High volume density. 7/12 cores diseased. 6 Gleason score. 56 years old. Married. Still working. Otherwise healthy.

Remedy Method single choice
	Removal
	Radiation
Votes accepted starting: 06/21/19 05:05 PM
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At the end of this year, it will be 5 years since i opted for the radiation seed implant treatment.
They told me my PSA level got up to 7.6, but i forgot the Gleason score number, after going through the biopsy.
So for me, i have one more PSA blood test to have done, then i guess in the world of medical science, they consider you a prostate cancer survivor at the 5 year level.
My past PSA levels were down to a 0.2, so the doctors and me are happy campers.
You and your doctors are the ones to figure out if you hafta have the damm thing removed, or external radiation treatment, or the internal seed radiation implant treatment.
Having it removed, opens up another world of after surgery affects that need to be gone over, for a decision making.
If it has to be removed, then you have no choice in the diagnosis.
Good luck.

I would say try the radiation first and if that fails well you know the next step,. I have had many friends go though this and the radiation always worked except in one guys case.
Good luck and man i pray it will all work out for the best somehow.
Stu

Your going to be surprised in casual friends or acquaintances, that have gone through prostate cancer, because it's never brought up in casual conversation.
I found out that a few of my friends went through the same thing, when people bump into one another and ask, "Hey Valuckas, how ya doin these days?'
I think the ratio is 3 out of 5 guys are gonna run into this problem in later age, but it happens to younger people, too.
So an early diagnosis, early treatment, helps tremendously.
I forgot my Gleason score after the biopsy, but my PSA numbers got up to 7.6 when they said, "get a biopsy"
Now at the end of the year i need one more blood test, to check the PSA levels, and then for me it will be 5 years, and i guess in the medical science world, they categorize you as cancer free.
My PSA levels were down to a 0.2, so the oncologist,urologist, doc's are happy, and i'm happy.

Most guys I know that have had it, have had it removed. My older brother about 5 years ago had 40 radiation treatments. The radiation is painless, but it causes collateral damage - in his case, it was his bladder. Last year he had bouts of peeing blood which landed him in the hospital every time. Then other problems started. On 12/20, he passed away, but I can't say it was any way connected to the prostate cancer.

Ask your doctors what they would recommend. Maybe go to another urologist & get a second or third opinion. Remember, prostate cancer is very survivable if you get it early! Good luck!

My doctor says removal because I am “young enough and healthy enough” to get things back to near normal in no more than six months. More likely to be 3-5 months.
My dad had radiation at Mayo 15 years ago and his came back on him last year and actually got outside the prostate. He is 80 now.
I expected to go the radiation route but my doctor says my long term results would be more favorable with removal. I’m leaning that way but I have not committed to anything yet. He will support me if I decide for radiation.
Correctly stated, a lot of men have dealt with this and won’t talk about it unless asked. I’m just trying to gain knowledge from experience, read credible sources and then make a decision that is the right one for me.

Ya, external radiation treatments are 5 days a week, and then for up to 8 or 10 weeks.
If i elected for the external treatment, i would of had to commute 55 miles down the highway, and then 55 miles back from the Travis Air Force Base Hospital.
Didn't want to be a super commuter on the highway, every day, and when they realized i was in the Sacramento area they farmed me out to the civilian U. C. Davis Medical Center for the internal seed implant as the VA here doesn't perform that type of surgery.
In my case they informed me, that i was an excellent candidate for the implants, as i was told it was low level cancer, confined to the gland.
But there is no way to sugar cote this illness.
Having it removed you can become incontinent, then needing to have a catheter up little willie, or leak all the time, or at times, and then your in depends.
But that's lots better than being 6 feet under ground at the cemetery.
But everyone is different after the surgery, so it's a crap shoot in knowing the aftermath.
Then there is the sex side of the issue, that's embarrassing to talk about, with the doctors, as it's quite personal.
Medically they call it ed, but i call it ld (limp dick) that's hard to talk about with the doctors.
Lot's to know about, making a decision.
Whatever you decide, wish you well, but lots before you have gone through it.
Doesn't bother me at all talking about it, as i also have other serious issues going on with me, on my insides.
Jim V.

Been there, done that, got the T shirt. No one can tell you what the best course of action is on this site because nobody has the same circumstances etc, and that includes me. My Urologist was the Professor the of Urology Dept at The University of Texas Medical Branch at John Sealy Hospital in Galveston Tx. I loved her to death as she was very honest and straightforward and she told me, Surgeons want to cut, Oncologists want to radiate. She told me that in her experience, that radiation was more risky for reoccurence down the road as they do the treatments and the tests, but really have no certainty that they killed it all. That said, if you have a Radical Prostatectomy (removal), they will take out lymph nodes in the area as well as the prostate and if they are clear and the cancer has not spread to them, it usually means that the cancer was caught early enough and was contained in the prostate, BUT THERE IS NEVER ANY GUARANTEES ON EITHER OPTION! Since I live in Houston, and had good insurance, I went to M.D, Anderson Cancer Center for a second opinion. I picked out one of their top guys and he confirmed everything my Urologist said and told me that I needed to quit screwing around and make a choice, as, the longer it goes, the better chance it has to spread, and that your spine was very close and you did not want it spreading there. After doing all my research, I decided that removal was the most sure thing and had it done at MD/A. They use the DaVinci Robot to do the surgery and it is much less invasive than manual surgery. It is far more precise and reduces the odds of collateral nerve damage from hands and instruments rumaging around in your guts! I have a visible scar about 1-1/4" long above my navel that still shows after 3 years, and I believe there were 4 other incisions about the size of a dime around my abdomen, but they faded completely away. I will tell you that if you elect surgery, find a Urologist that does them frequently, mine did 6-8 per week. Those are the guys that have the experience and finesse to ensure the best outcome and I cannot emphasise how important that is! Any Urologist is "qualified", but the guy that does two or three a year is not the one you want! Just because you like your Urologist is no reason to not pick the best most experienced surgeon available! I was out in 24 hours, got the fun of having a rather large catheter in for ten days or so, not really bad, but that tube makes you nervous. You almost certainly will have some nerve damage from either treatment, You might come back fairly well, but as they told me upfront, you will probably need Viagra the rest of your days, but lots of older guys need it that have no prostate issues, so that is not a deal-breaker. You need to do your research well and make your decision. I loaned out a book that I wish I had had when I was diagnosed, as it explained all aspects of either treatment very clearly and easy to understand. It is out on loan to about my third friend that has been diagnosed since me, and I will get back here with the title for you. Any of you guys that are facing this and want to talk, send me a PM and I'll give you my number and we can talk. I am certainly no expert, but sometimes it really helps to get feedback from someone who has been there. Prostate Cancer is as big a threat to men and as widespread as Breast Cancer in women, but as our society does not put much value on men these days, you don't hear much about it. PC is very survivable if diagnosed and treated early, Do NOT screw around, start getting PSA tests when you turn 50 and if you are a black male, in your 40's. Best of Luck! Lee.

A few quick thoughts -

Go see another doctor, one who specializes in this AND the operation. If both test show similar results, then the decision will be made by you and your doctor(s).

While prostate cancer is easily 'cured' if caught early, it does have some serious down-sides. IF seeds are an option (honestly, 7 of 12 is pretty high - you may not want to risk it spreading to other organs, like your bladder), that is an option to seriously consider because -

there is NO turning back when removed. Removal will more than likely solve the cancer issue, but there is a cost. If you opt to have it removed, or if that is deemed the best, safest way to go, then make sure you go to a hospital that uses the DaVinci machine AND your doctor is well-versed in using it. THIS is a must. Anything less and the results will be far worse.

Some things to bear in mind -

Use of the daVinci by a skilled surgeon will reduce the incident of incontinence to almost zero.

Your chances of an abdominal (or incisional) hernia is 50/50.

Despite being in perfect health, you will NEVER go back to 'normal' in the bedroom. Ever. Don't believe that part (the doctors saying you will return to normal), because things will not be the same with you. You simply can't do what you did before.

The emotional toll for most men post-operation is larger than indicated. Remember, you will lose two of the three things that define you as a man (you can still pee standing up).

Most of all, you are not alone in this. Most doctors can refer you to previous patients for their advice and help, and you may want to do this, just so you know exactly what to expect should you decide to remove it.

Most importantly - think long term. It's better to give up a few things than to give up ALL things!

I just read Hemi71x's reply above mine and he makes good points. I will tell you that I had incontinence (just little leaks) for about a week after they removed the catheter, but if you are in halfway decent shape and do your Kegel excercises before and after surgery as they instruct you to do, with a little luck and perserverance you will probably be like me and it is a non-issue, Don't sweat the small stuff, dying of cancer is no way to go! I am not embarrassed to talk about ED either, including getting shots in Ol Johnson to wake him up, and trust me, they don't hurt! Don't be afraid to ask, 'cause it is all good and your family needs you! PS: Jer is right about the bedroom, loss of some sensitivity is a factor, everyone is different, but the least amount of nerve damage done during surgery, the better the prognosis. On a lighter note, you will now be able to empty your bladder in about three seconds!

I opted for the DaVinci surgery. One night in the hospital and you go home. The catheter bag is a PITA but what a relief when they pull it out. I felt fine and went back to work after 2 weeks, that was a mistake. I recommend that you take at least 4 weeks off to heal. Incontinence was bad at first, I had leakage for 6 months. ED is permanant, they said I could try Viagra or Cialis but I'm divorced and don't date much so I have accepted it. They say it is not hereditary, but it is prevalent amongst brothers. Sure enough, one of my brothers was diagnosed a few months after I was! Good news is 2 years later we are both healthy and enjoying our families. Get your PSA checked yearly guys, mine went from 3 to 19 in one year, I'd probably be dead by now without the warning.

My uncle just found a PSA of... 20 something? and I believe had the prostate removed? I need to call home and get some updates.

A while back, I came across this article which was really pretty interesting about a possible new treatment option.
https://www.wired.com/story/cancer-treatment-darwin-evolution/

If you haven't done so already, get a copy of Dr Patrick Walsh's "Guide to Surviving Prostrate Cancer" fourth edition. My Dr. recommended it to me while I was waiting for my biopsy, which at least at this round came back negative.

The main points he makes are:

All cases are different so find a comprehensive treatment center that does all types of treatments so you are not just directed to what they specialize in.

If you elect for surgery, also as stated above, find a surgeon that does A LOT of this. The more the better. His goal is at least 100 per year.

He discusses all of the latest developments in treatment including cryo/thermal ablation. This book is a must for anyone facing prostrate cancer, and should be read by all males over 40.

Gonna get one coming right away. Thanks.
My surgeon has done over 2000 since 2006.

I agree find a doctor that has done thousands of operations. My doctor assured me that he was an expert at this surgery. I was favoring radiation at first. I asked my doctor (surgeon) many questions. One thing that swayed my decision was the doctor’s comment “If you do radiation treatments first, AND it doesn’t work, the surgery is 10 times harder”. I asked why. He stated that the prostate and surrounding tissues change from the radiation and become a more gelatinous like mass. It is harder to surgically cutout the where the prostate gland from some of the surrounding tissues. That changed my mind. I also had 39 radiation treatments after the surgery because after surgery laboratory dissection found the the cancer was at the edge of the prostate. Just had my check up yesterday and have been 5 years clear. Knock on wood.

I would ask your doctor about the surgery first approach and see what he thinks. Good luck in the process.
Ron

I don't have any prostate experience, but I was waiting to see if this "radiation issue" popped up here.
My cancer was in my head & neck which involved surgery followed by chemo & radiation.
The one thing the Docs all agreed on was that radiation seriously damages your ability to heal.
Which is why in my case I had surgery and then had to wait 2+ months to start radiation so that my body had a chance to heal.
During the waiting period the and it jumped to additional lymph nodes & a saliva gland then the rad & chemo killed it.
Once the radiation does it's damage, healing becomes iffy. I'm my case I still haven't shaved the right side of my face in 3yrs
And my gums look "off"... you can definitely see the damage done.

Treating prostate with radiation may be done with a lower dose... I have no idea.
But I do know my Dad had prostate cancer; was treated with radiation and he is still doing fine many years later (81 now)
I don't really know what it all entailed other than he had to drive 70miles 1 way to Fox Chase in Phila for all the treatments,
He didn't tell me or my brother until he was done with all the treatments & got his 1st all clear follow up...
He's 100% German... so not big on the whole "sharing" of health stuff.

Good luck... and as others have stated, pick one and have it done, the sooner the better. (Applies to all cancers)

Maybe a second opinion? And if so, consider Dr. Joseph J. Busch in Chattanooga, TN @ Diagnostic Radiology Consultants. Instead of biopsy, a 3D MRI is performed, that gives a global view of the prostate.
I first was diagnosed at age 57 in October 2011...Gleason 6, PSA 6.5. Urologist was Dr. David Hall in Morgantown, WV and the immediate recommendation was a choice of surgery, seeding or radiation of some kind. So, after the initial shock of being told I had the “C” word, I chose active surveillance. I sought a second opinion, resulting in continuing the surveillance. That physician discussed the PSA number rise is important, but the the speed in which it elevates is a greater importance. Since 2011, every six months, I submit to a PSA test and the number has cycled between 4 up to 8.7. Relocated 2015 to Huntsville, AL. Since, I have been a patient of Dr. V. Keith Jimenez @ Urology Specialists. He says...”you’ve got a big ol prostate, around three times normal”. One biopsy since 2015. Then fall of 2017, PSA result is 8.7! He recommends Dr. Busch. Following the MRI, Dr. Busch discussed, displayed and answered questions with me and my wife for an hour or so. The results of the MRI, revealed the cancer to be a spot less than 2mm. Still, I continue with active surveillance. My next appointment will be PSA test and 3D MRI.
If your number is pretty fast on the rise and 10 or more, treatment of some kind likely needs done. But, if it’s not increasing and is below 10...well, maybe treatment can be avoided. I mean, any of the treatment is coupled to a risk factor of some type.
Should I ever need more than surveillance, that SOB is getting the hell removed. Da Vinci method.

1 out of 3 men over 50 yrs old will get prostate cancer, I was one of the 1 that got it (found out I had it) in mid 2004 1 out of the ten samples was cancerous, early detection was my friend My PSA had been going up steadily for the previous 6 yrs.hence the biopsy exam 1 out of 2 men older than 80 will get it also
At that time the survival rate according to the Drs. I had (3 different ones) at Kaiser medical center in Fontana, CA all quoted the same stats, 50% survival rate for the radiation seeds and 80% survival rate with the surgery I opted for the surgery
My brother in law opted for the radiation seeds around then also and he died a slow painful two yrs. ago from it not being cured
I got to know another guy up here in Bend,OR several yrs. later who found out he had it very late in his life, over 65 yrs old, he opted for a new surgery procedure developed after I had mine and they didn't get all of it so he had to go in for radiation treatments later. His long time(40+ Yrs) wife left during his treatment and he ended up getting a new girl friend around 20 yrs younger than him and they are still together ten yrs. later
Think hard, choose wisely and good luck and may God bless you

my old man had prostrate surgery in his mid sixty's, plus colon cancer surgery shortly after, and he lived a full life until he was almost 82.

No personal experience here (praise the Lord) but have had cancer issues in the family. My thoughts and prayers are with any and all who have or had cancer of any kind.



Tim