I was a 16 and got the RRP. Of course I was only 46, but I think RRP is a
very good decision for your father.

Signature
Prostate 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
PSA .1 .1 .1 .3 .4 .8
EBRT 05-07/2002 @ 47
PSA .3 .2 .2 .2 .3
Erection 05/12/2003 @ 48
HTbegins 07/21/2003 @ 48
PSA .1
Lupron 7/03, 8/03, 12/03
> John (my father) Age 67 very good health
>
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>
> Whats your feelins on haing a RRp with the figures i've mentioned above.
> John (my father) Age 67 very good health
>
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> When the specialist felt around for a lump he could not find anything.
> Therefor, we think my father is a T1a.
Not that it makes much difference, but a prostate cancer found through
PSA testing with negative DRE results is usually classified as T1c.
As you say, the PSA is marginal with respect to the Partin tables, but
remember the 10 ng/ml dividing point is somewhat arbitrary. In
reality, the lower the PSA the more likely it is that the cancer is
confined to the prostate, but nothing radical happens as you pass 10.
The best you can determine from the Partin tables is that with Gleason
6, the chances of the cancer being organ confined is between 62 and 75
percent. But remember even that is a rough estimate subject to error.
In any event, even if it isn't organ confined, there is a good chance a
surgeon will get it all, the chances for a cure in such a case are
excellent.
> Further, the specialist told him he believes the cancer is contained in the
> prostate and no too active.
>
> He has been asked to go and decide which procedure to take and it looks
> fairly certain that he is going to choose RRP. His decision to the
> specialist will be given on Tuesday.
He might also look into the possibility of external radiation. I was
67 when I was diagnosed with Gleason 7=3+4, PSA 4.5, T1c. My doctor
suggested either radical prostatectomy or external radiation. I chose
the former, but in retrospect it was a close call. As you approach 70
or older, the likelihood of not being permanently impotent following a
RP goes up significantly, even if your surgeon is first rate at nerves
sparing surgery. The impotence figures for older men are better with
radiation. Also, you need not worry so much about what may happen 15 or
20 years hence. I recovered erections after about 18 months, but had I
been five years older I would have chosen radiation. (Note that no one
knows at present the very long term success rates for the modern methods
of radiation therapy because they haven't been in use long enough, but
there is a reasonable chance that radiation will prove just as effective
as surgery. For up to ten years, it is already known that such is the
case.)
> I am worried about the high PSA and Gleason in my hope that the doctor will
> be able to remove all. PSA 10 seems to be on the border on the Partin
> tables and i'm reading some negative and positive stuff re chances for a
> complete cure and length of life and getting a little confused.
>
> Whats your feelins on haing a RRp with the figures i've mentioned above.
As I think I've noted, it is a borderline age with respect to choosing
between radiation and surgery. One important factor is the skill of the
surgeon, which is very crucial. One thing that influences many men is
the fact that after surgery, the post-surgical pathology report may give
you a better idea of just how extensive the cancer was. If, as is
usually the case for a cancer like your father's, the report is
encouraging, that can help alleviate some of the anxiety about
recurrence. Also, some of us don't like the idea of killing of the
cancer in degrees over a couple of years instead of getting rid of it in
one procedure.
Patrick Walsh's Guide to Surviving Prostate Cancer is a good initial
guide to these matters.
Leonards reply is very informative, right on the nose. I was 69 with PSA
7.2 -->7,9 in one month, Gleason 6
corrected to 5 after surgery. I was not eligible for radiation due to
radiation of the groin for a
previous cancer. Have anyone looked at seed implants. A number of fellows in
our US TOO! group
have had them and are quite satisfied. Of course Urologists are surgeons and
will almost always
recommend surgery and a radiation oncologist will want to do external beam
or seed implants.
Tom
> John (my father) Age 67 very good health
>
[quoted text clipped - 22 lines]
>
> Whats your feelins on haing a RRp with the figures i've mentioned above.