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Open RP scheduled Oct 4, 2010

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Posted 9/28/2010 12:41 AM (GMT 0)
I am new to the forum, and for the next 7 days will be saying goodbye to my prostate.  I've known it all my life.

Seemed like a nice guy, till he got lumpy and angry.

1st cousin with similar story as below

Age 54, 54 at DX,

PSA 1.5

Lump found on DRE June, 2010, confirmed with urologist July 2010

Biopsy August 2010: Positive 1 of 12 cores, 0.1mm less than 1% of tissue core

Gleason 6, 3+3

open RP surgery October 4, 2010

Post-surgery Pathlogy Report: TBD

I am now having some anxiety over the decision for surgery.  Pathology report has the dreaded word "adenocarinoma" , but such a small amount.  Should I wait or isn't this the purpose of routine screening to catch it early and pull it out.  My wife says, just like with pregancy, cancer is the same.  You can't be a "little bit" pregnant.  You either have cancer or you don't. 

Posted 9/28/2010 1:11 AM (GMT 0)
Wont tell you what to do Chef, but welcome aboard and listening to the wife is usually a good thing. I dont miss my prostate, however I miss my body that I had before all of this began. Focused on living fully now and understanding what is important and what brings me joy at this time in my life. Best to you and keep us posted.

Michael

Posted 9/28/2010 5:25 AM (GMT 0)
PSA 1.5, Gleason 6, 1% of one core...DRE = lump. Hmmmmmmm, strange..

Recommended reading:

'Invasion Of The Prostate Snatchers," Blum, Scholz
"Guide to Surviving Prostate Cancer" Patrick Walsh.

I'm a STRONG believer in surgery, but in your case, you might want to do a little more research..JMHO..
Posted 9/28/2010 11:54 AM (GMT 0)
Strong believer in learn all you can, get mulitple opinions and don't rush into any treatment and especially realize all your risk factors up front if possible...it is a one way travel. My brother has done A.S. with parameters slightly higher than yours (very slightly), going on 6 yrs. and no change in psa level and so far appears very sane. (no warranties with or without treatments).

You could cancell this right now and study it all up, it likely took 10 years to show up on the radar with PCa, many men have PCa and just don't know of it, especially after age 50 and up.
If you live to be 70 they say about 70% of men would be found with PCa, most die of something else statistically.

It is your decision, I cancelled my original radiation treatment, the day before it was to start...glad I did...found better radiation protocol and more experienced doctor and this particular female doc also misinformed and lied to me about sources for IMRT centers nearby, said they didn't exist, but they did and even existed with neutron & photon machines and the doc at that next facility even knew her personally. So, it was all about containing the sale to home base and I would have gotten EBRT radiation and from less of an expert, go figure. This was in 2002 and IMRT useage was around but not as prevelant as it is now. Shows bias and agendas in some treatments, that is the message. This was not the first of these either in my getting 8 opinions, all covered by insurance too.
Posted 9/28/2010 12:49 PM (GMT 0)

I am one of the few men here  that actually regret rushing into to surgery so quick.  I look back on it now after three years, and I really wish I had waited awhile and monitored my psa before I jumped into surgery.  Even though I was lucky and I have no ED issues after my surgery, and only minor continence issues like stress leaks, I still think that I could have prolonged it a few years more and enjoyed my prostate for more time. I really really miss my prostate. Sex is just not as enjoyable as before.

My biopsy was a Gleason 6,  2 of 12 cores positive with <5% cancer, no lumps on the prostate, and a  PSA 4.5.  Prior to my biopsy in 6/2007, my psa had been hovering between 3 and 4 for since 2001, so I know that I had that cancer well before my actual diagnosis in 2007.  I think I would have been a perfect candidate for Watchfull Waiting for a few years more, but just knowing that I had the cancer inside of me, this over rode any desires I had to take my time and wait and see.   If I could do it over again, I wish I had waited a few more years.

I have a question for you? Why are you going with open surgery?   

Posted 9/28/2010 1:03 PM (GMT 0)
Me and my prostate were getting along just fine too, then it decided to get balky on me, so I went all RP on it. ;-)

Seriously, welcome, and sorry you're here.

Only you can decide the best course of action, based on the information you have available. I can tell you that if you read enough posts here (HW) or anywhere, you may become overwhelmed with opinions.

I can tell you that my wife and decided that whatever route we took, there would be second guessing.

Keep in mind that this post is coming from a guy who is all of 5 days post open RP, so I have no clue how things will turn out for me (I pooped today, so I have that going for me).

Good luck with whatever you decide.
Posted 9/28/2010 3:10 PM (GMT 0)
I would call off surgery and do some more research!!! They already have you in the Oct Club on the other thread! Now if you need to be there,well  that's fine [calling something like prostate surgery a club is kinda weird IMO] Don't join the club yet research,research,research!!!! If your having anxiety listen to yourself,and there is such a thing as a little bit of prostate cancer.I wouldn't necessarily run so fast into surgery! Just my opinion..... the guys here can give you first hand accounts of what they've been through........not something I would want my husband to go through without adequate research. Cooper
Posted 9/28/2010 5:48 PM (GMT 0)
Surgery is your decision, but it's a big one. The consequences on erectile function and urinary control range from minor to life changing. The consequences can be minor (I'm an example) but this board has numerous members in the life changing consequences camp. Once you get it, there is no going back. It's a bit unusual that you were felt to have an abnormality on digital examination, but had a really tiny spot of cancer on biopsy. You might consider having a second opinion on the biopsy results, further investigation of your tumor (scans or waiting a bit and repeating the biopsy) and other opinions from physicians on treatment options, including active surveillance. You have plenty of time to investigate your cancer and your options--this is not an urgent situation.

However, you are young in the PCa world, and even if you eventually decide not to have surgery, you need to have your gland watched carefully over future years.
Posted 9/28/2010 8:37 PM (GMT 0)
CHEFBOZ -
- I expect you have done your research and even with your low numbers continue on the surgery path - instead of alternative treatments as others may suggest
- the only one that can decide that is you
- one of the best post-op things for your recovery is to be content within yourself on your choice of treatment / doctor / hospital.
-wishing you all the best for October 4
- and here's to a steady and boring recovery.
hugs to you and your wife,
BRONSON

P.S. there is a ladies only link that your wife might be interested in checking out - see the information links at the top of the page -
Posted 9/28/2010 11:32 PM (GMT 0)
With the exception of the lump on DRE (that gives me pause), your stats are similar to my husband's. We went through 3 months of vacillating among treatment options after the positive biop, but the idea of the cancer there was ultimately too much for him, and out it came in an open RP July 6th. And although it IS cancer, as your wife said, your "moderately differentiated cells" of your Gleason 6 can be lived with for many years til something else takes you out of this world. The crappy thing about PCa is that no one can predict who progresses quickly and who keeps their cancer cells slow-growing. It's all your decision based on what you can live with and I wish you all the best with your final treatment option.

That said, my husband does not look back even though the final path report didn't show more than the original G-6 and he currently is wrestling with ED. However, he had adenocarcinoma on both sides, which makes him feel it was the correct decision - more was there than originally detected. One thing that also effected his final decision is the stats on longevity - he was 59 at diagnosis with no co-morbidity issues and both parents live(d) long lives into their 80's and 90's.
Posted 9/28/2010 11:50 PM (GMT 0)
"With the exception of the lump on DRE (that gives me pause), " <NEirish>

yeah, that gives me pause too...That's the piece of the puzzle that does not fit..
Posted 9/29/2010 1:03 AM (GMT 0)

Hi Chefboz and welcome to our site. Don't think of it as much as saying
goodbye to your prostate, but more of saying goodbye to cancer (hopefully).

Your numbers look quite good and you should be able to look forward to a quick and complete recovery which ever method you choose.

All the best to you.

Mag

Posted 9/29/2010 1:54 AM (GMT 0)
i would delay the surgery, and reasearch all my options, perhaps including AS, surgery is a huge step at this time.

david in sc
Posted 9/29/2010 3:54 AM (GMT 0)
Welcome. I went through what you are going through a few months ago (Dx in June 2010) and appreciate your concerns.

The advices are all good and you need to do more research to see what is best for you as PC is a very individualized disease. I now believe there are many treatment options that will give you good outcome and you and your doctors are in the best position to decide what is best for you. If I were to do it over, I would take a little more time to research other treatment options.

Quite often, the biopsy is under stage, i.e., shows better staging than it actually is. For me, the biopsy said a very small < 1mm in only one core had cancer and was a Gleason 6. Post surgery, the pathology report came back with a lot more cancers in both lobes and some cancers were Gleason grade 4. So, I am happy I did not do AS which my urologist actually felt was a viable option for me. Of course, I still do not know if I my cancer is really confined and only time and many PSA tests will tell.

I had my first post op PSA today and will find out in a couple of days.
Posted 9/29/2010 10:58 AM (GMT 0)
Hi Newporter, RRP is Robotic (DaVinci) surgery, right? ? ?  so you said you would do more research, and consider other options-what do you mean? ? ?

Eveyone else who says more research-I am aware of the other options- but felt open was best,  now I am questioning any procedure.  One great poster suggested I will second guess any decision I make.  .....certainly true so far.

Posted 9/29/2010 11:31 AM (GMT 0)
chefboz - with numbers like yours ( except for the lump), some have chosen Active Surveillance - watching the PSA and prostate condition without rushing into surgery - other options would be RT radiation therapy , Brachytherapy ( radioactive seeds implanted) - check out the information FAQ's at the top of the website -
-as well as-
www.yananow.net/
and hit their DON'T PANIC button

-the best solution for you MAY just be -"get this cancer out of me" referring to your wife's" little pregnant" comment -
or - it could be less invasive treatment - that decision is yours (and your wife's)

-I am a surgery guy and no regrets - my PSA was well within the safe lines for AS - but I wanted it out of me - after further testing, we discovered more was wrong that expected -and had surgery - I was NOT a candidate for other treatments ...

-we just want you to have NO regrets on whatever course of action or treatment you take -
-was there any mention of what stage of cancer your samples were at?

-this is a confusing time with multi-layered questions and answers and opinions for a confusing disease.
-research - ask questions - get answers ( rinse and repeat until you are content )

sincere hugs
BRONSON
Posted 9/29/2010 12:01 PM (GMT 0)
chefboz, the decision you make is worth researching very carefully because the stakes are high. And if you are not completely convinced about your decision to have surgery then it's worth postponing till you have the answers you need.

In my opinion before you make your decision I think you need to understand what that lump is all about because the lump doesn't fit neatly into the story of a very small gleason 6 cancer. Maybe you need to consult another uro or two to get another opinion on the lump or maybe you need another biopsy after screening tests like an endorectal MRI or a colour doppler. Although these screening tests frequently give false positives or false negatives and therefore are not proven to be reliable, maybe they will point you in the right direction as to what that lump is.

An
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