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Posted 11/22/2011 5:20 PM (GMT 0)
I met with my urologist yesterday (Dr. Savage) at MUSC (Medical University of South Carolina) to review the results of my biopsy. Of 12 cores sampled, 7 tested positive - Gleason score 6. Percentage of tissue involvement ranged between 5 and 80 percent. My urologist considered the tissue involvement to be in the medium range. He advised against "Active Surveillance". I would not have considered AS in any case.

I have requested a second biopsy opinion (Bostwick Lab), and am hopeful for a consensus. My urologist told me that I was a candidate for either surgery or radiation treatment. We discussed both options, and I have an appointment with an Radiation Oncologist next month. Proton therapy is not available at MUSC, and the nearest facility is 300 miles from home.

I am leaning toward Brachytherapy. MUSC has a highly regarded physician who specializes in Brachytherapy treatment.
I've just finished reading the journals provided by "Just Julie" and "Gleason6". Both were very informative - Thank-you! very much. This is an amazing website, with so much valuable information available at your fingertips! I've just started to read Dr. Walsh's book - "Guide to Surviving Prostate Cancer", which someone on this board recommended.

I just have one question at this time. My urologist told me yesterday that the urge to urinate was more pronounced with patients who decide on Brachytherapy vice surgery. I'm wondering just how common this problem is - and if it goes away in time. I'll keep everyone informed of my decision process, and thanks again for all the support. Jimmy42

PSA 2.9 (7/11)
Biopsy: 7 of 12 cores positive (5-80 pct)
Gleason score 6
Prostate size - "smallish"
Posted 11/22/2011 6:16 PM (GMT 0)
Not heard of urgency issue re brachy. hopefully soemone will come in with more info.
And re what to do and when I was wondering how old you are?
Alf
Posted 11/22/2011 7:47 PM (GMT 0)
Jimmy,

Sorry to hear of your positive dx. But sounds like you have good choices in front of you. Are you in S.C. as well?

I would not reccomend AS for you either in your case.

David in SC
Posted 11/22/2011 7:51 PM (GMT 0)
Jimmy - wishing you all the best as you continue your research as to what is the best treatment for you - had not heard of bladder urgency due to brachy - as a RP guy - urgency returns to "new normal" in a few weeks to months - it took me 15 weeks to get control of bladder again -
-you have come to a great site here - lots of patient-to-patient support - and information -
all the best,
Bronson
Posted 11/22/2011 8:05 PM (GMT 0)
Jimmy, yes...usual short term side effects of brachytherapy are urgency and frequency of urination.  This is usually well controlled with Flomax and staying away from caffeine and alcohol.  In most cases, this only lasts 2-3 months.  I can't remember if you checked out my "brachytherapy journey" which is a cut and paste at the bottom of my signature.  You will see a fairly complete story of my entire journey which is now almost three years old.  I will update this in a couple of weeks when I get my 3 year PSA.  From a side effect stand point, my life has been pretty much the same as before the procedure and I really only think about PCa when I come to this site to check on both new and old friends.

Tudpock (Jim)

Posted 11/22/2011 8:57 PM (GMT 0)
Hi David:

Yes, we live in Pawleys Island, SC. MUSC in Charleston is best equipped to handle prostate issues. Charleston is about 70 miles away - an easy drive during the daytime. Jimmy

Purgatory said...
Jimmy,

Sorry to hear of your positive dx. But sounds like you have good choices in front of you. Are you in S.C. as well?

I would not reccomend AS for you either in your case.

David in SC

Posted 11/22/2011 8:59 PM (GMT 0)
Jimmy,
Frequency and urgency is common in Brachy patients. If inactive I had to go at least once per hour and if active it was about every two hours. This lasted for 4 weeks and didn't stop me from enjoying normal daily activities. You have to get used to the urgency because as soon as you feel you have to go you better look for a bathroom real quick. This also went away in about 4 weeks. As Tud said, stay away from caffine and alcohol and take your flowmax and things will be fine in a few weeks.
JT
Posted 11/22/2011 9:06 PM (GMT 0)
HI Jim:

It's reassuring that urgency, if experienced, is usually a short term effect. I won't mind taking Flomax, but giving up caffeine and beer would be a challenge! I have not read your "brachytherapy journey", but certainly will. Thanks for the response, and good luck with your 3 year PSA check. jimmy


Tudpock18 said...
Jimmy, yes...usual short term side effects of brachytherapy are urgency and frequency of urination. This is usually well controlled with Flomax and staying away from caffeine and alcohol. In most cases, this only lasts 2-3 months. I can't remember if you checked out my "brachytherapy journey" which is a cut and paste at the bottom of my signature. You will see a fairly complete story of my entire journey which is now almost three years old. I will update this in a couple of weeks when I get my 3 year PSA. From a side effect stand point, my life has been pretty much the same as before the procedure and I really only think about PCa when I come to this site to check on both new and old friends.


Tudpock (Jim)

Posted 11/22/2011 9:49 PM (GMT 0)
Jimmy:

Pawley's Island is beautiful, and what an abundance of good seafood places. I live in Easley, about 10 miles west of Greenville.

david
Posted 11/22/2011 10:17 PM (GMT 0)
Everybody has their own opinion and mine was to go RRP. Turns out i fell into the "2%" that are 100% percent incontinent. Not a good recomendation for that approach but i still like the idea of having one more bullet in my fight if it comes to that. A close friend had brachy and he had a terrible time for about 3 months till the seeds died down. incontinence, bowel problems and upset stomach and generally felt bad. My bad experience with RRP and my friends with brachy are anecedotal and don't mean much statistically but the down sides of all the treatments are real, or they can be. I would be sure to talk and listen to the doctors that perform the other treatments as well. Once you decide and go forward you are stuck with the results. I wouldn't say your are "lucky" but you are fortunate in one regard, with a gleason 6 you don't have to rush into any one treatment and you have all treatments as options at this point. If you chose any type or radiation, beam or brachy, you are done with maybe your most effective treatment. RP, you still leave radiation on the table. That said, even though I have no facts to back this up, I wonder if radiation is as effective if it is performed after RP? Maybe my thinking might be skewed from being member on this site as we tend to be those who have one or another lingering issues after our choosen treatments and our results and concerns may not the the best guidance for initial effectiveness? However if you have continuing issues, then we may be a great, maybe the best, source of information and advice. Again, this is just my opinion and you know what they say about opinions. To sum up " my opinion" , take your time till you are sure then don't look back. I think statistically all of your options, except maybe AS, are pretty much the same for your chances for a one shot cure, i hope your treatment is a one shot and welcome to the group.
Ron
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