3+3 Gleason

Welcome, and sorry about your bad luck.

A little more info about your situation would be helpful. Where do you live? What's the total cores and involvement? What's your age?

From what I understand, if you do radiation, while not always impossible, surgery is more difficult, as is finding a surgeon to do the procedure. Additionally, I believe more options are available now if there's a recurrence after radiation treatment

You've been through your fair share, that's for sure. Just wanted to wish you well.

MD

How old are you?

those two links were very good, thank you

Thanks, I am in CA, Southern part near Big Bear.
I have an appointment at Loma Linda for Proton
The other 2 cancers were treated at Naval Med Center San Diego, I am going there to talk to my Oncologist, He is still there. I hope to get a less bias opinion.

Just went to Kaiser LA and got a consult about the seeds.

I am just realizing I have time
The other 2 there was not time, no decision making, There was only one direction.
With this one I need to slow down. My first reaction was to get it out.

So , yes I need to slow down, and research

BSelig-

I'm glad you're slowing it down.

Active Surveillance is a good option. If San Diego is closer for you than LA, UCSD has an excellent Active Surveillance program. They've developed an new kind of MRI (called RSI-MRI) which will be very useful when you have a confirmatory biopsy within a year on their program.

If you want protons, and I can't think of any reason to prefer it to other options, go to Scripps rather than Loma Linda. Scripps has a much better machine. I know Loma Linda is closer, but they haven't published anything about patients treated in this century, which makes me suspicious. Insurance coverage may be a problem too. Both protons and conventional IMRT would work just fine, but they are a long ordeal (about 40 treatments) and expensive for no benefit over other radiation therapies.

/pcnrv.blogspot.com/2016/08/proton-therapy-at-university-of-florida.html

SBRT was my choice (see links in my signature). Chris King, the pioneer, is my RO at UCLA. If San Diego is closer, Don Fuller (who you just read about for salvage SBRT) would be a good choice. High dose rate brachytherapy would be an excellent option, and Jeff Demanes at UCLA is the pioneer of that technique. Low dose rate brachytherapy (seeds) works well for low risk guys too. But I'd caution you to find a seed brachytherapist who is very experienced (I don't know of one in Southern California that I could recommend).
There are lots of good, experienced surgeons in the area-- each of the major tertiary care facilities in the area have one or two (e.g., UCI, UCLA, USC, Cedars-Sinai, etc.). All of the above therapies have a 95+% chance of giving you a lasting cure, and they all have salvage therapies, so your decision should be based on other factors.

/pcnrv.blogspot.com/2016/09/5-year-sbrt-trial-high-cancer-control.html
/pcnrv.blogspot.com/2016/08/high-dose-rate-brachytherapy-hdrbt.html
/pcnrv.blogspot.com/2016/08/ldr-brachytherapy-ldrbt-monotherapy.html

As for seeing an oncologist, I don't see what that gets you. It is true, he may be unbiased (although I'd argue that every doctor has biases). But he will certainly know a LOT less about all those therapies than the expert practitioners I hope you will talk to. Prostate cancer is different from other cancers in this regard. For other cancers, we start with an oncologist who then recommends specialists. With curable PC, we seek out specialists in each therapy and make our own treatment decisions. A medical oncologist for prostate cancer is the doctor we see when the disease has progressed to the incurable stage.

I am looking into Dr. Finley also, you mentioned him on another post,

Kcheves also mentioned a Dr he went with

Kailey I hope will keep updates, her husband is at the same stage I am.

Glad these are here and people are so helpful

Has anyone changed their diet? I have changed to a Veggi on the side of Vegan, to stay away from cheese(Hard to do) milk, and meats. I am a bratwurst sausage guy, so not fun either.

The last time I changed my diet was about 15-20 years ago. I don't follow a diet that is supposed to do anything other than promote general good health. I do limit fats and sodium, but not in any way intending to impact my PCa.

Personally I do not believe that there is any significant benefit to be gained by further diet modifications. To me, the important word is "significant." There may be studies that show some benefit for some patients, but on the whole I haven't seen any objective, randomized trials that do anything to make me believe that we can control cancer through diet.

Who are you seeing at Cedars? Howard Sandler is the head of radiation oncology and is more involved in radiation research than anyone. His staff now includes Zach Zumsteg, who he brought in from MSK (under Zelefsky) to start their SBRT program. Mitchell Kamrava now does HDR brachy there (Demanes at UCLA was his mentor). Several guys speak highly of Christopher Ng at Tower Urology.

Kia Michel pushes HIFU, and I mean pushes. Insurance will not cover it. Read this first:

/pcnrv.blogspot.com/2016/12/focal-ablation-unresolved-issues.html

If you are interested in focal ablation, the doctors with more experience at it would be Duke Bahn in Ventura for cryotherapy (which insurance will cover - but he doesn't accept insurance), and John Feller for FLA in Indian Wells (not covered by insurance).

I think Ahlering is as good a choice as any in the region. I don't know Dr Chuang. See the list of questions to ask urologists at the end of the sticky for the newly diagnosed.

BSelig said...
Thank you for the in put, right now it is more like grabbing everything, looking at it, and then throwing away what I do not want or need

I like that approach ('cause that's what I did). As long as you know you have time and research doesn't make you nuts, then I think it's better to consider tons of alternatives before settling on the one that is right for you. That you you will feel educated, informed and capable of making a great decision.

Jim

B__I like your attitude. I've always felt that once you've made a decision, run with it and hope for the best. Hopefully the occasional 'decision changers' won't ruin it for you. You've got enough going on!

I was given a pretty nice 'goodie bag' when I left Johns Hopkins, so I really didn't need much right away. I bought Depends pads and briefs for when the catheter was pulled. Some recommend absorbent pads in case of a leak to sleep with, but I never had that. I slept in a recliner due to the cath tube while it was in, and put the bag in a wire mesh bucket beside the chair. I could just carry the whole darn thing to the toilet as well as the shower!

You may need some lube for the cath/penis point, but I'd see what the hospital will give you first upon discharge. I got plenty of that stuff in my bag. Worst part? Some 70-ish nurse looking at, and describing how, I need to clean my junk!

P.S., don't over buy on the pad stuff. You may do better than you think. What guy wants to have a few dozen packages of man pads sitting around his place?!