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    Prostate Cancer treatment questions
    tgrahame posted:
    I was diagnosed in March with prostate cancer. Not really a surprise as my father had it (it was not what he died from). My brother also was diagnosed and treated at 50. I am stage T2b. My eurologist recommended a prostectomy. I went for a second treatment option opinion to the doctor my brother used. He recommended (or suggested) HDR brachytherapy, which is what my brother had. My brother is doing fine and has had consistently low PSA since his treatment. I have the luxury of being able to talk to my brother as far as after treatment side effects and the length and severity of them.
    My next step is to make a decision on my tratment option. Being that I was diagnosed in March, I really should get my treatment scheduled for no later than January 2011. I understand the eurologist approach to the prostectomy in that it guarantees that I will be cancer free since my cancer is contained and the prostate would be removed. It just seems to radical at this point based on my brothers experience. that is also the feeling of the second opinion doctor I spoke with.
    I guess what I am asking for in this post is to hear from anyone who has had either treatments and if they would be willingto offer their opinions.
    I am 50 years old and otherwise healthy. I have a pretty good diet and exercise strongly at least 3x a week. I have no sex or ED isues. I feel pretty confident that I should be able to recover relatively quickly from either procedure.
    Thank you in advance to anyone who is willing to share stories or opinions.
    bogie11 responded:
    My experience is that I had proton radiation therapy 18 months ago at the University of Florida proton therapy center. I've had no side effects, had a great time while there, and my PSA has been dropping every checkup since.
    samame responded:
    I had high intensity focused ultrasound just over two years ago, I experienced no side effects, it's only a two hour treatment in the hospital sedated, then you leave. It's commonly called hifu, "high-foo". Trouble is you must leave the country because we are the only country that hasn't approved it yet, we who have had hifu think it's all about money, as hifu has been used for many years around the globe. Here is some information on it from N.I.C.E. the institute that looks into all medical treatments in the UK. ..
    HIFU is relatively new there as well, while I understand that some 250 hifu centers treat cancer in France. Anyway, read this for a more open viewpoint, as my experience was so good I am very biased:

    Here's a paragraph from their write up:
    "The experts said that the possible problems that
    could happen with HIFU were urinary
    incontinence, the formation of a fistula, damage
    to the bowel and erection problems. But they
    said that HIFU treatment seemed to be safer
    than other treatments that involve destroying or
    removing part of the prostate."

    BTW, the FDA is conducting trails on hifu right now, both for treatment of organ confined and for radiation failure. I had to leave the country to be treated, as are many men, American doctors accompany us to places like Burmuda, Bahamas, Canada and Mexico. International HIFU has a organization that books all treatments and doctors schedules, it's quite upscale.
    samame replied to bogie11's response:
    Did your doctor actually say he quarantees cancer free after surgery? Doesn't seem possible.
    Judd W Moul, MD responded:
    While I try to be unbiased and not offer specific medical advice, I do favor nerve-sparing radical prostatectomy for most men who are very young like you. At my center, we offer a multidisciplinary clinic where men can see a urologic surgeon, a radiation oncologist, and a medical oncologist at the same visit for full discussion of the options. In most men who are very young, like you, we tend to favor radical prostatectomy. Even our radiation oncologists tend to favor surgery over radiation for very young men. The skill of the surgeon is more important than the type of surgery. In other words, the surgeon's experience is the most critical factor- not the type of surgery (ie robotic, etc.) In very experienced hands, the robotic procedure is probably just as good as the gold standard, open nerve-sparing operation. However, I prefer the small incision, open surgery for three reasons: 1. The open is hands-on; the robotic surgeon has no ability to feel the tissues. 2. The open does not enter the intestinal cavity but most robotic cases violate this space. 3. Published results show that robotic outcomes are no better than the open and may be worse for urinary and sexual recovery.
    Best wishes with your decision and treatment,
    Dr. Moul

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