hi phil - we all feel scared when we get this bad news, so what you are
going through is normal.  

the key is research, research, research.  i need to be comfortable with
your choice of treatment.  

each choice of treatment has good sides and bad sides.  it isn't a one
size fits all.

given the basic facts that you have given, the RP is a good choice
because it is early and your chance for recovery is excellent.  

you didn't say how old you are, but since the doctor is opting for the
RP, i was venture to say mid 50's to 60.

i hardest part of all of this is the waiting game.  but you'll do fine.

~ curtis

knowledge is power - growing old is mandatory - growing wise is optional

Hi Phil;
My father and grandfather both passed away when I was 7 yrs old so I
appreciate your concern for no family history of Cancer.
Was wondering how old you are. I'm not going to attempt to give any
advice since I'm new here too. I did get 3 opinions before deciding on
my course of treatment (urologist, oncologist and radiation
oncologist). They all suggested the same thing with not even a mention
of surgery and all seem to think the prognosis is good.
Good Luck and stay in touch.

Hi Phil,

You don't say how old you are, and that can make a difference.  It seems
that the younger you are the more likely the urologists will recommend
surgery.  You also didn't say (and maybe don't know) what your PSA was a
year ago.  A rapidly increasing PSA will also increase the likelihood that
surgery will be recommended.  Everyone is scared to some degree, but it's
better to be scared by what you know than by what you don't know.  Did you
ask the urologist why he didn't recommend radiation as opposed to surgery?
I'm having brachytherapy in early January, primarily because it seemed to
have less side affects and short term "annoyances" (others here might
quibble with that term).  My PSA is 4.0 and my Gleason is also 6.  And I'll
be 62 soon.  I would think that whether you have a family history or not is
moot at this point.  You know you have PCa with our without a family history
of it.  Keep reading this group.  You'll learn a lot.  I certainly have!

Welcome to the newsgroup, Phil.  As for the club, I am sure you did not wish
to join us.

Your Gleason score of 6 is the lowest you'll find of anyone here, save one.
And only ? of us were diagnosed with a PSA below 5.  So, comparatively,
you're one of those that the rest of us get jealous about.

It is only important to know about prostate problems in the family when
deciding when you are going to start getting your PSA tested.  That is moot,
of course, because you have already been getting it tested and you are
already diagnosed.

It is only normal to fear the unknown.  But, let this be known.... an RRP is
much less of a trail for the patient than it is for his loved ones.  Since
you've been reading the newsgroup, you already know that we struggle with
the aftermath sometimes, but the operation is easy.  It'll be over before
you know it.

So, how old are you?  Where do you live?  and tell us about your family.
You are among friends.

Below is a copy of my previous post, you might find of some use.
Tee

Greetings To All,
Some time ago I sent a post asking for an advice and received a lot of
very professional and useful information. Now, after the surgery, I would
like to share my experiences, which could eventually benefit people
contemplating surgery and curious how recuperation goes. Here is some
background:

I am 57 years old, white, born in Europe.
PSA before biopsy 4.6, Declined Proscar!
Biopsy 5% positive on one side and 10% on the other,
Gleason 3+3, Staging T1c, Volume 45 g,
Biopsy results received on October 4th,
Surgery (RPR, nerve sparing) took place on November 24, 2003

Surgery was done under general anesthesia and lasted for 1 h 20".
After operation I was hooked up to a morphine pump and used total of two
syringes 50 ml each. It helped me a lot because I did not feel any pain
or very minimal. Incision was around 5 inches long and I had 14 metal
clips to hold both sides in place. I was discharged from the hospital on
Thanksgiving morning.
Foley catheter was a real pain, you know where, and it was removed last
Monday (full three weeks!). The procedure of the catheter removal was
almost painless. Urination now is painless as well and a bit more
frequent than before surgery, but I still drink a lot. After I am done
peeing, sometimes I feel increased bladder pressure but after 10 seconds
it goes a way.
Before surgery, I was doing Kegel exercises and am still doing them now.
I am happy to report that it probably helped me a lot bc I am almost 100%
dry. Just in a case, I am wearing a small pad and before I go to bed I
check it and it is dry like a bone. In bed I wear only boxer shorts
without any additional protection. When I move really fast or cough or
sneeze I may dribble a few drops but that's all.
My follow-up visit is scheduled for January 5 and before that I will go
to have PSA done.
The last thing is the recuperation time. In my case I could go back to
work even today - three weeks and three days after surgery. But I will
take more time off, most likely 7 weeks total. I saved a lot of sick days
and I feel that now it is good time to use them.
In conclusion, I highly recommend this particular type of surgery, but I
do realize that it is not the best method for all.

Happy Holidays to all,
Tee Doubleyou

PS Tomorrow will be four weeks after surgery and today morning I had
first spontaneous erection. It lasted only for a few minutes but I am
sure that the nerve sparing surgery was really nerve sparing.
Tee.

--
Miser, qui nunquam miser!

Hi Phil...Sorry to hear about your diagnosis.  I remember mine about a
year ago, just like a kick to the gut.  Take some deep breaths and
realize that things could be a lot worse.  It's late so I just want to
make a few quick points.  Read and learn so that you can make an
informed decision about treatment.  Pushing your surgery out another
month or two isn't likely to change things for the worse, so take what
time you need; just tell your doc to reschedule if that's what you
want, he should be supportive of this.  Second, get an expert to
reread your biopsy slides.  They are notoriously difficult to grade
and you don't want to plan treatment for a GS 6 if you have something
else.  Experts have better skill at reading the slides.  You can find
a list of experts (and a lot of other useful info) at
http://www.prostate-help.org/cagleex.htm
If you do select surgery (BTW I did), be sure to read M. Han, A. W.
Partin, M. Zahurak, S. Piantadosi, J. Epstein and P. C. Walsh; J.
Urol., 169, 517-523, 2003 to get an idea of what the 10 year
statistics look like...Best wishes and good health, Ron

Phil,

Many people here have recommended a second opinion.  I would
also like to recommend that.  There are at least two reasons for doing
it.  One is that the pathology report you were given may be wrong.  Mine
was underdiagnosed (cancer worse than reported by the first pathologist),
and apparently this happens to very many people.  Secondly, it is useful
to meet another specialist and get his or her recommendations, both as
a check on the first doctor, and so that you'll have another practitioner
against whom you can compare the first doctor to see if you think he is
as helpful/competent/concerned as you would like him to be.  I personally
think the choice of doctor is as important as the choice of treatment.

Other things to think about:

1. You might want a second opinion from a radiation oncologist.
Radiation can have fewer side effects and faster recovery.  Radiation
oncologists I have met say it's just as good as prostatectomy.  Surgeons
often say it is not.  The truth is --- what do I know?  But I have chosen
radiation myself.

2. If you choose surgery, there are several kinds, including retropubic
that cuts an incision from the navel down, laparoscopic that cuts a hole
and tunnels in, and one that goes in through the perineum from the bottom.
Then there are "nerve sparing" and non-sparing varieties.  I would ask
your Uro for the full details of which operation he would perform and,
if you can find out, how many he's done and how successful they've
been.  Of course all doctors believe their work is good, but not all of
them really are specialists, or good specialists.  Even urologists may
specialize mainly in things very different from prostate cancer and not
do very many RP procedures per year.

You're in a battle here, but it's winnable.  Keep your spirits up.

Best of luck.

   Alan

   It sucks to be sick. Think of it like a thorn that needs to be pulled to
make it go away forever. Take a deep breath... read alot... ask
questions.... and you'll be OK. We're all the same boat, and we are still
here. Good luck!

Phil, whatever method you choose, it will be the right one....Best of luck
and quit worrying....

I made my decision before reading this NG. My decsion was based on research.
I found myself researching on-line until 3 and 4 every morning. I
persdaonnly talked with 13 people who had PC. 6 had RRP, 3 had seeds, 1 had
seeds and ER, and 3 had seeds and IMRT. I opted for seeds and IMRT. Gleason
was 4+3.

Mike

Hi, Philski....

I can still remember when I got the news on the phone from my doctor's nurse
after the second biopsy.  I felt as if I had been kicked in the gut.  I
imagined the worst.  It was not a good time.

But I read and read and read.... and I asked lots of questions...
www.phoenix5.org is a great site for information.... and I chose to have a
laparoscopic radical prostatectomy on Nov. 21, 2002... nerve sparing.  I did
very well.  It was the first surgery I had ever had at age 51.  It was much
less difficult than I had imagined.  I had surgery early one morning.....
went home the next morning.  Cath came out several weeks later.  I was
continent about 6 weeks after the cath came out... still waiting to see some
signs of erectile function.  But I feel great.... and PSAs have been
undetectable!!

So it's not a death sentence!  Just spend the time researching all you
can.... be your own advocate with the docs... I'd even suggest a second or
third opinion about other treatment options.  Then, make your choice and
don't look back.  You have a lot of years to look forward to!!

Take care....
MikeH