Prostate cancer: What treatments did you choose? Results?

Posted by assad4zamani @assad4zamani, Oct 13 8:13pm

Hello all,
I’m 73 and healthy with no conditions but Recently I have had PSA of 5.8 and then a biopsy that resulted in T2a grade and Gleason score 7 (3+4). I have been bombarded with so much information and many options of treatments. I’m leaning toward Robatic Laproscopy surgery. I would sincerely appreciate your comments and experience in this area and also what should I look for and be concerned if anyone tried other options and how was the results.
Many
Thanks

Assad, I would agree with your choice but please read on. Even though the biopsy may seem pretty conclusive you may suggest another biopsy. How many samples did the biopsy include and also how many had a Gleason score above 5? If you do have the robotic surgery insure your surgeon has performed large amount of this type of surgery, ie, at least greater than 300. I had this surgery better than 10 years ago and I'm sure there have be some refinements in the process. The surgery is relatively quick and recovery involves no major pain or long rehab. You should be feeling comfortable within a a week of surgery. Following up with your Doctor will give you guidance as to any additional treatment that may be necessary, ie radiation, chemo or other. My surgery, seemed to be marginally successful as I do have some residual microscopic cancer but it has been managed satisfactorily. Two or three of my biopsy samples were in the 8 range. I did have radiation and 10 chemo treatments shortly after surgery. I am currently on hormone treatment for last three years and my PSA has been staying under one and had never went above 6-7 since surgery. I was 68 when I had my surgery. Currently in good shape and really no limitations. Only very minor incontinence and ED has taken over especially since starting hormone treatments. Review the comments you receive from others and hopefully you will arrive at a very positive decision. My best to you for a full recovery. Alan

REPLY

Good morning, I had 12 biopsy samples taken. 8 were positive. PSA of 16.Gleason 7 (4+3). My urologist deemed it Stage 1 and wanted to operate immediately. Like you, I was bombarded with information. I then went to Moffitt Cancer Center with all my results. My first appointment was with a urologist (surgeon). He reviewed all the test results and said it was inoperable because it had spread. It was actually Stage 3. He said the operation would have to be followed by radiation and that was not ideal – radiating an area that was healing from surgery. I went on androgen deprivation therapy with high dose brachytherapy and 25 external beam radiation treatments. My suggestion is to go to a nationally recognized comprehensive cancer center for a second opinion. In my experience they did what was right for me. A urologist is a surgeon. If all you have is a hammer – everything looks like a nail. I am happy with the results. Hormone therapy has side effects but I am working through those. Best of luck to you.

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@dmadi61

Good morning, I had 12 biopsy samples taken. 8 were positive. PSA of 16.Gleason 7 (4+3). My urologist deemed it Stage 1 and wanted to operate immediately. Like you, I was bombarded with information. I then went to Moffitt Cancer Center with all my results. My first appointment was with a urologist (surgeon). He reviewed all the test results and said it was inoperable because it had spread. It was actually Stage 3. He said the operation would have to be followed by radiation and that was not ideal – radiating an area that was healing from surgery. I went on androgen deprivation therapy with high dose brachytherapy and 25 external beam radiation treatments. My suggestion is to go to a nationally recognized comprehensive cancer center for a second opinion. In my experience they did what was right for me. A urologist is a surgeon. If all you have is a hammer – everything looks like a nail. I am happy with the results. Hormone therapy has side effects but I am working through those. Best of luck to you.

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Dmadi,
Very wise choice. The urologist I went to had done at least three biopsies and found nothing. Finally, after a bout with urine retention he decided he was going to remove the prostate by surgery (for and enlarged prostate?). Remember he had three negative biopsies. When he did the biopsies the nurse asked if he was going to numb the area as other doctors did. His reply "No a lot of trouble." It all went back, as I found out later, when he and I had an argument over treatment of a family member, that I thought was water over the dam. Make long story short I too had second opinion with urologist at clinic about 120 miles from home. He did find cancer and sent me to the Cancer Institute a the clinic.
I am so glad I went for second opinion and would urge all to do the same.

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I strongly urge you to read Robert Marckini's book (second edition) "You Can Beat Prostate Cancer and You Don't Need Surgery to Do It." Amazon link is here https://www.amazon.com/Beat-Prostate-Cancer-Dont-Surgery/dp/1734202203/ref=sr_1_1?dchild=1&keywords=Robert+Marckini&qid=1602681064&s=books&sr=1-1
It is the most comprehensive guide to all your options and is a Godsend to all us PC patients. I am at Mayo Clinic in PHX now getting fine treatment.

Liked by dmadi61

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@mrbill

Dmadi,
Very wise choice. The urologist I went to had done at least three biopsies and found nothing. Finally, after a bout with urine retention he decided he was going to remove the prostate by surgery (for and enlarged prostate?). Remember he had three negative biopsies. When he did the biopsies the nurse asked if he was going to numb the area as other doctors did. His reply "No a lot of trouble." It all went back, as I found out later, when he and I had an argument over treatment of a family member, that I thought was water over the dam. Make long story short I too had second opinion with urologist at clinic about 120 miles from home. He did find cancer and sent me to the Cancer Institute a the clinic.
I am so glad I went for second opinion and would urge all to do the same.

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Thanks Mr. Bill.

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@alanr

Assad, I would agree with your choice but please read on. Even though the biopsy may seem pretty conclusive you may suggest another biopsy. How many samples did the biopsy include and also how many had a Gleason score above 5? If you do have the robotic surgery insure your surgeon has performed large amount of this type of surgery, ie, at least greater than 300. I had this surgery better than 10 years ago and I'm sure there have be some refinements in the process. The surgery is relatively quick and recovery involves no major pain or long rehab. You should be feeling comfortable within a a week of surgery. Following up with your Doctor will give you guidance as to any additional treatment that may be necessary, ie radiation, chemo or other. My surgery, seemed to be marginally successful as I do have some residual microscopic cancer but it has been managed satisfactorily. Two or three of my biopsy samples were in the 8 range. I did have radiation and 10 chemo treatments shortly after surgery. I am currently on hormone treatment for last three years and my PSA has been staying under one and had never went above 6-7 since surgery. I was 68 when I had my surgery. Currently in good shape and really no limitations. Only very minor incontinence and ED has taken over especially since starting hormone treatments. Review the comments you receive from others and hopefully you will arrive at a very positive decision. My best to you for a full recovery. Alan

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Good Morning Alan,
I sincerely appreciate your reply to my concerns. Urologist is my friend and he took 20 samples and found cancer cells only on left lobe of prostate. I talked to my general doctor and he recommended surgery as well.

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I had cancer on the left side only as well. They remove the entire prostate anyway. The left side has nerves responsible for the erection process. I came through surgery with that ability still functioning. Your mileage may vary. Had I been diagnosed earlier, I might have escaped the surgery process. Do not hesitate to schedule surgery if the sexual function is important to you.

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Hi Assad, your post took me back 2 years when I was given my diagnosis. My urologist met with me and gave me a book on treatments for prostrate cancer. Basically, the treatments fell into two categories, surgery and radiation. The author quoted a study that really stuck with me. It said that patients who got treatment at cancer centers had better results then those didn't. He stated that cancer centers may have more experienced doctors using the most current research to treat cancer. I chose to have treatment at Mayo Clinic in Phoenix using there proton beam radiation therapy. One of things that Mayo did that my urologist didn't mention was to do a thorough scan of my bones and organs to determine if the cancer had spread, which makes the treatment more difficult. They also put me on Antigen Deprivation Therapy for 18 months, since my Gleason score of 4+4 or 8. Checking research on treatments using ADT with radiation improves chances of successful treatment by 20% with Gleason scores that high.

So, I understand what you are going through, but getting advice from the most knowledgeable and experienced experts is critical to understand options and the full treatment protocols. By the way, since my treatment there has been research out on gene repair options for prostrate cancers that you might look into. It doesn't involve surgery nor radiation.

Best of luck.

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Hello Wayne
I sincerely appreciate you detail information and your experience. As t said I’m bombarded with info I have tentatively scheduled for Nov 18 surgery, but definitely I’ll ask questions and recommendations that you brought up.
Thanks
Assad

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@stoney

I had cancer on the left side only as well. They remove the entire prostate anyway. The left side has nerves responsible for the erection process. I came through surgery with that ability still functioning. Your mileage may vary. Had I been diagnosed earlier, I might have escaped the surgery process. Do not hesitate to schedule surgery if the sexual function is important to you.

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Hello Stoney
I appreciate your reply and experience. Please let me know when you did surgery and what are the issues and concerns after surgery, I heard a lot about leaking. Did you do any radiation after surgery and what kind. I love to hear from you.
Many thanks
Assad

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@assad4zamani

Hello Stoney
I appreciate your reply and experience. Please let me know when you did surgery and what are the issues and concerns after surgery, I heard a lot about leaking. Did you do any radiation after surgery and what kind. I love to hear from you.
Many thanks
Assad

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I postponed surgery in favor of attending my daughter's wedding. The doctors were fine with that (3-month delay). November is soon enough. You'll have a bone scan to see if it has spread (not likely to have spread). You will have associated lymph nodes removed and tested for cancer (they filter contaminants), along with the entire prostate. Some nerve structures will be removed on the left side as a precaution. They can't take a chance and leave them intact, sorry. Left side nerves a responsible for getting an erection. I had and continue to have leakage (it is manageable and I wear female pads in my underwear at night). I walked 2 miles a day for one year for healing purposes (that's just me). Kegel exercises will strengthen your bladder control, but I've found that starting and stopping peeing over and over until the bladder was empty, worked better than Kegels. Start these right now, before surgery. Now about sex. After your catheter is removed, take your prescribed blue pills as directed. (honeybeehealth.com has them for .38¢ per pill). You will have blood in your pee for a while maybe some clots as well. The sooner you have any sex, the better, and as often as you can tolerate it (lol). Use it or lose it. You will have zero ejaculate fluid and your orgasms will feel quite different but still pleasurable. You may and probably will experience a decreased size in penis length through the healing process. I purchased the RestoreX®(Mayo approved design) penis traction device for around $500. It's worth it but your mileage may vary. Feel free to contact me at any time if you have more questions. Good luck to you!

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@stoney

I postponed surgery in favor of attending my daughter's wedding. The doctors were fine with that (3-month delay). November is soon enough. You'll have a bone scan to see if it has spread (not likely to have spread). You will have associated lymph nodes removed and tested for cancer (they filter contaminants), along with the entire prostate. Some nerve structures will be removed on the left side as a precaution. They can't take a chance and leave them intact, sorry. Left side nerves a responsible for getting an erection. I had and continue to have leakage (it is manageable and I wear female pads in my underwear at night). I walked 2 miles a day for one year for healing purposes (that's just me). Kegel exercises will strengthen your bladder control, but I've found that starting and stopping peeing over and over until the bladder was empty, worked better than Kegels. Start these right now, before surgery. Now about sex. After your catheter is removed, take your prescribed blue pills as directed. (honeybeehealth.com has them for .38¢ per pill). You will have blood in your pee for a while maybe some clots as well. The sooner you have any sex, the better, and as often as you can tolerate it (lol). Use it or lose it. You will have zero ejaculate fluid and your orgasms will feel quite different but still pleasurable. You may and probably will experience a decreased size in penis length through the healing process. I purchased the RestoreX®(Mayo approved design) penis traction device for around $500. It's worth it but your mileage may vary. Feel free to contact me at any time if you have more questions. Good luck to you!

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Thank you very much for replies that are helpful and comforting. I’ll be in touch.
Best
Assad

REPLY
@stoney

I postponed surgery in favor of attending my daughter's wedding. The doctors were fine with that (3-month delay). November is soon enough. You'll have a bone scan to see if it has spread (not likely to have spread). You will have associated lymph nodes removed and tested for cancer (they filter contaminants), along with the entire prostate. Some nerve structures will be removed on the left side as a precaution. They can't take a chance and leave them intact, sorry. Left side nerves a responsible for getting an erection. I had and continue to have leakage (it is manageable and I wear female pads in my underwear at night). I walked 2 miles a day for one year for healing purposes (that's just me). Kegel exercises will strengthen your bladder control, but I've found that starting and stopping peeing over and over until the bladder was empty, worked better than Kegels. Start these right now, before surgery. Now about sex. After your catheter is removed, take your prescribed blue pills as directed. (honeybeehealth.com has them for .38¢ per pill). You will have blood in your pee for a while maybe some clots as well. The sooner you have any sex, the better, and as often as you can tolerate it (lol). Use it or lose it. You will have zero ejaculate fluid and your orgasms will feel quite different but still pleasurable. You may and probably will experience a decreased size in penis length through the healing process. I purchased the RestoreX®(Mayo approved design) penis traction device for around $500. It's worth it but your mileage may vary. Feel free to contact me at any time if you have more questions. Good luck to you!

Jump to this post

I elected robotic surgery (also postponed a few months for daughters wedding) just over a year ago and could not have been more pleased with the outcome. I just had another PSA and it was still undetectable so I am very fortunate. I was out of the hospital in less than 24 hours after the procedure and have had very little long term affects. Pain was minimal and after a week with a catheter was back to near normal activity. No leakage and slight impact on ED which was already an issue but pills do help. The best advice I got was to be sure to have a surgeon who has had lots of experience and is why I chose Mayo and was not disappointed and not wait too long so that the cancer was contained.

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@curt24

I elected robotic surgery (also postponed a few months for daughters wedding) just over a year ago and could not have been more pleased with the outcome. I just had another PSA and it was still undetectable so I am very fortunate. I was out of the hospital in less than 24 hours after the procedure and have had very little long term affects. Pain was minimal and after a week with a catheter was back to near normal activity. No leakage and slight impact on ED which was already an issue but pills do help. The best advice I got was to be sure to have a surgeon who has had lots of experience and is why I chose Mayo and was not disappointed and not wait too long so that the cancer was contained.

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Thank you very much and I appreciate your reply and it is comforting for me and glad that you have a good result. I’m 73 , how old were you at the time of surgery.
Thanks
Assad

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