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Medical Forum / Diseases and Disorders / Prostate Cancer / July 2005radioactive seeds v total removal
I am 65 with a Gleason of 8 and a very localized tumor. I really want to do the seeds, but my freinds say I am too young. Input anyone. In my opinion, a localized prostate cancer can be treated with seed therapy or prostatectomy. It depends on the stage and the prognosis of of the tumor. A less aggressive one can be treated with seed. On 7/6/05 10:22 AM, in article 1120663321.501759.137780@g14g2000cwa.googlegroups.com, "easygoinbob" <bob@mahaninsurance.com> wrote: > I am 65 with a Gleason of 8 and a very localized tumor. I really want > to do the seeds, but my freinds say I am too young. > > Input anyone. Much depends of the size of the gland, your health and the like. An off the cuff response, and all things being equal, either seeds or open surgery could be fine. You would need to go into with your eyes open given the Gleason 8 can have a higher rate of recurrence (was it a gleason 4+4=8/10 or 5+3=8/10. Do you have a high PSA?). Many docs would talk with you about combination seeds and external beam if you did not want to go with open surgery. Some may also want to give you a drug to knock down your testosterone for a few years after radiation. I tend to think with the more aggressive Gleason grades consideration for combined therapy with the anti-testosterone drugs are something to think about, but people do differ in their opinion about this kind of thing. Best to just sit down with a urology doc who does both open surgery and seeds and talk about things. Hope this helps. ME Thanx for the detailed input. My Gleason number was 3+3 = 6. 8 was a typo. > Thanx for the detailed input. My Gleason number was 3+3 = 6. 8 was a > typo. With a Gleason 6, at age 65 you could be a reasonable candidate for seeds. Personally, I think you would have a better chance in the long term if you chose surgery, but I'm not a physician, and I'm sure others would disagree. The reason your friends have told you that you are too young for seeds is that there is more data available about the long term success rates for surgery than for seeds. More important for you might be the skill and qualifications of the doctors you have available. One method or the other might have a theoretical advantage in general, but you would be better off using a skilled physician with a good track record for cases like yours than a less skilled practitioner using a "better" method. You should also think carefully about why you prefer seeds. Sometimes people are scared off by the words. For Gleason 6 cases, the differences in results and side effects for different methods are not that different. Make sure you are making the decision for real reasons that make sense to you rather than because of irrational fears. It is also possible, depending on the details of your diagnosis, that doing nothing now and continuing to monitor the cancer might be a reasonable alternative, but of course nobody here can tell you if you are a reasonable candidate for such an approach. You really have to dicuss these matters with your doctors. > > Thanx for the detailed input. My Gleason number was 3+3 = 6. 8 was a > > typo. [quoted text clipped - 5 lines] > young for seeds is that there is more data available about the long term > success rates for surgery than for seeds. Here you go again trying to make your personal opinions FActs. You know as well as anyone that the long-term studies are underway to 10 years now with no results on surgery VS NOTHING. So why make fun of brachytherapy when nothing is as good as something. >>>Thanx for the detailed input. My Gleason number was 3+3 = 6. 8 was a >>>typo. [quoted text clipped - 10 lines] > now with no results on surgery VS NOTHING. So why make fun of brachytherapy > when nothing is as good as something. George Conklin again shows his inability to read. I don't see how anyone who actually read what I said could infer that I was making fun of brachytherapy. Also, I stated a personal opinion but also implied there was no spcial reason why the questioner should pay special attention to it. Finally, in what he left out, I also suggested that he might dicuss with his physician the possibility of doing nothing. By the way. The latest results from Holmberg, et. al. does show, at least in the Swedish context, that radical prostatectomy is superior to watchful waiting according to several criteria such as prostate cancer mortality and evidence of disease progression. Myself, I consider such studies interesting, along with other information, but I don't think anything has been established yet beyond all reasonable doubt. Unfortunately, with dieaseses like prostate cancer, which have very long time horizons, it is difficult to settle anything with any one study. > I am 65 with a Gleason of 8 and a very localized tumor. I really want to > do the seeds, but my freinds say I am too young. Odd. I'm 58 and was seeded last November for a Gleason 3+3. Nobody thought I was too young to go that route. It depends more on tumour stage, gland size, things like that. FWIW, eight months on, I would make the same choice again. Over on alt.support.cancer.prostate you'll find lots of people with strong opinions in favour of (or against) any approach you care to propose :)  SignatureGreg Louis |
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