Prostate Cancer Community

There are several good books on the subject, the ones by Patrick Walsh and Gerald Chodak will give you the background you need..While this is a great forum, it's peer to peer utility is limited by it's format..Find your way to HealingWell.com, prostate cancer forum, to find a fast moving forum with many very helpful members who have seen it all...

The decision between surgery and the many forms of RT is one that troubles ALL of us..Many factors come into play, including how accommodating your insurance is and the facilities that are available to you..

I chose surgery as my primary treatment (G-9, PSA 14) because, if it failed, I had a second chance with radiation..(surgery did fail). Also, with surgery, the entire organ can be examined pathologically and a MUCH better idea of the extent of the cancer can be obtained..But that's just me..You will have to make up your own mind...Just remember treating PC is big business and they all try to sell the product they have on the shelf and they all seem to minimize the side-effects involved with the treatment they are selling...

Mine was similar. Gleason 3 3 on path from a TURP. Later upgraded to 3 4 from the surgical pathology report.

I have some minor bowel problems and was concerned about the side effects from radiation. Felt that I could better withstand the expected side effects from surgery than from radiation.

Also I did not like the idea of 6 months of radiation treatment.

I had robotic surgery 5 months ago and no problem with ED and almost no leakage.

So you've had a great experience considering? How was it for two weeks with the catheder? I'm not sure I can handle that? Does it hurt or feel weird or do you get used to it? And no problems sexually at all after 5 months?

So surgery can fail? I thought they could be sure the got it all that way. Have you had relapse and used radiation? Thanks for the help with books and the forum, btw!

Catheter is a minor issue in the grand scheme of PC treatment. It's no problem even going out and walking around. Except for the night I forgot that I had pinned the tube to the side of my bed and tried to get up, having the catheter removed is the worst few seconds of the experience. Age 59 at diagnosis with PSA 5.2 and Gleason 7. Upgraded to Gleason 9 after surgery (Robot Assisted Laparoscopic Prostatectomy) with growth outside prostate. Yes, surgery can "fail" but it's not the end of the world. I also avoided radiation due to bowel problems. You have time to decide. Don't rush and don't rely on a single professional opinion for your treatment. Good luck.

In my case the catheder was only in for 7 days.

And it was much better than the 20 hours I had one in for TRUP. That one was setup to only be temporarily and was tied to the bed. Anytime I try to shift in bed it hurt.

This time is was a hassle and I clumsy with handling it the first couple of times.

But no real problems or pain. Of course I was kind of limited in my activities.

One hint. I normally wear briefs, but wore boxers during this time.

As far as my recovery - First i will say that, from everything I have read, that it was very quick.

8 days after removing the catheter I stopped using the pads, although I got a dribble or 2 for a couple of more weeks. And erections returned in about 10 days.

So surgery can fail? I thought they could be sure the got it all that way.

Even if the cancer has not spread outside the prostate and all of the margins are clear a few cells might have already escaped out of the prostate and over the years grow.

If you go to Sloan Kettering website they have tables that show the percentage of probability of that happening.

For the test results you need the full pathology report showing which cores had the PC and the percentage in the cores.

Sorry, what's TRUP? Thanks for the great advice.

Also, I went to the Sloan Kettering website to find the tables and can't seem to locate them. Can you help? Thanks.

Here it is

http://nomograms.mskcc.org/prostate/index.aspx

That was suppose to be TURP. That is "roto-rooter" of the prostate for BPH (old geezer enlarged prostate).

They go through the urethra with a tool to cut out the material that is restricted the flow of urine.

So it only samples a small part of the prostate. In my case they found less than 10% of the "chips" had PC.

And when it was removed the pathology report showed threads in both sides of the prostate. Only 5% of the prostate, but they ran the the full length of the prostate and INTO the capsule, but not penetrated so the margins where clear.

Having it out and also knowing the details gave me some confidence.

At my age , 67, they mentioned the possibility of active surveillance. After getting the path report I am glad that I did not wait.

But at your age I doubted that option was mentioned.

I am 52, Gleason 7, PSA 6.4 and just underwent a relatively new, fairly non-invasive procedure for PCa called Irreversible Electroporation of the prostate, also known as Nano Knife. This procedure has only been around for 2 years so there is not much data, but there is a lot of promise with this one. I chose it because it gave me a plan B should the cancer return. With this procedure, I could opt to have it done again, or choose prostatectomy, radiation, seeds, etc. All options are still open to me. In this procedure, electrodes are inserted into the prostate through the perineum and an electrical field of up to 3000 volts of electricity is built up in the prostate. This electrical field causes pores to open up in the cell membranes. Since a cell cannot live without an intact membrane, it dies. Of course, the doctor tries his best to only target the cancer cells, but some good cells to get caught by this. I had this done on last Tuesday, June 7. I have the catheter removed on tomorrow, 1 week post procedure. I have had no pain from this procedure. Except for the catheter and some pressure from the prostate area the 1st couple of days post procedure, I have been fine.

My procedure was performed by Dr. Jaime Wong of the Malizia clinic in Atlanta, GA. Dr. Wong is the foremost expert on this procedure in the world so I was in great hands. He has also performed thousands of prostatectomies so if this thing should come back, he will remove my prostate via DaVinci surgery. I can highly recommend the Malizia Clinic and Dr. Wong if you are anywhere near Atlanta, GA. The Malizia clinic was started by Bernie Marcus, one of the co-founders of Home Depot, when he had prostate cancer. He was not happy with the way he was treated by his urologists so he opened his own clinic. I have been treated like royalty by everyone at this clinic.

Good luck with your decision. Making the decision is the hardest part of this ordeal.

Thanks for the very interesting reply. Never heard of this before. How many of these procedures have been done and what is the track record? I like the way it preserves future options.

Im doing a great deal of research alongside my husband and this caught my attention. He is a Gleason 7. Where you nervous about going through a procedure that has not been in the market for the length of time needed for it to have years of results? Do you live out of state and if so how has the aftercare been? Thank you for this post. It has given me an interesting direction to consider that hasn't been on our list before--and hopeful too. Congrats on your success thus far.

I have a Wall Street Journal article about Nono Knife that you may find interesting. I will E-Mail a copy of the entire article, for personal use, to anyone requesting it by E-mail, to:

"John@newPCa.org" (aka) az4peaks
"022
"022 OCTOBER 5, 2010
Some Doctors Question New Cancer Treatment
NanoKnife Used in Select Hospitals Shows Promising Results, but Hasn't Received 'Gold Standard' Test, Maker Says

By THOMAS M. BURTON
Some doctors are raising concerns about a new cancer-treatment device that uses electrical jolts to zap tumors but that hasn't been through a large clinical trial to prove it's safe and effective in people.

The device, called NanoKnife, is currently being used in about 13 U.S. hospitals including Baptist Health Medical Center in Little Rock, Ark., University of Louisville, and Shands Hospital/University of Florida in Gainesville, Fla. Each machine costs as much as $300,000. Some of the hospitals are aggressively promoting the device in ads and media presentations. One radio ad by the University of Miami's Sylvester Comprehensive Cancer Center says NanoKnife offers "real hope" to patients with liver, lung or kidney cancer with "almost no side effects."
The NanoKnife has been tested on animals and a small number of human patients, says its manufacturer, AngioDynamics Inc. of Queensbury, N.Y. "We have not done randomized, controlled clinical trials, the so-called gold-standard studies," says company chief executive Jan Keltjens. "We think this is a very promising technology for treating cancer that is otherwise untreatable."
Regarding the hospitals' ads, Mr. Keltjens says, "We are not part of the whole PR machine. It's not something we are happy about." He declined to elaborate.
The NanoKnife, which is also available in five hospitals outside the U.S., has so far been used to treat about 300 cancer patients world-wide. Doctors who have used the device say it has saved lives, including among prostate-cancer patients. While complications from the treatment have been reported in a few patients, some doctors say they are mainly concerned about what isn't known about the device because of a lack of evidence.


"There is growing concern in the interventional oncology community [that the NanoKnife> is being widely adopted prior to having gone through the necessary rigors of controlled investigations and clinical trials," says Riad Salem, chief of interventional oncology at Chicago's Northwestern Memorial Hospital. Northwestern doesn't have a NanoKnife, he says.
The NanoKnife's journey from testing in animals to being promoted as a cancer fighter highlights a shortcut the Food and Drug Administration allows for granting regulatory approval to certain medical devices. When a device is deemed similar enough to another already on the market, it can get approved with little or no clinical evidence." - - -
the article continues but is too long to complete here because of Posting limitations by WebMD.