Well, it may be that Dr. Leibowitz and his small number of followers are
right and the rest of the experts on prostate cancer are wrong.

But, let me tell you what I've learned by reading Patrick Walsh's book
Guide to Surviving Prostate Cancer and other sources.  Generally,
hormone therapy of any kind is not recommended as a primary treatment
for early prostate cancer which probably has not spread beyond the
prostate.  Short term hormone therapy is often used in conjunction with
radiation.  It seems to make the cancer cells more susceptible to damage
from radiation.  Most urologists don't think it is a good idea before
surgery because it may mislead the surgeon about the extent of the tumor
 when he goes in there.

Hormone therapy is regularly used to treat prostate cancer which has
spread beyond the prostate, and I believe there may be some recent
evidence that its use after primary treatment may prevent recurrence in
certain cases, but I am not an expert, and I am not sure about that.  I
don't believe most urologists would recommend it unless there is
evidence of recurrence or a high likelihood of recurrence, since it does
have rather significant side effects.

Doing nothing is probably a bad idea in a case like yours if you have a
life expectancy greater than 10 years.  As you may know, there are some
in the medical community who believe that many prostate cancers don't
need to be treated and would never bother the patient in his lifetime.
No one knows just how many cases fit in that category and how to decide
which ones do and which don't.  But a Gleason 7=3+4 case is near the top
end in aggressiveness among those cancers considerable curable by early
treatment.  Your relatively low PSA is a good sign, but the fact that
doctor found something on DRE puts you at higher risk.  Still I think
the great majority of urologists would consider your cancer treatable
and would recommend either radiation or surgery.

But remember that any advice you get here is from lay people, so you
really need to discuss it further with your doctors.  If necessary, get
an opinion from still another doctor.

Let me introduce one idea which is based on my expertise as a
mathematician.  In a situation where there are two reasonable
alternatives and you really can't choose between them, then it makes
perfect sense to flip a coin.   You probably wouldn't feel comfortable
doing that so you should try to find some other way to make a definite
decision and not worry too much if it is the best possible decision.
The point is that although from an outsider's point of view, it may
appear to be a random decision,  if you feel better about it, it is the
right decsion for you.  In point of fact for many men, in particular men
over 65, radiation and surgery are probably about equal as reasonable
choices.  If in fact one were clearly better than the other than it
would make sense to choose it.  But the reason you are having trouble
deciding between the two is that in fact either is an acceptable course
of action.  In this connection,  Patrick Walsh in his book suggests
thinking about the possible effects in a few years of the choice you
make.  Imagine plausible bad case scenarios, not necessarily the worst
cases,  and try to imagine how you would feel about them.  That migh
help you make your decision now.

I was diagnosed at age 67 with a Gleason 7=3+4, T1c, PSA 4.5 cancer.  I
was in good helath and had a life expectancy of at least 15 years.  My
urologist recommended either radiation or surgery.  I chose surgery
because I wanted to get the thing out of my body right then, and I was
willing to face the plausible side effect of impotence.  (You can still
have a satisfying sex life if impotent, and I managed it for some 18
months using a pump until erections started to return.)  I also have an
irrational fear of radiation for personal reasons I won't go into.  On
the other hand, a good friend with a roughly similar case (but higher
PSA) chose radiation, largely because he wasn't confident he had access
to a good surgeon.   Had I been 5 years older I would probably have
chosen radiation myself.  In retorspect, I see that it was important to
make a decision, but it wouldn't have mattered all that much which
decision I made.

Bob Leibowitz, M.D.
DIPLOMATE
AMERICAN BOARDS OF INTERNAL MEDICINE AND SUBSPECIALTIES OF
MEDICAL ONCOLOGY AND HEMATOLOGY
2080 Century Park East, Suite 601 · Los Angeles, California 90067 ·
310-229-3555 Fax 310­229-3554
Father of non-invasive treatment for prostate cancer
Pioneered Triple Hormone Blockade
Pioneered Proscar Maintenance
Coined and Created the terms: Triple Hormone Blockade and Proscar
Maintenance Therapy
One of the first to advocate Intermittent Hormone Blockade and believes
the best local treatment is Systemic Treatment
Treats all stages of prostate cancer with triple hormone blockade and no
local treatment
As of January, 1999, has treated over 175 patients with clinically
localized or locally advanced prostate cancer with triple hormone
blockade followed by Proscar maintenance and without any local
treatment. No R.P.; no radiation therapy; no seeds; no implants; no
cryotherapy. All of the men have achieved an unmeasurable PSA (less than
0.1) while on triple hormone blockade.
Number of men requiring a second cycle of hormone blockade - NONE!
Treatment of Localized Prostate Cancer With Intermittent Triple Androgen
Blockade: Preliminary Results in 110 Consecutive Patients, a published
paper at The Oncologist. You can view the complete paper here.
Dr. Bob's and Dr. Steve's Recommended Vitamin List
Hormone Blockade Versus Radical Local Therapies -- and the Winner is....
Testosterone Levels and Prostate Cancer - The Higher, the Better?
Statins
Early Hormonal Therapy Works ridiculously well
High Dose Testosterone Replacement Therapy
Calcitriol
Prostate Cancer Antiangiogenic Cocktail
Cox-2 Inhibitors(revised)
Regarding Androgen Receptors
Curcumin
Thalidomide
Zometa
Review of 133 patients
Shark Cartilage
Hormone Blockade as the Sole Treatment of Clinical Stages T1-T3 Prostate
Cancer: Experience in 100 Patients
I am the only one you are afraid to believe
Angiostatin
Thalidomide
Hormone refractory prostate cancer
Testosterone Replacement
The Facts, Doc, Just The Facts
The Transitional Zone Era
Prostate Pearls
The Will Rogers Phenomena
Antiandrogens
The Capitulation of Radiation Therapy
Proscar Greetings on Father's Day, 1997 and Immediate Versus Deferred
Hormone Blockade.
THE FUTURE IS NOW!! (PART I)
THE FUTURE IS NOW!! (PART II)
THE EMPEROR'SNEW CLOTHES
Emerging Concepts in Prostate Cancer, 1997-2000
Emerging Concepts in Prostate Cancer, 1997-2000 (PDF)
You Can Live With Clinically Confined Prostate Cancer
A letter to Dr. Patrick Walsh
Addendum to the above letter
They have been doing radical Prostatectomies for at least the past 20
years and yet an editorial in the journal Urology asks if we only had
more data
I personally believe that treatment with total androgen blockade
utilizing Zolodex (or Leupron) plus flutamide plus Proscar will
ultimately be shown to be the most effective therapy for men with
prostate cancer
PSA - It's major usefulness will be to deter radical Prostatectomies and
radical radiation therapy
Evolving Choices in Treatment of Prostate Cancer and Minimizing Side
Effects ofTreatment
TRUTH IN ADVERTISING
The gold standard is so tarnished that I no longer am able to recommend
radical prostatectomy

knowledge is power - growing old is mandatory - growing wise is optional    
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."

Hi, ty....

I remember very well the exact moment when I learned that my biopsy results
were positive for PCa.... got the news from my doctor's nurse over the phone
when I called in to check.  An appointment was set up with the doctor right
away, and I had surgery two months later.  20 months later, I have not yet
had any return of the cancer.

I would suggest that you read as much as possible to become informed about
PCa and the many options for treatment.  Patrick Walsh's Guide to Surviving
Prostate Cancer is a great book.  www.phoenix5.org is a great Web site for
information on anything related to the prostate.

Take a moment to breathe.  There is a good possibility that your cancer is
contained and that you can choose a method of treatment that will eradicate
it entirely.  That my be surgery, radiation, radioactive seeds, or
combinations of those.  But please do *something*.  It's not a decision you
have to make in the next week.  If possible, you might want to see another
doctor for another opinion.  You might want to ask about the different
treatment methods.  If you should opt for surgery, there is the retropubic
radical prostatectomy.... or the laparoscopic route.... and more recently,
the laparoscopic with robotics.

The most important thing, I think, is to learn as much as you possibly
can.... and then make the best decision for *you*.  It would be so much
easier if there were one *right* treatment that fit everybody, but that's
just not the case.  And you will need to advocate for yourself with your
doctors.  Let them know you are informed and don't hesitate to ask questions
for clarification.

Finally, please use this group as much as you need to.  We are here to offer
support and information, when possible, because we have all been where you
are now.  We have chosen different treatment options.... and we have had
varying degrees of success.  I know what the fear is like... but you can't
allow it to lead you to *inaction*, as that would not be a pleasant road to
travel.

Take care.... please keep us posted!

MikeH
domiha@hotmail.com

In addition to getting some education by reading Dr. Walsh's book and
researching this further, my advice is to go to a leading Cancer Treatment
Center such as Sloan-Kettering (NYC), Dana Farber or MGH Hospital (Boston),
MD-Anderson in Texas.Have team consult that includes a urologist, a
radiation oncologist and an oncologist who specializes in prostate cancer.
The team should be able to assess your specific situation, explain the
various options and help guide you towards  the the treatment most
appropriate for you.

Robert

It depends a lot on your age and your own assessment of risk. I have
read the posts on Dr. Leibowitz and his 100% patient success after 7.5
years. However, I have also read that 15 years appears to be a
"tipping point" for PCa aggressiveness. At age 66 I had an RRP last
month at UCLA from a well-known surgeon because I believe it is the
"gold standard" for treatment. My goal is to live to be 100 which
gives me 34 more years to account for. I was T2C, Gleason score 6, PSA
6.6. PCa was 100% contained with all negative margins and no lymph
node infection. Radiation or triple androgen therapy was not my
choice. I chose to get it over with in one fell swoop. My
nerve-sparing surgery was successful with semi-erections after a
month. I am confident I will get my potency back within 1-2 years.

Welcome, Ty, to the club no one petitioned to join.

Your GP is a non-entity.  Thank him for his service to date, but he's
obviously out of this ballgame.  Prostate cancer is very specialized and
medical treatments are constantly improving.  Your radiologist spent a large
portion of his life learning how to be a radiologist and radiology is now
how he feeds his wife and children.  Same with your surgeon.  They both are
correct, probably, that they both can do the job.  But you have to decide
what's best for you.

A big part of the alternatives you have is your age.  If you're in your 40s,
you need surgery.  If you're in your 80s, surgery is unlikely.  I suspect
you're in your 50s and have the whole gammut from which to pick.

You have time, so use it wisely.  Get hold of Dr. Patrick Walsh's Guide to
Surviving Prostate Cancer.  Read it from cover to cover if you can and at
least from the beginning through the treatments chapter.  Go to
www.phoenix5.org and see what they have there.  Read past posts here from
people who have gone the surgery route (I did almost 4 years ago and I'm
still here), external ratiation route, radiated seeds route, etc.

Then, make a decision and get it done.  Don't look back.

Alway remember, we're here for you.

Go ahead and call them or e-mail him,they will answer you right away.There
have been a few or the last years that have done it with good results,but no
longer post here.This is a good news group but some times closed
minded.Remember they use to take your tonsils out just in case.

As some have mentioned you need to educate yourself and make a decision.
http://www.phoenix5.org
http://www.cooleyville.com/
Phoenix will provide all the general knowledge you will need.
Cooleyville will give you the spin on radiation.
Doing nothing will kill you!
Bev