Prostate Cancer

[Guest]

I am a healthy, active 56 year old with no history of cancer of any kind in my family. My PCa was discovered during a routine physical (DRE). My PSA is 2, my Gleason is 3 + 3 and I have been staged at T2a. The cancer is in 50% of the samples of one lobe.

So far I have consulted with two surgeons and two seed guys. They all recommend surgery because of my age (finally I am too young for something), there is only 10 years worth of data on seeds and there is no effective salvage treatment for seeds gone bad.

I can hardly stand the thought of the surgery itself let alone the side effects. Seeds would be my choice, but it doesn't make much sense to totally fly in the face of medical professionals, not to mention leaving myself with no effective fall back position.

On the many prostate chat boards I am reading about many men who are totally happy with their seed therapy and have no unhappy side effects. But, I must admit that for the most part they are older than I am and have not reached the 10 year mark yet.

Any thoughts from anyone? Any recommndations for a brachy doctor in Minneapolis?

Thanks

[Guest]

As a surgeon, I too strongly favor surgery for 56 year olds with T2a disease. Readers?
[quote] I am a healthy, active 56 year old with no history of cancer of any kind in my family. My PCa was discovered during a routine physical (DRE)... [/quote]

[Guest]

I am not a medical person so you may wish to give more weight to those who are. As one who had the surgery six years ago, I would think you would want to give serious consideration to seed implants. They have been done now for at least 15 years, and it is my understanding that overall results compare with the surgery.

Still, there are many who favor surgery. If you opt for that, just be aware of the fact that 59.9% of men report problems getting an erection, and 8.4% urinary difficulties, 18 months after the surgery. (These figures are taken from a major study reported in the Journal of the American Medical Association a year or two ago.)

ceb4
[quote] I am a healthy, active 56 year old with no history of cancer of any kind in my family. My PCa was discovered during a routine physical (DRE)... [/quote]

[Guest]

I am 56 as well and all surgeons in our major urban area recommended surgery over external radiation/seeds with my young age being a major reason, so it would seem wise to go this route. Did either of the surgeons you saw recommend removing the neurovascular bundle on the side of the cancer? I assume you have a palpable tumor since it was discovered on DRE. This is the major issue for me.
[quote] I am a healthy, active 56 year old with no history of cancer of any kind in my family. My PCa was discovered during a routine physical (DRE)... [/quote]

[Guest]

There certainly is 10 year data on seeds. Overall survival approaches the level of radical prostatectomy. This must be evaluated in light of the reduced complication rate.

It's not true that there is no salvage therapy for seed failures. Second generation cryosurgery of the prostate (freezing) has been approved for this purpose and is just now becoming available in most of the country. The available evidence suggests that this treatment can create at least 3 years of undetectable PSA in 65% of patients who otherwise would be incurable. Only longer trials will tell us how many of these patients are truly cured, but 3 years is certainly a good start.
[quote] I am 56 as well and all surgeons in our major urban area recommended surgery over external radiation/seeds with my young age being a major reason, so it would seem wise to go this route. Did either of the surgeons you saw recommend removing the neurovascular bundle on the side of the cancer... [/quote]

[jim1948]

I see that this is from March. did you do anything and if so, what. Are you satisfied? I too have to make that decision very soon. Thank you.

[rkaynan]

The posts on this topic make me very nervous. I opted for radiation that I recently finished and certainly hope I made the right decision since it was hardly mention during this topic. I'm 52 and had a Gleason score of 6 (3+3).

[Red Doug]

You need to google the Loma Linda U proton department and look into a very good alternative to surgery. Get treated, and then be almost normal afterwards. Even with robotics there is a risk of long time leakage, and deminished sexual function.

In fact, I am scheduled for proton therapy myself in Nov. My Gleason hit a 5+ something. It broke through and got unto the bladder neck and I am using the proton treatment instead of regular radiation as follow up after surgery. Google it- find it- get their free book and video- great department- personal contact.

[Red Doug]

Here is a link to Loma Linda U:

http://www.protons.com/?type=search&keyword=loma%20linda%20proton%20therapy&adid=2951453448&placement=&gclid=CMn9s6SgkJwCFQoMDQodUWNvYA