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New and looking for the way to go
MikDun posted:
Just found out to that a Gleason reading on half of the gland and all 3 came in at 3 4=7 PSA is at 9.6 drs say it has to come out. I say no to many side effects. I was wondering if anybody has had luck with just the 9 weeks of external beam radiation?
BobKy responded:

Welcome! It would be helpful to know how old you are. Given the generally slow-growing nature of PCa, please take sufficient time to make an informed decision.

I HIGHLY recommend you join me at this patient-oriented conference in LA, September 9-11. I've attended several of these patient conferences over the years and I've always leaned something important for my treatment decisions.

Check out the agenda (see Prostate 101 for the newly diagnosed,Friday.) and the faculty. You get to mingle with these experts and ask questions.

I was diagnosed in 1995 at age 50 with PSA 18 , Gleason 3 4 and clinical stage T3c (cancer spread into my seminal vesicle.) Had cryosurgery, it didn't work and have been doing Intermittent hormone therapy ever since. The moral of the story: it's not over 'till it's over...

Best of luck,

MikDun replied to BobKy's response:
Thanks Bob,
I am 58 yrs young. Just not sure which way if any to go.The comments so far are to remove it. 2 really good friends who had it done in their late 50's said they would never had done it if they knew then what they're experiencing now. I guess like you and a few others have told me to take alot of time checking every option out there. Does the hormone therapy work for you and does it destroy the cancer cells? Are you doing any other treatment like radiation?

BillH99 replied to MikDun's response:
Hormone therapy only SLOWS down the growth of the PC, does not eliminate it.

It is used in 2 cases. One with radiation treatments.

And the other is if you have re-occurrence after other treatment.

With surgery the side effects are immediate and improve over time.

With radiation there are some immediate side effects, but most of them are delayed and they get worse in the next 2 years and then stay the same.

About a year ago there was a survey of people that had radiation or surgery. At the end of 2 years (when the surgery would have recovered as much as they will and the radiation people would have maximum side effects) they asked about their quality of life.

Both groups reported the same quality of life. But remember as part of picking a procedure each person looked at the possiblity of side effects and considered which would be more of a concern to them.

Two advantages that I see to surgery is that;

1. You have the whole prostate for the pathologist to examine. Biopsy is only a sample of limited areas and often does not give the full picture.

2. If you have re-occurrence then you can have radiation treatments after surgery. Vs versa is not possible.

If you click on my name you will see a list of my post and some give more details of why I chose surgery and my outcome.
az4peaks2 replied to MikDun's response:
Hi Mik, - Before deciding on treatment, I would suggest that you have the slides from your Biopsy sent, for a second opinion, to a recognized specialist in examining Prostate tissue. Johns Hopkins and Bostwick Laboratories are 2 that come to mind, but there are others, generally found at institutions with high enough volumes to justify such pathologic sub-specialization.

Once the subjective Gleason Scores are confirmed, you can more confidently move ahead in your INFORMED decision making. You have choices and you have time to make them but first you need to be comfortable that the status of the disease you have now is accurate. A map to a desired destination is not nearly as helpful, if you don't know where you are now located on it.

There is time to learn but anecdotal tales of what happened to other INDIVIDUAL patients, is not nearly as reliable or helpful, as is the cumulative evidence derived from published, peer-reviewed medical studies reporting results from groups of men, with similar disease characteristics.

We are all individually different which is why we can each be separately identified by DNA. In addition Prostate Cancers can vary as well, but you can learn about PCa and you have a reasonable time frame to do so. ALL treatments have POTENTIAL side effects (morbidity) but most are age sensitive and your younger age may well prove to be your greatest ally.

At 58 y/o you have an actuarial life expectancy of 22 years and that is the time period that needs to be considered, not the shorter term 5 to 10 years usually cited in medical studies. I will be happy to answer any specific questions you may have, if you desire. Good luck! - (aka) az4peaks
BobKy replied to MikDun's response:
Hi Mik,

Bill and John have given you excellent information.

Yes, intermittent hormone therapy has been very effective for me. I also have changed to a vegan diet (with some cold-water fish.)

After my cryosurgery, the PSA started to rise (during a period when I was not doing hormone therapy.) My doctor did another 12-core biopsy and could not find any remaining cancer cells. Given the possible morbidity of radiation,and the high probability that my cancer was already systemic (Initial PSA 18 and PCa spread into one seminal vesicle), I elected to continue with the intermittent hormone therapy.

Hormone therapy:

"Hormone treatment is primarily used if prostate cancer has spread outside the prostate. It does not cure cancer. The purpose of hormone therapy is first to delay the progression of the cancer, and second, to increase survival while maximizing quality of life."

The reason why hormone therapy does not cure prostate cancer:

"[a name="Hormonal Therapy">Hormonal Therapy is based on the fact that prostate cancer cells frequently use the male hormone, testosterone, as "fertilizer", and the absence of testosterone leads to the death or weakening, (apoptosis), of many, but not all, prostate cancer cells. As a result, many patients with incurable prostate cancer, (Stage D and late Stage C), can have their life extended and quality of life improved by the use of hormonal therapy. "

What you will rapidly discover is that forming a PCa treatment plan is not an exact science. It's all very confusing to the newly diagnosed man (who thinks he must do something "NOW.") That is why we stress the importance of making an informed decision. Get a second opinion,as John points out, on the biopsy samples, Get a second opinion from other PCa specialists (radiation oncologists and medical oncologists.) Finally, join me at the LA prostate cancer conference; I guarantee you will be amazed by what you learn !!


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