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DECISION TIME
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mjhud posted:
JUST BEEN CHECKED FOR PROSTRATE CANCER FROM BIOPSY AND DOCTOR SAID THAT OF THE TWELVE AREAS HE CHECKED, THREE HAD CELLS OF A LOW GRADE NATURE? MY QUESTION IS TO HAVE THE PROSTRATE REMOVED TO PREVENT FURTHER SPREADING, AND WHAT KIND OF LIFE STYLE WILL THIS LEAVE ME AS TO HOW LEAKING WILL BE AND IF ANY OTHER LEAKING CAN OCCUR FROM THE RECTUM.
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billh99 responded:
You need to get a copy of the biopsy. You need to know the Geason grade of the cells. And the percent of cancer cells seen.

And what is your age and PSA reading.

In addition to surgery there are several types of radiation and watchful waiting.

There are also a few less common treatments.
 
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mjhud replied to billh99's response:
thanks for your input, haven't been to doc.yet after biopsy. when he called he told me it was low grade? and it was in 3 of the 12 area's he checked. i will know more after doc visit on monday the 9th, thanks again, will get back to you, and by the way, is this similar to what you have been thru?
 
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billh99 replied to mjhud's response:
Mine was somewhat different.

I had a TURP because of BHP. Pathology report showed less than 10% of the chips removed had PC with a Gleason score of 3 3.

That is low grade.

I decided on treatment. But if I did not I wanted a biopsy before hand as the TURP does not sample all of the prostate.

The reason that I decided on treatment was that I am 66 and in good health. But did not want to have the PC increase in say 5-10 years and not be as healthy and not having the options for some treatments.

And I found a relatively new study that indicated that if you had PSA of 2 or higher at age 60 and then got PC that the probability of it being aggressive is high (75% IIRC). And mine was 2.3 at age 59.

in general the success rate with both surgery and radiation are the same. But there are no head to head studies.

A study last year of people 2 years after treatment both those that had surgery and had radiation reported the same qualify of life.

But those are based on self-reporting and something that bothers one person might not bother the next one.

In general people that have surgery or more like to have urinary incontinence and people who have had radiation or more like to have bowel problems.

And I already have some minor bowel problems and the though of bowel problems was a real concern.

Also I did not like the though of 6-8 weeks, 5 days a week of radiation treatments. Although there are some that are shorter.

You asked about "leakage".

In some cases the rectum is damage during the surgery. The prostate lays right next to it. This is not a common problem. But i don't know the percentage.

Urinary incontinence and ED are common problems with surgery. But they typically improve over 6-12 months.

As you start looking at you options you will find more specific statistics.

In my case I had a catheter for 7 days and after it was removed I had urinary control after 8 days and my erections 10 days. But I know that quick of recovery is not common.

Besides the luck of the draw I credit that with being of normal weight and physically fit and active. A study has shown that those that are over weight has 30% more problems and those that are not fit have 30% more problems. And those that are both 60% more problems.

And I just finished a round of physical therapy for back and hip problems. And i practiced the kegel exercises before the surgery.

And I am glad that I had the surgery.

The pathology report of the removed prostate showed that the PC was more extensive that originally thought. It was up graded from 3 3 to 3 4. And the PC was into the capsule, but not through it. So it was still contained.
 
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Fairwind replied to billh99's response:
While you are waiting to see the doc, pick up a copy of "Guide to Surviving prostate cancer" by Dr. Patrick Walsh and learn what lies ahead, what choices you have, what to expect...it's available anywhere, including eBay or Amazon
 
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mjhud replied to Fairwind's response:
thanks for your inpurt. been to the doc, he explained that because of my age, 71, surgery was not recommened because my gleason score was 3 3 & 3 3 for 6 considered a low grade slow moving, so my options were: 1 watch and wait with reg.psa and another biopsy in 6 mo. 2. was the radiation seeds inserted and explained the plus's and neg's of that. 3. he said that the method he thought i should follow was the freezing of the prostrate etc. because the side effects were less and the killing of the cells was more effectially sure. so i am at the stage of deciding whats best for me and what i could handle after either procedure.
 
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Fairwind replied to mjhud's response:
As radiation treatment (in all its forms) has made rapid advancements, the cryogenic treatment is losing favor..Impotence is almost guaranteed and curing your cancer is not guaranteed..Look into the seeds plus IGRT combo treatment and get a very high cure rate and low side-effects..Like ALL PC treatment, success depends on the skill of the practitioner..On the bright side, very few men die of Gleason 6 PC...So no matter what treatment you choose, the results will be good...
 
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wifeofpatient replied to billh99's response:
I like your recovery report. My husband is 50 and in pretty good shape and not over weight, He will be having robotic prostatectomy in about a month. He is already doing the kagel and we are studying to see what to expect. Do you have any other advise. I have order the books that were recommended.
 
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miguelito51 replied to wifeofpatient's response:
had the robotic procedure at the mayo clinic in phoenix...am very happy with the results...life will be different for sure, but recovery was quick and after my checkup, there was no trace of cancer! woo hoo! do those kegel exercises! it will def make a difference. as far as the quality of life...nerve sparing surgery will give you a distinct advantage if performed by someone who knows what he/she is doing. being as your hubby is somewhat young (like myself), the opportunity for a trifecta ( sexual function, continence, and no cancer) is a good one. i'm real happy i went with the surgery - it has only been almost 5 months, and sexual function is close...viagra does make a difference, but it's more of a reassurance than anything else. just be patient! no leakage, however, and positivety is very important! i'm not a fan of radiation unless one is a bit older...although a slow moving cancer, sometimes it can be a bit more aggressive in younger patients from what i understand. your husband should do very well if he is in good shape. good luck...
 
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1keifer1 replied to Fairwind's response:
I too had the DaVinci robotic surgery, I too had to wear the foley cath. It was a great relief when removed after 7 days. That was my worst part of the surgery. I was cut one morning and sent home the very next day at noon. It is extreamly better results compared to radical surgery and saves the nerves which alot of the times they are not saved with a radical surgey. Less complications and blood loss. Good luck to you with your choice.
 
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Kjdon77 replied to miguelito51's response:
Hi, thanks for the infos..it helped us what to do re my dad's early detection of PC..he is 70 and I'm afraid if he will undergo radical surgery bec of the risks..we plan the robotic surgery instead.. He was diagnosed just a week ago that he is on early stage of PC we were told to go back in 3 months to wait and see and for another biopsy..we cannot decide us of now whether we wait or we go to the robotic surgery already ASAP to contain the PC...his dr said His PC is not even yet on Stage 1...that's why we were told to wait and see but we are also given a choice of a surgery as early as now...your advices world be of big help to us...thanks!
 
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bogie11 replied to Kjdon77's response:
Please investigate proton radiation before making a decision. It has minimum to zero side effects, whereas surgery has a high probability of incontinence and/or impotence. I chose proton at 84 and have had no side effects for over three years. I'm delighted.
 
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johnboy72 responded:
Same with me with a Gleason score of 6. I've been advised to have it removed within the next 2 months at the Robotic Institiute in Celebration Fl by Dr. Patel. #43 in the country. Life should return to normal within a couple of weeks, so I've been told.
 
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steady022 replied to johnboy72's response:
I just finished my radiation treatments - all 43 of them. Other than having some incontinence so far I really did not have any major side effects. I see the string above and wonder if people are reading different books than I am. If I only had 3.3 or 6's in the samples, I would have done watchful waiting with regular PSA tests for changes. There is really no hurry to just jump and do something especially if you are over the hump - what I would call 65 or older. It is a very slow growing cancer and I would encourage you to take your time to figure out what to do. Some guys just want it out, no matter what and go the surgery route. If you go the surgery route, the DiVinci is the only way to go. But the outcomes of radiation & surgery when you have 6's or 7's are just about equal. After reading all I could, taking to a number of doctors including my own family doctor, I decided to go the radiation route just for quality of life. We will see how it all pans out. I will tell you this, if I were over 80 and found out I had PC and it was a 6 or 7, I would ride it out. You are going to die from something else before the PC catches you.
 
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shc5549 replied to steady022's response:
I'm 63 still active and working full time. Routine blood tests 18mo ago showed jump in PSA prompting a biopsy as precaution and they found pre-cancerous tissue. Another round of blood tests a couple of weeks ago showed another jump in PSA prompting another biopsy and they found low grade cancer in 1 of 12 samples taken. After talking to urologist and thinking about various treatment options vs surgical removal I think I will just have prostate removed rather than do any of the treatment options. Robotic surgery technique rather than cutting me open seems to be less invasive. Thinking that I don't want to go through treatment only to risk having to remove anyway later. Discussions seem to support this. Thoughts?


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