Hey all from JimBob,

About 6 weeks ago I posted my diagnosis , PSA 4, Gleason 6 ( 3+3 ),
stage T1c, biopsy positive in 5% in 1 of 12 samples and reasonably good
health at 57 years of age.

Have not posted much but kept lurking and getting info. My wife and I
met with my uro-doc about 2 and a half weeks ago to talk about treatment
options and came to the following decision ( also based on consults with
several other medical specialists ).

Radiation ( all forms ) ..... Once you do it, you'll never go back,
except to radiation. That was the biggest turnoff as far as RT was
concerned. I did recently respond to a poster questioning which way to
go treatment wise with the "you can't put a scrambled egg back together
again and do surgery on it". Even the radiation oncologists tend to
agree, however reluctantly. Although RT is a viable first option in many
cases, just not mine !!

Surgery ..... As I live in the NE ( mid Atlantic ) my primary doc wanted
me to go to Hopkins in Baltimore for the RP. Could have done it but the
family logistics and related stuff was a real barrier. During the
consult with my uro-doc he advised that if I was not going to Hopkins he
strongly suggested that I stay with his practice of 6 surgeons, all with
10-20 years experience in RP's among the other urinary stuff.

When I suggested a couple of the large teaching hospitals in the "big
city" near us ( I will leave unnamed to avoid fire-fights ) he said that
he had "grown-up" in those facilities and that they were the last place
to have RP's done. Why, I asked ..... turns out that in many cases the
surgery is done by surgical residents without the level of experience
necessary to minimize side-effects ( incontinence is one of my biggest
concerns ).  In my uro-docs practice they have a rule that every RP is
carried out by the patients primary Uro-doc/surgeon in the practice and
that there is *never* any surgery caried out unless another one of the
surgeons from the practice is "table side" as the assisting ( no interns
or first year residents in this crowd ). He also confided that a number
of the practice's patients are from the "teaching hospitals" that
performed less than stellar surgical procedures. I was also reassured by
all the other consults that this urology practice was "best in show" in
my particular neighborhood.

When I questioned their long term results he said that their survival
and side effect success rate was very comparable to the regional cancer
centers due to their level of experience and technique. I asked about
giving blood prior to surgery cause I read that some of the guys here
were doing it and he pretty much poo-poo'ed the idea as it was almost
unheard of for any of their patients to need blood. I'll take the chance !

So tomorrow I show up at the short procedure unit at 9:30 for "slice and
dice", get introduced to Mr. Foley and then go home Friday PM. If it was
not for the surgery I would be looking forward to a few days on my butt.
It never occurred to me all the stuff around the house that needed doing
before I'm on "restricted activity" for a while. Man I'm tired from the
last week of fixing, fetching and preparing.

So I'll be back a-postin' with my surgical diary of sorts Saturday
morning. Thats if I can get past the guard ( my wife ) to the computers
on the third floor.

Bye for Now,
JimBob