CancerCompass message board discussion started by Worriedsick on 4/7/2008 http://www.cancercompass.com/message-board/message/all,22779,0.htm Sat, 11 Oct 2008 00:00:00 GMT Sat, 11 Oct 2008 00:00:00 GMT http://backend.userland.com/rss RSS.NET: http://www.rssdotnet.com/ 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 Worriedsick Mon, 07 Apr 2008 00:00:00 GMT 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. Johnw100 Mon, 07 Apr 2008 00:00:00 GMT  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.  ThanksTake 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 Censusgirl65 Mon, 07 Apr 2008 00:00:00 GMT 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!  karenCensusgirl65 -  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  Worriedsick Tue, 08 Apr 2008 00:00:00 GMT 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 agleason grade 6. He is in overall good health. His urologist wantedhim to go with surgery( radical prostatectomy ). We decided to gofor second opinion on treatment options. Now we feel after he sawthe radiation oncologist, he should go with the brachtherapy(seedimplants).  I pray we are making the best choice for him, and Ihope you and your husband find the best path too. It is hard to makedecisions when all options for treatment, sound risky . Thanks.       tym2play Wed, 09 Apr 2008 00:00:00 GMT 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/  DocTV Fri, 11 Apr 2008 00:00:00 GMT 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! Linb1414 Sat, 12 Apr 2008 00:00:00 GMT  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!  karenCensusgirl65 -  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   SEPONPK Thu, 08 May 2008 00:00:00 GMT 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. SEPONPK Thu, 08 May 2008 00:00:00 GMT 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.  SweetAdeline Thu, 08 May 2008 00:00:00 GMT Hi-I don't know whether you will still be following this message board or not,but I thought I would throw in my two cents worth.  I recently underwent a radical prostatectomy at GBMC with the DaVinci robotic system. My surgeon was Dr Daniel Dietrick,also of Chesapeake Urology.  I would strongly recommend you consult with him. My surgery was 100% successful & my PSA was 0 thirty days later. He rates my complete cure chances at 99%, given my Gleason score,pathology report & PSA.   My initial PSA before surgery  was 9.6,my gleason score was 3+3=6,3+4=7. Dr Dietrick has been performing nerve sparing surgery for many years & trains surgical teams in robotic surgery at both GBMC & ST. Joes.  The major advantage of surgery(aside from the best chance for a cure) is the pathology report. It is the only way to know that the cancer is still contained, since they also test the bladder neck,  lymph nodes & surgical margins. Also, most people regain urinary continence & potentcy after time. Radiation seeds can irreversibly damage both nerves & delicate blood vessels that are saved by a skillful surgeon. patient1 Fri, 30 May 2008 00:00:00 GMT Hi - Thank you so much for your info!   I believe everything you say and I agree!   We are now at Hopkins with Dr. Ballentine Carter and he has done over 2000 of these surgeries and is known for his nerve sparing technique and lack of incontinenct and "hydraulics":-) problems.  My husband will have the surgery on June 9th.  I am optimistic that all will go well.  Thanks for you response and I am so happy to hear that you are doing so well!!  I wish you continued good health!!  thanks! Worriedsick Fri, 30 May 2008 00:00:00 GMT Hi,Good it sounds like your husband will be in very capable hands. The only problem I had after the surgery( that no one warned me about) was gas pains that develop because they pump you up with co2 & that disapates into your intestines.  Very uncomfortable for a day or 2. Also it takes 4 days or so for your intestines to start to function again after the anesthesia.  That was the worst of it.  The actual pain from the incisions is very minor since they're so tiny. I was back to lifting weights & doing situps 6 weeks after surgery with no problems.  Perhaps your new doctor has recommended it already,but the best book on prostate cancer was written by a Hopkins doctor, Dr. Patrick Walsh - Guide to Surviving Prostate Cancer.  Even though you've made your treatment choice already, it not only explains all of the options available but also helps decipher all the test results. Your husband has definitely made the right choice. Best of luck to you both.  Please be sure to let us know how it all goes. patient1 Fri, 30 May 2008 00:00:00 GMT