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Medical Forum / Diseases and Disorders / Prostate Cancer / February 2005How long the wait before RRP ?
I must have posted wrong-how long is the wait before Robotic Surgery. The average wait from Physician. hi arfey - i don't know about everyone else, but my surgeon said i should decide on a treatment within 60 days from the time i was sitting in his office. ~ curtis 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." http://community.webtv.net/PALMER_ENT/doc Thanks curtis--I've decided on the RRP, but I haven't received a call that was supposed to come last week. I think I should contact them without waiting Psa 16.3 Gleason 3+4=7 age 69, but in good shape. Again-Thanks Hi, Arfey. You must weight the time necessary to research your condition against the time it would take your Gleason 7 to go up to Gleason 8 or for your cancer to go from the prostate to the seminal vesicles. Fortunately, for you, cancer grows very slowly, normally, in a 69-year-old. I think you have several weeks to decide.  SignatureProstate Cancer Survivor (so far), not a doctor PSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3bN0M0 Seminal Vesicle involvement, Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron (1 mo) 07/21/2003 @ 48 PSA .07 .05 .06 .05 Lupron (4 mo) 8/03 (48), 12/03, 4/04 (49), 09/04 (50), 01/05 non Illegitimi carborundum > Thanks curtis--I've decided on the RRP, but I haven't received a call that > was supposed to come last week. I think I should contact them without > waiting Psa 16.3 Gleason 3+4=7 > age 69, but in good shape. > Again-Thanks Have you seen any references that PC progresses through Gleason levels with time? Neither I nor my oncologists are aware of any trend like that. I really cared about that once I realized my stupid initial doc had been ignoring blazing PSA flags for over two years. I.P. > Hi, Arfey. You must weight the time necessary to research your condition > against the time it would take your Gleason 7 to go up to Gleason 8 Thanks I.P. for the reply. I wonder if a Hormone treatment during the wait would be a good Idea. For what purpose? Not only is HT a long-term proposition (compared to a wait for surgery). but it is of no use as a pre-op ("neoadjuvant") treatment. To quite Johns Hopkins 2005 Prostate Disorders White Paper, "There is general consensus that HT prior to RP provides no benefit in terms of cancer cure". It adds that no [good] trial has shown a survival benefit for neoadjuvant HT before brachytherapy, either. Thus the SEs and cost of HT would gain nothing in those cases. I.P. > I wonder if a Hormone treatment during the wait > would be a good Idea. Again I.P. thanks for the info. I hadn't researched this at all This is a great forum. Arf If you think you're learning a lot here, wait 'til you've read some PC books and start cruising the university, hospital, and PC websites. PC has taken four man-months and a man-week from my life I'll never get back; the 4 man-months was the research and the man-week was the surgery downtime. And I'm glad you dragged that thought out of me, because I just realized I have already gotten some of it back by accelerating my treatment to get it behind me earlier, and I will reap far more high-QOL years by avoiding HT, which only that research persuaded me to do. It was time very well spent, IMO, and I still have the HT option for a few more months. I.P. > Again I.P. thanks for the info. I hadn't researched this at all > This is a great forum. Wouldn't be a bad idea in your case. 16 PSA is pushing it. It would be nice to arrest the cancer in place until your protate is removed. At least that's the theory many PCa docs are going with right now... and it makes sense. For a month or two, HT is just a minor inconvenience. I woudl seriously consider it if I were you. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3bN0M0 Seminal Vesicle involvement, Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05 PSA .07 .05 .06 .05 non Illegitimi carborundum > Thanks I.P. for the reply. I wonder if a Hormone treatment during the wait > would be > a good Idea. No. Now that you mention it, I don't think so. Stands to reason, however, that there is that possibility. The very first cell that decides not to die (that's what cancer really is) is obviously not already a Gleason 8. It is a 1. When it dissects, it is a 2. All of our cancers have gone up from there. It just stands to reason. The unknown (at least to me) is do they automatically go to 10? I assume there is a possibility they go up to a 7 and just stop. Or up to a 6 and just stop. The worst PSAs I've seen on this NG are in the thousands. One was 4900 and he was a Gleason 7. There was a Gleason 9 at 2450. Everything over 100 where a Gleason was also reported were: 114 G7 146 G9 (deceased now) 189 G7 640 G7 704 G7 865 G7 1614 G9 (deceased now) 2540 G9 4900 G7 The highest G6 and can find is PSA 72 Conversely, of the Gleason 9s reported 7 single digit PSA 7 more < 50 1 > 50 < 100 1 triple digits 1 1614 1 2540 Two 10s have been reported; one was PSA 11 and one was 53. Kramer's Theory: Since cancer is literally cells that have forgotten how to die, Cancer continues to grow if unchecked by external (to the cell) means. Since PSA is directly attributable to PCa in absence of other factors and PCa continues to grow if unchecked, then PSA is equal to time, albeit variably so. The first PCa cell has a Gleason of 1. As that cell replicates itself, the 2nd cell has a Gleason of 1 and therefore the cancer has a Gleason of 2. Ergo, if a cancer has a Gleason > 2, it has grown to that level over time. However, since PSA has no direct ratio with Gleason, then the rise in Gleason is not directly tied to time. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3bN0M0 Seminal Vesicle involvement, Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05 PSA .07 .05 .06 .05 non Illegitimi carborundum > Have you seen any references that PC progresses through Gleason levels with > time? Neither I nor my oncologists are aware of any trend like that. I [quoted text clipped - 5 lines] > > Hi, Arfey. You must weight the time necessary to research your condition > > against the time it would take your Gleason 7 to go up to Gleason 8 >I must have posted wrong-how long is the wait before Robotic Surgery. The > average wait from Physician. If what you're asking is, how long between the time you say "Go" and the surgery actually takes place, I was told it would be about 30 days, needed to "schedule the operating room". I suspect there's a fair amount of scheduling involved. You've got the surgeon, the anaesthesiologist, the robotic equipment, the operating room, a room at the hospital afterwards, and various other assistants. The people involved have already got other operations and appointments lined up that they can't get out of. For example, the surgeon may have scheduled office visits for 2-3 days a week for two months in advance, scheduled surgeries twice a week, and need to leave at least a certain amount of time available for emergencies that couldn't be scheduled but crop up all the time. And also, since these people are only human, they've probably got vacation time scheduled too. However if the doctor hasn't gotten back to you, by all means, call his office and lean on them. Tell them you're anxious about this, the cancer isn't getting any smaller, and you need to get this done. Tell them the doctor promised to get back to you before this and hasn't. Be nice, but be pushy. That's what I'd recommend. Alan You're right Alan, I just made initial contact with the Dr's Secretary and am faxing the information they request. I was given a window of the End of March for the target date, but still will have a conference with the Physician..Thank you so much for the reply.. Keith |
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