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Medical Forum / Diseases and Disorders / Prostate Cancer / December 2004

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After radiation

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st - 14 Dec 2004 02:34 GMT
Hello There:

I would appreciate a little help for my girlfriend's dad. Forgive me if I
don't use the

right words, I am not too knowledgeable in prostate cancer.

He is 71, he has practiced sports all his life, lean and healthy until 6 or
7 months ago when he noticed he was going to urinate too many times.

He was diagnosed with having some cancer cells in the Prostate, placed in
some kind of drug treatment, (Casodex and others) and then given around 37
sessions of Radiation. A week or so after finishing his radiation, he was
given the ok to travel to visit his daughter (my girlfriend). The doctor
said he was fine.

We go to walk with him 5 days a week, (fast walking for about 40 minutes)
because he feels great every time he goes,  but in the last 4 days or so, he
has mentioned to his daughter he has some irritation, he blames maybe
certain spices in the food or about 1/4 of small glass of wine he had about
7 days ago. I believe what he gets is diarrhea, and I noticed that he still
goes to the bathroom to urinate a lot. (he will go before we start walking
and maybe 15 min. later and at the end of the walk again).

My question is this:

If he got the drug treatment and the radiation, shouldn't he be back to
normal?

I was planning to invite him to eat in my house (I eat very healthy) is
there anything I should be aware of about food?

Is normal that he still has to go to urinate so often?

Thank you for your reply in this subject, I will read it before I show it to
my girlfriend.

I don't want her to get too worried.

Regards,

M.
EverettRWadsworth@yahoo.com - 14 Dec 2004 14:54 GMT
st,
Your girlfriend's dad was very smart in choosing radiation over
surgery. I was reading in Dr. Hennenfent's new book "Surviving Prostate
Cancer Without Surgery" that radiation therapy appears to work just as
well as radical surgery but with much fewer side effects.  However
there still are side effects and what you described should be expected.
I was wondering if he was ever checked for prostatitis?
Regards,
Everett
Leonard Evens - 14 Dec 2004 16:03 GMT
> st,
> Your girlfriend's dad was very smart in choosing radiation over
> surgery. I was reading in Dr. Hennenfent's new book "Surviving Prostate
> Cancer Without Surgery" that radiation therapy appears to work just as
> well as radical surgery but with much fewer side effects.

You are still hung up on the issue of surgery.   For some patients,
radiation is a better choice and for some patients surgery is a better
choice.  There is no one answer in all cases.  If Hennenfent actually
says that, then he is misleading his readers.

It does appear that on the average, radiation is as effective as surgery
for up to 10 years.  It seems plausible that it is as effective for
longer than that, but the data is not in yet.   In the 1980s surgery was
not very effective at all.  That was because they couldn't deliver an
adequate dose of radation to the prostate without damaging surrounding
tissues.  But modern methods are much more effective at direction the
radiation to the appropriate areas and avoiding collateral damage, so
they can use much higher doses.  But these newer methods have not been
in use long enough to collect very long term data.

The side effects of surgery and radiation are not that different.  Both
can produce impotence and incontinence.  Radiation is a bit more likely
to cause bowel problems.  Most often these side effects can be treated.
 In older men, over 70, impotence after surgery is more likely than
after radiation  (75 percent compared to 50 percent).   In younger men,
if the surgeon is well qualified,  there is not much difference.

Since this man was 71, if impotence was an issue for him---and it isn't
for all men---then indeed radiation was a good choice for him.  For some
men, like myself, surgery is preferable for a variety of reasons.  I
understood the risks of urinary problems and impotence for both and
figured for me there wasn't much difference.  In addition, I wasn't too
excited about the possibility of bowel problems.  Finally,  I liked the
idea that right after the surgery I would have a good idea from the
pathology report of the state of my treatment.  On the other hand, a
good friend of mine with a similar case chose radiation.  In his case,
the primary issue was that, with his health insurance, he had access to
a world class radiation therapist but only a so-so surgeon.  That was
not a factor for me because my surgeon is highly qualified.  But had I
been in his situation, I probably also would have chosen radiation, and
had he been in mine, he probably would have chosen surgery.

The upshot is that, as I said, there is not one answer for all men, and
anyone who says that is misleading people.

> However
> there still are side effects and what you described should be expected.
> I was wondering if he was ever checked for prostatitis?

That is sort of moot at this point, isn't it?  Since they discovered he
had cancer, they treated it.  They would almost certainly have done so
anyway even if they felt prostatitis contributed to his problems before
treatment.  (In fact, BPH or prostatisis rather than prostate cancer
almost certainly caused his symptoms, and the cancer was only found
incidentally in the process.)  The radiation essentially destroyed his
prostate, and after he recovers from the treatment, any prostatitis he
once had won't be relevant to his current situation.

> Regards,
> Everett
EverettRWadsworth@yahoo.com - 15 Dec 2004 16:51 GMT
Yes, I am still hung up on the issue of surgery because I know I'm
correct.  Dr. Hennenfent is not misleading his readers.  His
conclusions are based on facts. His book thoroughly explains it.  I
found here on Dr. Hennenfent's board a post on an article about a uro
who has choosen surgery his entire career for his patients yet when
faced with the same problem himself did not choose surgery.
http://survivingprostatecancerwithoutsurgery.org/anyboard9/forum/posts/201.html
Regards,
Everett

>Leonard Evens wrote:
>You are still hung up on the issue of surgery.   For some patients,
>radiation is a better choice and for some patients surgery is a better

>choice. There is no one answer in all cases. If Hennenfent actually
>says that, then he is misleading his readers.
Leonard Evens - 15 Dec 2004 20:40 GMT
> Yes, I am still hung up on the issue of surgery because I know I'm
> correct.  Dr. Hennenfent is not misleading his readers.  His
[quoted text clipped - 5 lines]
> Regards,
> Everett

You clearly haven't done a survey of the entire medical literature.  You
are getting all your facts from one source.  So you don't know all the
facts.  In addition, you show no evidence of having the qualifications
necessary to judge the merits of different claims.  So your certainty is
based on faith in one source, which you are treating as if it were the
word of God.

It is highly unlikely that any qualified urologist would choose surgery
for all his patients.   Many prostate cancer patients are not
appropriate candidates for surgery.  That is particularly true of older
patients, who constitute a very large part of the prostate cancer
population.   So, unless this urologist was incompetent, in which case,
which decision he made is moot, the statement that he always recommended
surgery for his patients must be wrong.   Also, there is no
contradiction between a surgeon recommending surgery for those of his
patients for whom it is appropriate but deciding against it himself.  In
his case,  it might very well have been a bad choice for a variety of
reasons.

>>Leonard Evens wrote:
>>You are still hung up on the issue of surgery.   For some patients,
>>radiation is a better choice and for some patients surgery is a better
>
>>choice. There is no one answer in all cases. If Hennenfent actually
>>says that, then he is misleading his readers.
EverettRWadsworth@yahoo.com - 16 Dec 2004 15:52 GMT
I have read many books on the prostate.  They were all written by
urologists who seem to have a bias towards surgery.  Dr. Hennenfent's
book is much different.  Dr. Hennenfent is not a urologist but rather
an emergency room physician.  His own father and uncles had prostate
problems and never received adequate care from their uros.  Dr.
Hennenfent decided he would devote his life to finding out why by
researching the practices of the urology profession.  He has spent over
20 years writing this book.  His book is unlike any other book ever
written on the prostate.  For example other books briefly mention
prostatitis in a few pages just to get it over with.  The reader is
left not realizing the relevancy of prostatitis and this is exactly
what the uros want since uros have no interest in treating this but
would rather wait until it could develop into prostate cancer which now
surgery can be recommended to the patient.  Dr. Hennenfent's book
devotes a good chunk of his book on prostatitis and why this could
possibly be stage 1 of prostate cancer. And once diagnosed with
prostate cancer he also talks about the many alternatives to surgery
and how to make intelligent decisions and not to be a victim of the
urology profession where the standard of practice is malpractice.  This
book has helped me in my own situation and I believe has saved my life
and can save the life and quality of life of many others.  That is why
I keep referring to this book.
Regards,
Everett

>Leonard Evens wrote:
>So your certainty is
>based on faith in one source, which you are treating as if it were the
>word of God.
ron - 16 Dec 2004 19:54 GMT
Everett wrote...snip...Dr. Hennenfent's book devotes a good chunk of
his book on prostatitis and why this could possibly be stage 1 of
prostate cancer.

Take a look at this Medscape article ("Treatment of Chronic
Prostatitis")
http://www.medscape.com/viewarticle/494378

They note, "Despite its name, it is by no means certain that CP/CPPS is
associated with inflammation of the prostate or is even a disease of
the prostate."  CP/CPPS stands for Chronic prostatitis/chronic pelvic
pain syndrome...Best wishes and good health, Ron
EverettRWadsworth@yahoo.com - 17 Dec 2004 03:27 GMT
I took a look at the article.  CP/CPPS is always associated with
inflammation of the prostate and is a disease of the prostate.  Uros
conventionally ignore test results or ignore doing proper testing or
ignore following basic principals of medicine to make you think you
don't have a prostate problem so they can get back to their surgery.
Regards,
Everett

>ron wrote:
>Take a look at this Medscape article ("Treatment of Chronic
[quoted text clipped - 4 lines]
>the prostate." CP/CPPS stands for Chronic prostatitis/chronic pelvic
>pain syndrome...Best wishes and good health, Ron
George Conklin - 18 Dec 2004 23:20 GMT
> > Yes, I am still hung up on the issue of surgery because I know I'm
> > correct.  Dr. Hennenfent is not misleading his readers.  His
> > conclusions are based on facts. His book thoroughly explains it.  I
> > found here on Dr. Hennenfent's board a post on an article about a uro
> > who has choosen surgery his entire career for his patients yet when
> > faced with the same problem himself did not choose surgery.

http://survivingprostatecancerwithoutsurgery.org/anyboard9/forum/posts/201.h
tml
> > Regards,
> > Everett
[quoted text clipped - 5 lines]
> based on faith in one source, which you are treating as if it were the
> word of God.

  You just like to argue. All treatments come up about the same so if you
pick among them with a random number generator, it would not matter.
Leonard Evens - 18 Dec 2004 23:25 GMT
>>>Yes, I am still hung up on the issue of surgery because I know I'm
>>>correct.  Dr. Hennenfent is not misleading his readers.  His
[quoted text clipped - 18 lines]
>    You just like to argue. All treatments come up about the same so if you
> pick among them with a random number generator, it would not matter.

But he thinks radiation is superior to surgery.  Why don't you argue
your point with him?
 
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