Skeptic:

You say you are interested in anecdotal evidence and not the opinions of
your "biased" docs.

Why not investigate the large body of statistical research on this topic and
then make your decision. Google prostate + gleason and then prosate + partin
and read the articles. Make sure that you have the full picture of you
current state: PSA, Gleason score, clinical stage, DRE positive or not, etc.

I supect that you will find that you have a high probability of the PCa
having gone beyond the prostate gland and the seminal vesicles which are the
only thing that gets removed by surgery. Radiatation therapy has a decent
chance of killing anything outside of these two glands if done at a
reasonably early stage. If you wait your options get smaller.

Yes, your SEs are likely to be worse if you do surgery plus RT. The SEs of
the potential future therapy if you don't do RT now, ie RT + HT are much
worse IMHO. In other words the probablility is high that you will ultimately
have to do RT, so why not do it now while it has a better chance of success.

David

skeptic,
consider the following approach-
do the LRP - assuming your scans come back clean.
THEN decide what to do - worrying about what to do, or not do, next does
nothing but add additonal stress.
Options are actually several (would like to say many, but...)
Do nothing - that's what you suggest - is that fair to your family, loved
ones - ask them what they want - they are in this too.
RT - ok, that's an option now - even if the scans come back with bad
results.
There is some research that RP patients with rising PSA that have RT
actually have better long term survival than those that don't have immediate
rise.
[might be something about the cancer still being in the prostate bed, and
not having metastesized?]
Trials - there are over 400 trials on the cancer.gov site alone.

There are essentially two ways to look at what we have - and those
perspectives impact our quality of life.
One - we have cancer, woe to us, and all around us, be miserable, make those
around us miserable.
Two - we have cancer - it is SLOW growing [almost spelled it groin...that's
another issue] - if we choose to make the most of every day, live postive
lives, try to laugh [at ourselves, if necessary], help others, we will gain
the most out of the time we have left.

Said another way, if we wallow in misery and don't take advantage of life,
how is that different from being dead?

Make it the best Thanksgiving YOU can!

DanR

PRESUMING YOUR PSA IS ALL FROM CANCER, not from some incidental
infection, there's not much need for even the RP, lap OR open, and
certainly no need for prostate radiation, if your scans show mets. Many
doctors won't even remove the prostate if they find mere cancerous lymph
nodes, let alone ribs or vertebrae. But your short doubling time and
your PSA rising rate of more than 2 per year very dramatically increase
the likelihood that no treatment will cure you. That, plus your clear
fear of treatments, plus HT's almost certain dramatic exacerbation of
depression, gives me no reason to argue with your decision against
adjuvant (secondary) treatment. I wouldn't even start shaving your
crotch or buying Depends before the scan results are in, though, in case
they render surgery moot. If your scans a discrete met or two, radiation
of those spots may "cure" those apots, giving you relief until the next
spots occur. Ultimately, you may welcome HT if and when your met
symptoms become intolerable and too widespread for "chasing spots".

Now, about that depression. Some newer anti-depression drugs are far
more successful and far less obnoxious than the old meds. Make sure your
choose your depression doc as carefully as you choose our surgeon. My
mother-in-law's docs wrote her off as untreatable and near death when
they couldn't relieve her deep depression following a stroke. Her neice,
a geriatric psychologist, flew across the country, taught those docs a
thing or two, treated Mom with newer drugs, and the depression was gone
within a couple of days. Perhaps if you can defeat this depression
thing, you may be more willing to take your PC by the horns. A
two-pronged approach like that just may give you not only EXTRA years
but far HAPPIER ones.

I.P.

That's fantastic, Skeptic!  It may not seem like such a big deal now, but
you'll find that it is the most important step you'll make.  It's time now
to sit back and relax, knowing the hard part of this is behind you.  I
forget your exercise regime, but if there is none, I would start walking and
getting yourself ready for surgery.  Please let us know the date.

I think you'll be the 2nd among us.  Martin Howard made that decision and
continued with his urine therapy until is death.  Even I.P., probably our
most boisterous ADT opponent has never said, "none.... absolutely no HT."

I think you've heard all the anecdotes, Skeptic.  I would highly recommend
putting off RT and ADT decision until after you see if you're cured with the
RLRP.

...

Many here have had RP without radiation or HT.  Probably most of
the RP patients are in that category.

Most of those who have had RT or HT did so only after finding that
the RP did not, by itself, solve the problem.

No you won't.  Adjuvant radiation or HT will improve your odds
of success.  How much they will improve them still seems to be
a matter of scientific debate.

Your doctor is suggesting the most effective possible treatment,
i.e., the treatment that will maximize your chance of not dying of
PCa.  It's not an unreasonable thing for him to recommend.  However
the decision is yours.

As others have said, it would not be unreasonable to get the RP,
wait a month or two, and start getting PSA tests.  If the tests show
you still have cancer, go for additional treatment.  If not, then hold
off on additional treatments.

That is an intermediate course between whatt your doc is recommending
and what you want to do.  It will still give you a fighting chance if
the RP doesn't solve the problem, while avoiding extra treatment
if the RP does solve the problem.

Maybe not so traumatic.  It's partly a matter of luck as to how
traumatic
it is, and partly a matter of attitude.

I guess you've heard from us.  I don't know your docs.  Some docs
are dyed in the wool heap-the-treatments-on-em types.  Others are
not.  I guess you have to make your own judgment about whether the
doctors' recommendation is informed judgment or bias.

   Alan

Hello Skeptic,

You have made the trip so far. Knowledge of reality, search for information
and then choice to influence destiny. Good going!!! May you have the best of
luck as your choice plays through to it's conclusion. I will hope for your
best outcome and will follow your path if you choose to share.

You seem to be strong in this path so far. Stronger than you might have
thought you could be. You also seem to have grown from this dilemma. I too
have been made stronger and have grown more resilient by the realization of
my predicament and my attempt to do the best for myself. Each has the
obligation to themselves to the same. Your statements that you want no
further treatment if this fails because of the dreaded SE is understandable
and yours to make. Lack of choice for further treatment is a choice in
itself and has the dreaded effect of further side effects. I hope you can
still choose a path of least resistance, whatever that may be.

As far as the traumatic experience of your RLRP, you might be and hopefully
will be pleasantly surprised that you can get through it as easily as you
do. Hang on, take the bumps, the road may be smoother than you expect. I
hope you don't mind my philosophy here...I have tried to embrace this as a
way to make my experience with this predicament as meaningful and purposeful
as it can be.

You can respond via the NG or by personal e mail if you want. I will be
here...
Peter