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Recently diagnosed - seeking opinions on treatment options
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JMP5819 posted:
I just found out yesterday that I have prostate cancer. On various sites I have encountered many pros and cons between surgery and radiation and am looking for more advice, opinions, success stories etc. I want to learn as much as possible to make the most informed decision and any help will be appreciated. I'm 54 years old, in excellent health and feel great. I exercise at least 3 days per week. I had my annual physical in May and my PSA came back a 5.3. Unfortunately, my primary care physician had not checked my PSA for several years so I have no idea of whether the raised PSA occurred suddenly or over several years. My last test was in 2007 and was 2.1. My Father was diagnosed with prostate cancer in his mid 60's in the mid 1980's. I have no recollection of his PSA but he had radiation treatments that seemed to kill the cancer but had other detrimental side effects. When he was in his late 80's (2006 or so) it came back and had moved to his bones. It eventually caused his death. Due to my age and family history I had a biopsy done and one of the 12 core samples was cancerous - "right lateral base - adenocarcinoma with gleason score of 3+4 - involved 60% of the biopsy". I will be meeting with two Doctors in 2 weeks - one regarding radiation therapy and the other regarding removal of the prostate via the DaVinci robot. Due to my family history, age and biopy results, my Urologist's recommendation is to remove the prostate. I'm obviously in the initial stages of my research but will welcome any input. Thank you!
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billh99 responded:
I chose surgery over radiation for the following reasons.

1. Worse case I was more willing to accept urinary incontinence then bowel incontinence which can happen with radiation. And I have had past bowel problems.

2. You get a full pathology report with surgery. The biopsy is just a very small sample and you might have high grade PC that was not sampled.

3. You know if the margins are clear and the PC was contained.

4. If the PC was not contained you know to start radiation now.

5. If the PC comes back you can have radiation after surgery, not vice versa.

6. Radiation takes about 8 weeks.

Now my doctors says that I was not the norm, but I had the DaVinci and was out of the hospital in 26 hours. I had no pain, but some muscle soreness for about 3 days.

Catheter was out in a week and 8 days later I was basically dry. And 10 days later I started having erections.
 
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Jude525 replied to billh99's response:
Thank you Bill for sharing this. Like JMP I am recently diagnosed. Yesterday actually. My PSA was showing extremely gradual increases for years. That was consistent with my BPH. This past year it doubled. In the two weeks between routine testing and follow up it had almost doubled again. Gleason score of 6.
I am 47, in reasonable health and sexually active. Well, was up til the post-biopsy bleeding. I can wait for that to pass to resume.
I have already reviewed the greater aspects of pellet treatment and radical prostatectomy. Since both carry a risk of impotence, I am also leaning toward surgery to avoid incontinence. I will meet with a specialist in the coming week to review these in detail and to see if there is a more appropriate alternative (I live outside Boston, so may have access to treatments in early review/release.)
Your mention of receiving a full pathology will be helpful, since I was not aware of that aspect and will now include it in my discussion.
This is not my first illness that will require treatment, and, bluntly, I am just tired to death of researching treatment options. I am likely to do nominal research at this point. It has been a difficult year and I just want to get through this.
Knowing even one success story bolsters my choice of surgery. I just want it done with so I can find out what consequences are left behind to deal with and concentrate my energy on those.
I will do more research *sigh* but it was so nice that your's was the first post that I encountered.
 
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billh99 replied to Jude525's response:
It has been a difficult year and I just want to get through this.

One other difference is that surgery the side effects are worse at beginning and can improve for the first year or 2.

With radiation the side effects can be delayed and can increase fur the first 2 years.

However a study showed that after 2 years people that had radiation reported the same quality of life as those with surgery.
 
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JMP5819 replied to billh99's response:
Thank you Bill. As you did, I've decided that urinary incontinence is a much more acceptable risk. My father suffered with a number of problems due to radiation, one being bowel incontinence and although the process is much more sophisticated today, it seems the risk remains high. Another positive I've discovered is that post recovery, the PSA test becomes an absolute marker for cancer so any recurrence will be discovered in the early stages. No matter the choices I make, its a bitter pill to swallow as I've been healthy all my life and I'm still struggling to come to terms with the diagnosis. I 'm happy that your experience was a successful one and hope that you regain your health completely with no recurrence. I appreciate you taking the time to share your story, observations and knowledge.
 
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Basir U Tareen, MD responded:
It sounds like you're taking all the right steps and educating yoruself. I think you will find at your young age and health you should think about what will be the best long term as far as durable cancer cure and quality of life both.

If you choose surgery (which is what I believe the majority of men in your position would choose), just make sure you pick a very experienced surgeon with excellent outcomes.
 
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JMP5819 replied to Basir U Tareen, MD's response:
Thank you for your response Dr. Tareen, I appreciate your insight.
 
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billh99 replied to JMP5819's response:
Saw the urologist yesterday for 18 month followup. PSA still undetectable.
 
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jameshodge responded:
Sorry to hear that it's cancer but I'm sure that you will come through fine. There are many options for prostate cancer and they all have varying degrees of success. While in treatment consider taking natural prostate supplements like Super Beta Prostate. Super Beta Prostate scam is not real but may actually help you recover faster.
 
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jameshodge responded:
Sorry to hear that it's cancer but I'm sure that you will come through fine. There are many options for prostate cancer and they all have varying degrees of success. While in treatment consider taking natural prostate supplements like Super Beta Prostate that isn't a scam but may actually help you recover faster.


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