At the margin was Gleason 6 only. As read multiple times, including once by Epstein at Johns Hopkins....
Medved: Yes, he said he'd start monitoring for possible treatment at .1. My only unclear point now is his thoughts on Gleason 6 vs Gleason 7 and the idea that Gleason 6 metastasizing is very rare....
I was getting conflicting advice about my need for adjuvant radiation after I ended up with a positive margin after surgery. My margin is huge - 1.2 cm. Several radiation oncologists insisted on...
BobbieSan: Sounds like you and I have a lot of similarities. I can't tell you how much clarification I got with a one day visit to Dr. D'Amico at Dana Farber in Boston. He specializes in guys in...
Tall Allen: Surprisingly he didn't care if I was Gleason 6 or 7. His studies did not differentiate between the two. For Gleason 6 and 7 combined his studies showed an 18 percent recurrence (measured...
Tall Allen: Thank you. But worth noting that these shouldn't be universally accepted as gospel in all cases. My radiation oncologist touted these as GOSPEL when they came out and insisted I have...
Men: I appreciate all your input. I went to see Dr. Anthony D'Amico at Dana Farber in Boston. He's done a ton of studies on the need for radiation after surgery. Turns out he strongly suggested I...
David: Thank you. As painful as it may be for you to frequently have to recount your story, it's very useful for guys like me to know the possibilities. Lord knows my oncologists aren't telling me. I...
Peter: As usual you are a veritable font of useful information. Thank you. Funny how I can't get the highly paid medical 'professionals' treating me to tell me any of this....
I'm curious if anyone knows if there are new standards for ED drug coverage under the upcoming Affordable Care Act? Same question for some of the genetic testing, like Prolaris......
David: Per dose means one use. Each device comes pre-loaded with one pellet, so each dose is one use only. And don't even get me started on them not covering ED medications post surgery........
I'm a Kaiser patient. Kaiser charges me $60 per dose for Muse, regardless of dosage amount, and they don't cover any of it. This seems really high. Does anyone know of a cheaper reputable online...
Allen: Those links were terrific. Thank you. The one seems to indicate strongly that the genetic makeup of the individual is crucial. Given that, would it make sense to have the Prolaris genetic test...
Allen: According to Jonathan Epstein at Johns Hopkins, the positive margin is all Gleason 6. The bladder neck area was involved, but they couldn't find any actual cancer in the bladder neck itself...
Alison: Feel free to email me directly (email address deleted by mod) I'm happy to share my research and thoughts so far. Looks like your husband and I are in a similar circumstance. It's best to...
Peter: Thank you. Very interesting study on Gleason 6 and lymph nodes. Can we then say the same thing would be true of Gleason 6 and spreading generally? Or is that too much to say?...
Bohemond: Glad to hear of your good results. That's encouraging. I appreciate all that have responded, and am hoping for even more feedback. I did find this study interesting. Early Salvage Radiation...
David: Thanks. Actually a clarification. I'm actually PSA <.001. I updated my profile with that new PSA but it looks like the update didn't take effect before my first posting posted....
Cohorts and supporters: I posted on this topic a while back, but I'm still racked with indecision. One change recently is my last PSA (the second since surgery) came back as <.001. Yay for that, but...
David: How do you figure it would be related to testosterone?...
Note: This is an old thread that has seen recent discussion. Pay attention to dates and consider skipping to more recent comments. -- PeterDisAbelard This may sound really stupid, but I think I...
John, as always your posts are very helpful. Thank you....
John: Can you explain exactly what a medical oncologist does, as opposed to a radiation oncologist?...
JNF: Thanks. Yep, it looks like the test has a good history in use for other cancer. Anybody have any thoughts on it's usefulness for prostate? It's weird to me that not a single one of my urologists...
I'm sorry. What is PCA3 and what is PHI?...
Why aren't urologists or oncologists mentioning this or the Polaris test, put out last year? I've specifically asked each one I've met with if there is anything new in terms of treatment or staging...
Or the new Oncotype DX test? Seems to me it's the same as Polaris, but brand new. http://www.nytimes.com/2013/05/08/business/prostate-cancer-test-from-genomic-health-assesses-risks.html...
And what about Prolaris http://www.prolaristest.com/information-for-physicians/prolaris/? Seems to me I'd be an ideal candidate for this. But not a one of the four oncologists I've seen or the...
Tall: Thank you. But what I'm not seeing is what 'wait and see' really means. Does that mean they compare adjuvant to all men that 'wait and see' was the chosen option, including those that either...
Tall Allen (or anyone else): What recent evidence showing better cure rates if radiation given before 'recurrence' are you referring to? I'm having to decide right now between adjuvant radiation and...
Dude1969: Please email me directly. I'm very interested in Johns Hopkins-specific research that you mentioned....
Chris: I too regret having surgery. But not because of side effect. Because it left me with a positive margin the size of Mount Everest. I have a friend with colon cancer. Far more serious in terms...
Compatriots: Looking like I'm in for radiation, either now or later. I'm pretty up to speed on possible short term effects. But what about long term? My oncologist and my surgery guy seem to differ...
Compatriots: If you live in DC you may have an option for insurance AFTER you've been diagnosed. DC has essentially had an insurance exchange for quite some time, and they required CareFirst...
Logo: Epstein said my case was weird. Only one positive margin, but it was huge. Apparently that's pretty rare. Graded me a pT2x because of that. He said a positive margin due to intraprostatic...
TooYoung: Thank you. I've talked to two radiation oncologists, and they had different advice. One said do adjuvant as soon as urinary symptoms are ok. He said this even before knowing my .02 PSA. The...
Highlander: First I've heard of the Gleason 6 and the unlikeliness of spread beyond the prostate. That would indeed be good news for me. If you have any links to studies I'd really love to see them....
Peter: Thanks. You are right. Fixed now. Much appreciated....
Peter: Thank you. I'm in the unfortunate position of second-guessing my original decision to have surgery, and then second guessing my choice of doctors. I know, my head tells me that's stupid. But I...
Z06: Sorry about that. Pre surgery was 5.34 Surgery March 6. Prior to surgery one guy read my biopsy as Gleason 6. Johns Hopkins re-read it as Gleason 7 (3+4). After surgery they reversed. My...
Peter: Valid points. I'm seeing conflicting data out there about efficacy. Seems to me that the salvage radiation folks in the studies may have had salvage well after their PSAs started to rise, and...
Compiler: Why a medical oncologist, as opposed to a radiation oncologist? What's the difference?...
Logo: It's definitely .02....
Cohorts: Just got my first post surgery PSA today. It's a .02 And of course I already have conflicting advice from oncologists. One suggests I need adjuvant treatment as soon as my incontinence is a...
So TrueBeam cuts even the NovalisTX system time in half? That's pretty impressive. How much movement is there in prostate salvage radiation? I assume a lot, since the bladder and such is right there,...
Tall Allen: Thank you. Excellent summary. Do you know how the TrueBeam's speed compares to older Varian models? One oncologist I talked to uses the Varian 600N, which I can't seem to find much info...
John: How much SRT experience would you consider adequate? This particular oncologist has done about 250 prostate salvage therapies (specifically salvage, not radiation as a primary therapy) I'm...
Montiman: Thank you. I'm having a really hard time determining what criteria to use to determine skill levels of the doctor and techs. The guy I'm looking at currently has done about 250 adjuvant or...
Folks: I'm investigating my adjuvant or salvage radiation options. Had surgery a month ago and came back with a relatively huge positive surgical margin (1.2 cm). Spoke yesterday with an oncologist...
Folks: Looks like adjuvant salvage radiation is in my immediate future. I'm feeling like maybe I didn't do such a great job picking a surgeon, so now I want to do all I can to get the best...