Posted on 12/03/2018 7:07:37 AM PST by fwdude
I had two surgeons recommend NO surgery because of this. I joke, that if I'm 'lucky', I will die of something else before the cancer gets me.
However, since you have a surgeon that recommends surgery, it seems to me that this is the likely best route for you. I would, though, get a second opinion. I chose the Mayo Clinic for mine, and I'm glad I did. It's a 600 mile trip for me, but it's worth it.
>> Surgeon is recommending surgery (radical prostatectomy)
A surgeon will ALWAYS recommend cutting it out.
I received an elevated PSA during a blood test in June.
The doctor scheduled me for a MRI and CATSCAN. I got the catscan first then immediately went to the room for the MRI. When the MRI was done, they moved me to an operating room. I asked why and the quack said they always remove the prostate. I told him that he hadn’t even looked at the imaging results yet. He said it didn’t matter, I needed surgery. I put on my clothes and walked out.
Weeks later the insurance company said they would only pay for 1 imaging procedure, because the MRI and catscan were redundant. I had to pay for the MRI out of pocket.
I switched doctors and the new doctor said she’d just watch the progress over time, because the 2 imaging procedures were inconclusive (i.e., they could not tell anything).
I asked about a biopsy. She said biopsies are too risky. Because the prostate is so small and it needs 12 needle probes; there’s a 5% chance of infection from fecal matter; additionally, there’s a 5-8% chance of spreading any cells from the prostate to other organs and a 25% chance of spreading through the prostate during the healing from the biopsy. It’s just better to watch it with blood tests over time. She did mention something called a 4k test that supposed to be better than the PSA, but it’s not available from my insurance.
Additionally, prostate is the slowest spreading and growing of all cancers. It could take 7 to 10 years or longer. I’m in my mid-70s now. I’ll probably outlive the cancer.
Right now, though, I just started on by 12th season with shingles. And yes, I have had the vaccine, both the newer one and the older one. They took the typical shingles burning down to just itching, but it returns every year oalmost on the same day each time.
#MeToo on this one.
Several years ago, HIFU was unknown, cryotherapy was spotty.
The choices were surgery, external beam radiation (IMRT... modulated and image guided), or radiation with seeds.
I talked to a lot of people, and the recommendations were 50-50. Being somewhat cowardly about the immediate downside possibilities of surgery, I chose radiation. So far, so good.
If you opt for surgery, there’s a chance it will come back. I met a couple of people who had radiation after their surgery failed. For one guy (relatively young) it was six years after. For another fellow, it was 18 after.
If you have radiation, surgery afterward is not an option, because everything is kind of gooey in there, and besides, if it comes back, it is likely to be outside of the gland.
Here’s one thing I haven’t seen mentioned in the previous comments. When you have this, hospitals that are going to treat you realize you are worth something like $20 to $50,000 in insurance payments. Some of them have instituted a multi-doctor appointment where you meet with a combination of a radiotherapist, a surgeon, and a medical oncologist. They look at your tests, and help you decide (or pitch) which of their respective approaches is best.
Are you a VN veteran? Prostate cancer is a “Presumptive Illness” for VN Veterans. VA is well-versed in treatment of such.
I’m with you on the prostatectomy as the last resort. There are so many unknowns, and the medical industry deliberately downplays the lingering debilitating effects. A very large percentage, 20%, of patients have incontinence problems afterwards which never improve and are only likely to increase with age. Then there is the sex issue. Even if I don’t plan to again, I’d like to retain the ability reproduce offspring. A prostatectomy destroys that.
We men folk will all get prostate cancer if we live long enough. A urologist once told me that if you die at 90 from a heart attack an autopsy will show your prostate is cancerous cancer.
Are you a candidate for robotic surgery? Robotic surgery spares the nerves that allow for sexual function and urinary continence. Plus you can be back at work in a couple of weeks.
Ask your urologist. If s/he says no get a second opinion. The benefits of robotic surgery are just too great to move forward without aggressively seeking out all of your options.
Please read post 8. This notion regarding sex before the test cannot be stressed enough. I would even go 72 hours to be safe!
In 2005 my BPH had progressed to the level that I had to get up 5 times per night to urinate. I began a process of donating blood (reducing inflammatory excess iron) as frequently as possible. The effects were immediate and my CRP index is now below that of a 20 year old male. At age 69 I have no need to get up at night and can drive non-stop for 200 miles with a full bladder of coffee.
In my research, I’ve discovered that minimally-invasive robotic surgery does remove and preserve the prostate whole.
https://www.ncbi.nlm.nih.gov/pubmed/10762659
https://www.ncbi.nlm.nih.gov/pubmed/9824850
https://www.nature.com/articles/s41598-018-20311-6
https://www.graphyonline.com/archives/archivedownload.php?pid=IJCPP-129
Seeing as you live in Texas, are you near any of the M D Anderson facilities?
I know you have your own doctor, but I’m just mentioning this in passing.
Prayers up.
No, too young for VN. I didn’t graduate HS until ‘81.
I don’t think you said that cancer has been confirmed via biopsy. IF you have cancer or significant risk of cancer, make sure you opt for the treatment most likely to cure. That means radiation or surgery. Get that cancer now while it’s treatable. I’m glad for all the posters who had good outcomes with some lesser treatment or who didn’t have cancer BUT I knew too many who died and once it spreads it’s not curable. Don’t even consider playing around with the treatment. And I’d go to an MD Anderson center and get the latest on radiation and surgery options. Don’t rely on your local urologist see an excellent oncologist.
Catmom,
Yes, I am near MD Anderson as I live in the D/FW area. They are conducting the testing of my biopsy material to render a second opinion.
I sleep through the night without interruption, now.
Don’t go with radiation.
Funny how urologists find the need for urology work...good on you for pursuing a way for you to solve the issue. Especially without surgery.
Depends on how enlarged it is. The 4th (auxiliary) port can be cut and enlarged to remove the gland whole, but, at some point, the scar is almost as large as open...
I am reading a tremendously fascinating book. Very scientific. Please get it,because the stories are so diverse and uplifting. It’s not against any kinds of treatment, but anyone hearing the word cancer at their doc’s should at least read it. I’m listening to it on audible.
“Radical Remission.”
Documented anomalies that SHOULD BE STUDIED - - people who were given no hope and who changed their lives in multiple ways, and became healthy for many many years. Some of the stories are remarkable and it is an important read in general for people who have cancer or wish to prevent it.
Yes, cancer was confirmed with biopsy (see my post #19.)
The whole question is which treatment is the most likely to cure, keeping in mind the residual destruction in other functions. It’s a balance to consider.
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