Choosing A Treatment

I was recently diagnosed with cancer. My psa was 4.1. My gleason was 6 (3+3). I am 62 years old.My doctor put a lhrh implant lasting one year inside me. I'm going crazy deciding on radiation or surgery. I'm also considering watchful waiting. I would to avoid hormonal therapy as much as possible in the future. I should also add that only one of twelve cores showed cancer.That core 10 percent of the core to be cancerous. Anyone have ideas that can help me? Thank you.

Dear Ceasar,

first of all let me say i am very sorry you had to come and find this board.

with regard to opinions as to what you should do, only you and your doctor should have the final word. message boards cannot diagnose or treat people. having said that, and someone out there correct me if i am wrong, but isn't surgery the only chance for a cure?

if your staging workup shows you are stage 1 (no mets, no lymph node involvement), then you have a chance at being cancer free with radical prostatectomy (RP).

my understanding of it (and don't go by me, talk to your doctor) is that if you are relatively young, and if there is a chance for a cure, that is what you should do. radiation and chemo, i thought (and i could be wrong), will extend your life, but if you live long enough, the cancer will eventually kill you. At the age of 62 the actuarial tables say that statistically a male your age should live another 20 years.

when the cancer is diagnosed in someone who is 82 years old, it is a sure bet that something else (heart attack, stroke, a different cancer) will kill them well before the prostate cancer does. So in 82 year olds, RP is rarely done, and things are managed with non-surgical treatments like radiation and anti-androgenic hormones.

Where are all the experts hiding? Yoo hoo! (looks both ways)

-Amnia

according to treatment guidlines, you have 3 options given your age, PSA and Gleason. RT, RP or watch and wait. RT hs several options itself, like brachytherapy, cryotherapy, HIFU, etc.(some of those are not really RT, but I include them). Amnia's right, RP is the cure and watch and wait, well its an option. The only reason men tend to avoid RP is the dreaded side effects. However surgery has come a long way. There is even robotic surgery now. I think I would find a surgeon who does a bunch of them and ask for his side effect data. The hormonal therapy you have started, will work for awhile, perhaps years, but most PC eventually becomes resistant. I dont like watch and wait , at your age. In the end, the choice is yours. You can find success and failure stories from men choosing any one of these options.

I always suggest people read the book "Prostate Cancer Prevention and Cure" by Lee Nelson.

It's very comprehensive and covers stages, treatment options, nutrition, supplements. Essential reading for anyone diagnosed.

He covers several treatments which are "all equally effective" and makes the valid point that choice of doctor is VERY important regardless of what treatment one chooses.

Lifestyle changes, nutrition, diet, supplements, exercise are also important, regardless of what else you do.

With recent early detection much research into watchful waiting, and definition of low risk cancers etc by John Hopkins, Oregon, McGill is available here.

Best Wishes,

John

Dear Chester, I had my Prostate removed one week ago today 9/11/2006. This time last week I was laying in a hospital bed, today I am feeling about as well as can be expected. In fact I feel pritty darn good. I went in the hospital on Monday the 11th at 5:am and was discharged on Thursday at 8:00am. I am 54 and was diagonsed with prostate cancer in May of this year. Had a psa of 4.6 and a Gleason of 6, 3+3. I did a lot of resarch on all possible treatments, Seed Implants, Radiation and Radical Prostectemy. The decesion was mine and mine alone. I would do the same thing again, I have no regrets. The Dr informed me the Cancer is gone and did not spread beyond the Prostate. I have 15 staples in by belly and a hose up my penis, get them removed on the 25th. The pain after surgery is not really as bad as some people claim it to be, remember everyone is different and has a different pain level. I was given a Morphine pump and other pain medication. I know what you are going through and the decision you make will affect you and you have to live with it. Do what you feel is best for you, don't wait too long for treatment get it done as soon as possible. Wish you well and hang in there.

Fred