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Medical Forum / Diseases and Disorders / Prostate Cancer / March 2006

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Grueling Decision - BIG Letdown

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JayJay - 28 Feb 2006 11:20 GMT
Hello again. First let me thank everyone who has posted great info in
reply to my initial questions about deciding on surgery. Though not all
new, it helped me validate the decision we finally made, which was a
regular radical prostatectomy. I was pretty much an ideal candidate:
58, good health, Gleason 6, stage T1C. My wife and I talked to 2
surgeons and 1 radiologist. Everyone agreed that surgery was the best
alternative.

I had surgery on Wednesday, Feb 22 and have been home recuperationg
nicely since Saturday morning. The surgery went well, BUT there is a
real bummer of a complication. My lymph nodes were removed but when
they looked at my prostate and urethra they found that the urethra was
positioned at the top of my prostate. In order to remove the prostate
they decided they would cause too much damage and I would most
certainly be incontinent for the rest of my life. They stopped and
talked to my wife about it and (thankfully) my wife agreed with their
opinion of not proceding.

So, now it looks like I will be going through hormone therapy and
brachytherapy. It is a real bummer that having gone through the
surgery, I am still pretty much back at square one. At least my surgery
recovery will be a lot easier since nothing in the urinary tract was
damaged. Another good thing as that the (full) biopsies of my lymph
nodes came back negative.

Anyway, thanks for all the good support. I also want to emphasize that
you should make totally clear to your SO and uro what your wishes are
for the final outcome. I'm glad mine wasn't taken as "remove the cancer
at all cost".

-jj
Steve Kramer - 28 Feb 2006 15:52 GMT
Damn, Joe!  I can't imagine waking up to find that they didn't do the
removal (1st thought because your cancer spread) and you have to go through
brachy (which you already discounted).

And you're poor wife!  That's one hell of a decision to make without
preparation and without being able to consult with you.

> Hello again. First let me thank everyone who has posted great info in
> reply to my initial questions about deciding on surgery. Though not all
[quoted text clipped - 27 lines]
>
> -jj
JayJay - 28 Feb 2006 17:55 GMT
Steve,

Actually she knew exactly what my decision would be because we had
discussed everything pretty thoroughly leading up to the surgery. I
strongly urge anyone getting ready to go through an RP to make sure
your wishes are clearly understood, because like you point out, it's
too late to consult you when you're on the table.
Bill - 28 Feb 2006 15:56 GMT
This is the first case of prostatectomus interruptus I have heard of.
:-) JayJay, do you mean that the urethra was on the outside of the
prostate as opposed to running through it? Weird. I wonder if they
considered taking any biopsy samples of the gland (and seminal
vesicles) while they were in there and could get truly representative
samples.  

Bill Denton
RP 2/12/02
PSA .67
Memphis
JayJay - 28 Feb 2006 18:00 GMT
New term: PI. I like it! My Uro says he has only seen one other case
lkie it. His original post op discussion with me was after I was in my
room, and as I recall through the cobwebs he said it "ran over the
top". Not sure if he really meant it was outside or just running
through the top portion. I'll discuss it more when I see him tomorrow
at the office.
Stavros - 28 Feb 2006 16:53 GMT
This is emotionally difficult for you, of course, but you have to put it in
perspective and be grateful.  First, you've been spared incontinence (no
fun).  Second all the test results have come back fine.  Third, with your
initial testing (Gleason and TC), your prognosis is excellent.  Sure, you
have more to go through, but you can look forward to  a happy conclusion.
It will all be behind you at some point, thanks to your doctors' and wife's
decision.  Be of good cheer.

> Hello again. First let me thank everyone who has posted great info in
> reply to my initial questions about deciding on surgery. Though not all
[quoted text clipped - 27 lines]
>
> -jj
JJ - 01 Mar 2006 13:39 GMT
> This is emotionally difficult for you, of course, but you have to put it in
> perspective and be grateful.  First, you've been spared incontinence (no
[quoted text clipped - 35 lines]
>>
>>-jj

Stavros,

I am being cheerful as possible. I am going to see the Uro today to get
my staples out and to discuss further treatment. When I was still in the
hospital, he recommended hormone treatment a brachytherapy together
after talking to the radiologist I had been to see. I already started on
the hormone therapy. I hope to find out why the combo is better than
just going with brachytherapy next.

-jj

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Steve Kramer - 01 Mar 2006 14:58 GMT
> When I was still in the hospital, he recommended hormone treatment a
> brachytherapy together after talking to the radiologist I had been to see.
> I already started on the hormone therapy. I hope to find out why the combo
> is better than just going with brachytherapy next.

You have great numbers, indicating that the cancer is likely contained
within your prostate.  Hormone treatment will decrease the mass within your
prostate and the seeds will have less active cells to kill.

Signature

PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 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, 5/05, 10/05,
2/06
PSA  .07 .05 .06 .09 .08 .132
Non Illegitimi Carborundum

 
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