beth
Posted 3/26/2016 11:59 AM (GMT 0)
BT without a doubt. No cancer, quick recovery, no SE's...what's not to like? One of the best decisions of my life.

Jim
Posted 3/26/2016 12:19 PM (GMT 0)
Chiming in from the RALP side of the question. I'm good with my decision and the outcome. The whole point of the exercise is to pick the one, at the time, that is the right one for "me". All we should be doing is to point the newbies at the information, and allow them to make their own decisions without criticism or pushing towards a specific protocol. Then, once decided, to be supportive and never say, "you should have done X instead of Y".
Posted 3/26/2016 1:43 PM (GMT 0)
Will be five years this September since I had my prostate surgery and been pulling all great numbers since . ED is my only major issue so that would be my only regret that I didn't do BT.

I have cried and cursed that I threw my "quality of Life ' away for something that didn't need to be done.... have a hard time watching two people getting down and dirty (on TV OF COURSE ) MAKES ME REALLY MISS IT.

cmetalman
Posted 3/26/2016 1:46 PM (GMT 0)
I'm also fine with my decision with RALP. Still have SEs that I'm confident time will take care of.

Do I worry about recurrence? Hell yeah, but I would not 2nd guess my decision at all. I would worry either way with BT or RP but I became fearful of radiation and any SEs 10-20 years down the road even though many here have made it clear that with the newer techniques that is thought not to be a concern and studies seem to be reflecting that(Though I am not sure studies go 10 to 20 years out yet and I don't know how you can truly relate all side effects to the radiation as getting older alone brings their own host of problems; probably hard to figure what might cause what). Probably just irrational fears but this can be an irrational disease.

Having said that my initial thought was to go with radiation because I do not like surgeries either. I didn't like the thought of removing my prostate and initially I didn't even know what it was or what it did. Basically the choices really suck and had I gone either way I would have accepted whatever wonderful side dishes that came with it just to beat this thing...Jim
Posted 3/26/2016 1:50 PM (GMT 0)
I knew from the time I was diagnosed that I wanted surgery. My uro/surgeon offered to set up consults with radiation specialists and others, but I didn't even do that. My uro/surgeon actually performed my dad's successful prostate surgery back in 1995. open at that time, of course. Mine was robotic. My post surgery outcome in all respects has been great and I'm extremely grateful for that.



_____________________________________________
Born August 13, 1954. Age 61. Diagnosed at age 60.
Father diagnosed with PCa at age 60.
Started PSA testing in 2000, at age 46.
PSA history: 2/00-0.7; 1/01-0.8; 11/04-1.20; 11/05-1.05; 11/06-1.09; 11/07-1.29; 12/08-1.18; 2/10-2.23; 2/11-2.26; 2/12-2.15; 2/13-2.66; 2/14-4.46; 3 weeks on Cipro; 5/14-3.88; 9/14-4.24
TRUS biopsy on 10/27/14. 1 of 12 cores, left base, prostatic adenocarcinoma, Gleason 7 (3+4), 60%. Left lateral base, High grade PIN. "The tumor exhibits a predominantly Gleason grade 3
growth pattern with a very minor component of Gleason grade 4." PSA density .09. Impression: BPH and elevated PSA.
2nd opinion Dr. Epstein. 1 0f 12 cores, Gleason 3+4=7 involving 60% of core. Perineural invasion identified in this case. 1 core high grade pin. Prognostic Grade Group II.
RALP on 2/12/15. pT2a. Gleason 3+4=7. Volume of prostate is 50ml. Proportion of prostate involved by tumor = 2.1%. Estimated tumor volume (% involved by tumor x prefixation vol) = 1.1ml.
EPE absent. SVI and LN invasion absent. + margin posterior left mid. Nerves were spared. Continent at catheter removal. ED is improving. PSA at 7 weeks <.02, 7 months <.02. 11 months <.02.
Posted 3/26/2016 5:23 PM (GMT 0)
Celebrate, your humor is fine…The Queen was knighting with a scimitar she got from the east side at a garage sale…it can happen…budget cuts and all…
Nothing is off topic on my threads from my pov. I like to consider my threads a sanctuary. Im glad you both enjoyed the island of Hawaii{big island}. I worked at the Hilo airport back in the late 70's, married a local girl and worked HNL, OGG and MKK. Yes the frogs, cocqui frogs to be exact…cute if you ever see one…most folks never do. Tiny little critters that multiply rapidly. Big problem on the big island. Very noisy…not a croaking…but more a cacophony of whistles blending into a poor mans Martin Denny orchestration.
We live on Maui. I was going to go surfing this morning, but we had big rain last nite and previous nites. Too much runoff for me. Runoffs attract sharks. It will settle down. I go with my gut…not a good morning for surfing imo.
I will continue to pray for Beth and Gary and Beth.{see…You surround your Man } Its the best I can do and I mean that figuratively and literally… Aloha…Pono…Mana {a hawaiian trinity of sorts}
Posted 3/26/2016 7:03 PM (GMT 0)
Surgery.
No regrets whatsoever.
Great surgeon, great results.
Posted 3/26/2016 7:43 PM (GMT 0)
For me I say surgery again. If you have one rotten apple in the barrel then what would you do with that apple? Your instinct would probably say remove it? I would follow my instinct again. The long term side effects of todays radiation technique, and I mean 20 years and more, are not known today, thats scary. This is, and should be, a personal decision. For those who rather die with an erection than have there prostate removed, radiation is understandably their first choice. I am not sure that at the "moment of truth" we do 100% educated decision, or ...?
Posted 3/26/2016 7:58 PM (GMT 0)
a couple of things. I always **** when someone says they don't want radiation. NO ONE wants radiation. another thing. the name of the book is "Invasion of the Prostate Snatchers" not "Invasion of the Prostate Zappers" most of the guys who feel they were overtreated, IMO, had surgery which ironically is the the gold standard for treating prostate cancer.

when I hear someone say they opted for surgery because of SEs from radiation 10-20 years down the road it sounds like to me they wanted their SEs from the get-go.

I am just dismayed by the guys who don't want radiation but end up getting SR after after a surgery that should have never taken place.

ed
Posted 3/26/2016 8:21 PM (GMT 0)
I chose surgery after very carefully interviewing assorted practitioners and considering SE, etc.

For me, I had the wanted it out mentality but also the desire to know the exact pathology. I also liked SRT as a fallback option (a few folks take umbrage when I say that, but it is actually a very logical, valid reason). I also had a unique situation going on. I was having severe BPH issues. Flomax had worked great but was getting less effective. A few times, I was VERY close (jacket on) to going to the ER because I could not urinate. That was getting miserable. The surgery relieved that 100%.

Would I make the choice now, knowing what I do. Absolutely, due to the BPH issue. Sans that issue, it would be a much tougher call. I think people softsell the radiation SE. The surgery SE are clear and happen immediately. The radiation SE CAN be miserable, but not for a few years. I recently had a sudden urinary bleed that was very scary. It only happened once and resolved quickly. I suspect I just popped a blood vessel. But it might also be the start of radiation cystitis issues due to my SRT

But, again, if I had the decision to make now, sans BPH, I would be in a quandary!

Mel





Mel
Posted 3/26/2016 8:59 PM (GMT 0)
Agree with Tudpock..BT was easily one of the best decisions of my life.
Posted 3/26/2016 9:34 PM (GMT 0)
I'm not sure what the latest stats are, but I seem to recall reading somewhere that surgery is still the dominant treatment for uncomplicated PC, by something like a 2:1 ratio. And yet, in here, whenever this kind of question comes along, the ratio of RT (whether BT or ERT) to surgery patients is flipped substantially towards radiation. I'm not sure it means anything, I'm just pointing out the nature of this forum.

I also note that the 'radiation' guys tend to be much more vehement about the upsides of their choice and more dismissive of the downsides--and extremely willing to point out the downsides of surgery (which they didn't have btw) to any and all newbies. It's been pointed out many times that the people who tend to come and stay in a forum of this nature are those who have had difficult cases and difficult treatments. Those who made it through the 'once and done' treatments don't tend to stay around.
Posted 3/26/2016 9:48 PM (GMT 0)
Just so ya know, I have no regrets but I definitely would go BT knowing what I know now.. I know hypotheticals are tough to answer. Thanks for your input And again Pca is such a personal decision and this is because its outcome is so related to a unique interface tween host and parasite, if I may use that phrase in this context.
F8 your post was particularly insightful about folks in general and and the whole radiation bugaboo.
Happy Easter!
Posted 3/26/2016 11:17 PM (GMT 0)
Those who made it through the 'once and done' treatments don't tend to stay around.

Really??
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