Posted 2/17/2007 8:25 PM (GMT 0)
Hi Scout Too!
i like your positive attutide--it will help greatly as you proceed toward treatment and thereafter. i loved reading your blog--very interesting and nicely written (albeit some of the family history with health, etc. problems is sad). i am sure that you will have more chapters to add to it before you are finished! i find your posting here somewhat unique from others posting here in terms of your attitude toward your PC and your dilemma as far as deciding on a treatment. i can best comment on your posting by quoting from it and then inserting my comments followed by *****.
"None of the three urologists I've spoken with yet have offered anything in the way of what causes PC, though some acknowledge that there are high associations between PC and certain factors such as heredity, obesity, and diet. I'm taking their reticence as a combination of scientific caution and the practitioner's (as opposed to researcher) emphasis on treatment versus cause."
*****from what i have read they really don't know definitively what causes prostate cancer. they speculate that it is caused by a defect in the genes, too much fat in the diet and other lifestyle issues. i think your doctors are just being honest. the cause of prostate cancer is really irrelevant as far as being treated for PC at this (i.e., the treatment will not be specifically related to the cause, but to eradicating the cancer irrespective of the cause).
"At any rate, my research suggests to me that there are several things I may be able to do as far as attitude, diet, supplements, and lifestyle that may slow, halt, or even reverse this disease. At worst, they will put me in better shape going into whatever treatment I decide on, and I've seen a lot of research that indicates the better off you are going into treatment, the better your prognosis after."
*****although there are some guru's out there that make claims about halting or reversing PC through diet and other lifestyle changes, i wouldn't bank my life on it. apparently cancer was detected in 4 of 12 core samples, 3 of which are a gleason a 3+4. once you get to a gleason 7, you need to take action on treatment. this was confirmed to me by my medical oncologist. also, your psa of 8.2 should concern you (it has been rising rapidly in recent years which is not a good sign). supplementing your treatment with changes in diet, taking supplements and making other lifestyle changes makes sense and is highly commendable--but don't wait to find out if they will slow down or reverse your cancer. if you have been a vegetarian for a long time (as you claim in your blog), then you are already into some form of good health. bravo!
"The urologists tell me that I'll probably be OK if I wait anywhere from three to six months before having treatment (opinions vary)."
*****that is the general range of time, in your situation, i would not advise you to go beyond six months especially with the gleason of 7. i am starting my proton radiation treatment about five months after diagnosis of PC.
" I have several other personal reasons for waiting. I plan to do everything I can during that period to get as healthy as I can, and be monitored frequently. If I'm getting significantly better, I will delay treatment. If not, I'll have it."
*****again, don't bank on getting better with solely holistic approaches, unless you have been misdiagnosed in the first place.
" I don't like any of the conventional treatment options, but I'm leaning toward laparoscopic surgery. I don't like the long-term side effects of radiation. I also don't want the full-bore, open surgery due to the trauma on the system and long recovery time. I'm leaning toward laparo because I'm not convinced that robotic is any better, and one of the urologists told me that the best laparo doc in my area (D/FW) is a lot better than the robotic guy. I plan to meet with the laparo surgeon soon and schedule surgery for mid to late summer just to have the ball rolling and have something scheduled."
*****from what i have read--conventional lapro is quickly being outdated by robotic surgery. a great majority of the members here have had robotic surgery, many with very good results. in a negative commentary that i once read on lapro, it was described as "the surgeon trying to do the surgery looking in a rear view mirror". i believe that there is much more opportunity for damage to the rectal walls and other parts of the anatomy in the pelvic area through lapro surgery. i have read that lapro is the most difficult surgery to master. there is a french surgeon at Soan-Kettering in NY who is considered an expert in lapro surgery. in the hands of an unexperienced surgeon, it could be a disaster. based on what i have read, i believe that the learning curve for robotic surgery is easier than lapro surgery. if i had opted for surgery, it would have been robotic with one of the top surgeons.
*****there are several top notch robotic surgeons in the U.S. if you don't have a good one in your area, consider traveling to one of the top medical centers for robotic surgery. the fact that you don't have the best robotic surgeon in your area should not be a reason to settle for the lapro. examples of top robotic surgeons are Dr. Menon at the Henry Ford Hospital in Detriot who was a pioneer in robtics surgery many years ago and has probably done over 2000 of them. Dr. Tewari at NY-Presbyterian (Cornell) in Manhattan was also a pioneer working with Dr. Menon before he was recruited by NY-Presbyterian to establish and head up their robotic prostate surgery. there are many other excellent robotic surgeons and i am sure that some of the members can direct you to them.
*****with respect to radiation therapy, i think you need to do more research. the horrible long-term side effects of years past (rectal and urinary) are more of a rarity today, with improved and more sophisticated forms of radiation treatment such as IMRT/IMGT x-ray (photon radiation) and proton radiation. i am soon going to start proton radiation treatment for 8 weeks--i concluded, after ample research, that it is the safest form of radiation treatment with possibly the fewest short and long-term negative side effects. see my thread entitled "Proton Radiation Therapy --My Journey With Prostate Cancer". i too fought having a biopsy for over three years and that was not good. Although you are still a relatively young guy, men your age have opted for proton radiation therapy and the longer-term cancer free statistics are very encouraging. keep an open mind about proton radiation.
"This might not be the right route for other people, but one reason I'm headed this way is because cancer doesn't scare me. PC is treatable. I'm also led to believe by some of my research that all of us have at least minute cancers that come and go all of the time. Especially in the case of PC, one of the main differences between me and most guys is that I've had my PSA tested and a biopsy, but they haven't. My biopsy turned out positive, too, but I wonder how many of theirs would?"
*****again, don't get too complacent. i am not scared of PC cancer either, but time does become of the essence to decide on a treatment and move forward with it in hopes of achieving a cure. if PC cancer is not cured, you should be very scared of it. if it ever gets to the terminal stage, it metastasizes in the bones, breaking them down (causing osteoporosis) and resulting in nasty pain until the bitter end, some of which can be relieved through radiation treatment. it is not the way that any of us would choose to depart this earth!
i have tried to be objective here and as helpful as possible. i hope you take my comments and the comments of other members to heart. i think you have a slight "false sense of security" considering that you have moved into the gleason 7 category with an 8.2 PSA. i commend you for telling us exactly how you feel about your approach to PC--that's how we can be most helpful to you. i value the comments of other members and hopefully you will too. best of luck in deciding on a treatment and moving forward with it in the not too distant future.
Dave