Newly Diagnosed

Hi - I have been on this board for a year because my father had esophageal cancer.  He subsequently died from the first round of chemo.  NOW, I am on because my husband has just been diagnosed with prostate cancer.  His PSA is 5.2, down from 6.5 after a round of heavy antibiotics.  He had an ultrasound and 12 biopsies.  6 were positive consisting of some on each side (?)   Anyway, the question has become whether to do surgery or opt for radiation seeds.  This is new for us, so, my husband has concerns regarding both.  The biggest of course, is the ability to have an erection as well as incontinence.  I know how wonderful this board is for obtain valuable information, so, we are hoping for some responses of you all.  The unknown is very unsettling.  Any help would be appreciated.  We are in Maryland and are with Dr. Busky - the head of Chesapeake Urology at GBMC.  Thanks

If you havn't already done so, you need to obtain a print out of your biopsy report which provides details on the gleason score, % of cancer in each sample and a lot of additional information. The biopsy slides should be sent to an expert pathologist for a 2nd reading.

Biopsy readings are subjective: what looks like cancer to one person can look normal to another. It's surprising how many 2nd readings come back with a different diagnosis, which can sometimes influence consideration of treatment options.

Most important things is to find the best doctor available regardless of which treatment you select. There are a lot of variables like quality of the facility, equipment and treatment techniques, but a top doctor will provide the best chance of a good outcome with few side issues.

There are a lot of good publications available. For a very comprehensive and objective book, I like the one by Lee Nelson MD.  Although written a few years ago, it covers the main treatment obtions, diagnosis, choosing your doctor, stages, lifestyle changes, diet,nutrition etc.

The book by Dr Scardino, who is one of the top surgeons, is also very informative, but would probably  be more of interest where surgery is the main consideration.

The yananow site mentors section has stories from men who have used the various treatments, who would also be happy to provide answers to specific questions.

 

On 4/7/2008 Worriedsick wrote:

Hi - I have been on this board for a year because my father had esophageal cancer.  He subsequently died from the first round of chemo.  NOW, I am on because my husband has just been diagnosed with prostate cancer.  His PSA is 5.2, down from 6.5 after a round of heavy antibiotics.  He had an ultrasound and 12 biopsies.  6 were positive consisting of some on each side (?)   Anyway, the question has become whether to do surgery or opt for radiation seeds.  This is new for us, so, my husband has concerns regarding both.  The biggest of course, is the ability to have an erection as well as incontinence.  I know how wonderful this board is for obtain valuable information, so, we are hoping for some responses of you all.  The unknown is very unsettling.  Any help would be appreciated.  We are in Maryland and are with Dr. Busky - the head of Chesapeake Urology at GBMC.  Thanks

Take a deep breath and exhale.  You need to research your options.  I recommend attending a PCa support group meeting in your area so your husband can actually talk w/ patients who have had a variety of treatments.  My husband had the robotic sugrery with the "Veil of Aphrodite" procedure at Henry Ford Hospital in Detroit on 12/27/07.  The "Veil" is a new nerve sparing technique and Dr. Peabody has done over 1500 robotic surgerys.  My husband is 43 yrs old and had no ED issues prior to surgery.  We too were worried about function.  We have been intimate 3 times since the surgery, once w/o meds.  Sorry if that is too much info.  We have also been fortunate w/ incontinence, he wore pads for about 3 - 4 weeks.  Here is a link that may be helpful in deciding on treatment. http://www.henryford.com/body.cfm?id=41144

 After all was said and done, I found something about a Proton Beam Therepy.  That might be something else to research.  Good Luck

Thank you both for your quick replies!  

 Johnw100 - I agree with you that getting the best doctor and facility is critical!  Someone else on this board mentioned having his slides sent to Dr. Jonathon Epstein a top prostate pathologist at Johns Hopkins.  Being that Johns Hopkins is so close to us (although my Dad's experience there was not good), we are having the slides sent to Dr. Epstein and are requesting a copy of the biopsy as you suggested.  Hopkins is ranked third in the nation for cancer, so, after reading their treatment protocol and research findings, we are going to switch to a Dr. Carter, the head surgeon over there (should everything point to needing the surgery).  We will also check out the books you mentioned.  thanks for your input and I wish you the best!  karen

Censusgirl65 -  Thank you so much for your reply!   No, not too much info at all, it was what I was looking for :-)   That is very good to hear!   I am going to look at the site you recommended and the beam treatment.  Thanks so much.  I will pray for your husband's continued success and good health!!  karen

 

Hi Worriedsick, I am also facing my husband's recent DX: prostate cancer. His PSA was 7.0, after a round of antibotics it was 6.7. He was then referred to a urologist. His biopsies report came  back with a

gleason grade 6. He is in overall good health. His urologist wanted

him to go with surgery( radical prostatectomy ). We decided to go

for second opinion on treatment options. Now we feel after he saw

the radiation oncologist, he should go with the brachtherapy(seed

implants).  I pray we are making the best choice for him, and I

hope you and your husband find the best path too. It is hard to make

decisions when all options for treatment, sound risky . Thanks.

 

 

 

 

 

 

I was recently diagnosed with prostate cancer in Sept. 2007. From my research on the internet I realized that radiation treatment was potentially too damaging to the surrounding structures and has a high chance of Erectile disfunction and incontinence. Laproscopic prostectomy was alot less of a problem but it still had a high percentage of ED and incontinence. My best choice was the new procedure called HIFU (high intensity focused ultrasound) which has an ED of 20% or less and incontinuence of 0.6%. I have just finished having the Sonablate HIFU procedure on March 29, 2008. The recovery is more involved but I feel that it is worth it as I don't think that I will have any peripheral damage. You are given drugs to stimulate blood flow so that ED will not exist. I will not know about ED for a month or more but the doctor during the procedure stated that my nerve bundles were easily seen and so no chance of damage from the procedure. The ED of 20% from what I have seen from various sources is maybe a little high as the systems have improved over the passed number of years. The Sonablate HIFU website is http://www.hifucarecenter.com/ 

Hi, I am also a wife of a prostate cancer survivor. My hubby was 44 when diagnosed. I think treatment option depends on age as well as personal wishes. Typically the younger  you are when diagnosed the more aggressive the cancer and in our opinion the more aggressive the treatment. My hubby opted for a radical (his Dad died 18 months before from the same thing/ he was too far gone for the surgery and radiation/hormone therapy didn't touch the cancer). We decided that at the age of 44, life was the most important thing and the after effects we would deal with. His surgery was last July. He also  had 40 radiation treatments because it extended outside of the prostate capsule. His incontinence ended in November after the radiation treatments. In the beginning we tried viagra and another med (can't remember which one). They worked, but he felt pretty uncomfortable with the side effects afterward. He now gets about 80% of an erection. Just not quite as hard as what it used to be. But ......... good enough for now! The med's are there when he wants more. Honestly, because we appreciate life more , sex is better! 

Ask loads of questions. Surgery causes more side effects with age. Another site to look at is www.yananow.net  . Best wishes!

 

On 4/8/2008 Worriedsick wrote:

Thank you both for your quick replies!  

 Johnw100 - I agree with you that getting the best doctor and facility is critical!  Someone else on this board mentioned having his slides sent to Dr. Jonathon Epstein a top prostate pathologist at Johns Hopkins.  Being that Johns Hopkins is so close to us (although my Dad's experience there was not good), we are having the slides sent to Dr. Epstein and are requesting a copy of the biopsy as you suggested.  Hopkins is ranked third in the nation for cancer, so, after reading their treatment protocol and research findings, we are going to switch to a Dr. Carter, the head surgeon over there (should everything point to needing the surgery).  We will also check out the books you mentioned.  thanks for your input and I wish you the best!  karen

Censusgirl65 -  Thank you so much for your reply!   No, not too much info at all, it was what I was looking for :-)   That is very good to hear!   I am going to look at the site you recommended and the beam treatment.  Thanks so much.  I will pray for your husband's continued success and good health!!  karen

 

 

You have done all the right things, and have chosen the right Drs. I have no doubt everything will go well.

Good luck,

K.D.

As far as whether to have surgery or not ... my beautician's boyfriend decided to have the seeds instead of surgery.  Two years later, the cancer had spread to his bones and he passed away one year later.  My beautician wished he had the surgery instead of the seeds.