Re: Re: Symptoms and Symptom Distress in Localized Pr...

[Guest guest]

Dear Mr. ,

As to the cost of radiation, a lot depends on what kind of

radiation, who does it and where it is done. You mentioned

that you were leaning toward brachytherapy (seeds). I think

that is a very good alternative. I wish I could have had that.

Here is something I often send out to newly diagnosed men:

I am sorry to hear about your diagnosis. ABOVE ALL DO NOT

PANIC AND RUSH INTO TREATMENT. Your cancer has

probably been growing in your body for several years. It will not kill

you any time soon. It is your responsibility to make the treatment

decision, but it should be a well informed decisions. Before you

make a treatment decision that you will have to live with for the

rest of your life, get a second opinion from a doctor who does not

specialize entirely doing surgery. Take the time to learn all your

options. Have several PSA tests and make a chart. The PSA

will correlate fairly closely to the cancer activity. Do not rush

into any therapy if you have a moderate or insignificant cancer.

It will not kill you immediately- you may be much better off

just doing watchful waiting or a better term is Active Surveillance.

Again, make a chart and have several PSA tests. Look for any

upward trend and especially doubling time. You might also

change your diet and way of living if necessary.

I had my prostate removed in 1992- but we did not have as many

options at that time. I would not choose surgery today. I believe

that there are better options. If I had it to do over, I would choose

brachytherapy, (seed implants or HDR). Of course there are

other options such as External Beam Radiation or IMRT, Proton

Beam radiation (it is one of the better therapies, but expensive, some

insurance may not cover it), Cryo Surgery and soon we will have High

Intensity Focused Ultrasound (HIFU). HIFU may be the least invasive

of all, but still not FDA approved in U.S. Many are now choosing

Laparoscopic or Da Vinci robotic assisted surgery to remove

the prostate. But it has the same unpleasant side effects of

the Retropubic Radical Prostatectomy (RRP). For advanced

PCa, there is hormone ablation and several regimens of chemo.

No matter what therapy one chooses, there are always some side

effects, No matter who does it or how it is done, removal of the

prostate has side effects, some more pronounced and unpleasant

than others.

You are wise to do a lot of research. One reason not to have surgery

is because, for me, sex was never the same after my prostate was

removed. The prostate and the seminal vesicles manufacture almost

all of the ejaculate. During orgasm, the prostate squeezes down and

forces the semen out. This is a part of the pleasure of an orgasm.

One may still be able to have an orgasm after a RP, but it may take

a lot more stimulation.

Many men who have surgery are impotent afterwards. There are

nerves on each side of the prostate that control erectile function.

These nerves are difficult to see and quite often they are severed

or severely damaged.

Another side effect of RP is that many men lose some length and

girth afterwards. Several studies have been done on this subject.

Go to www.google.com and search for Loss of Penile Length and

Radical Prostatectomy.

Many men are also incontinent for some time after surgery because

the primary bladder valve is intimately connected to the prostate. It

is often damaged. Most men do recover urinary continence by

doing Kegel exercises which strengthens the secondary valve below

the prostate. Unfortunately, a few men never regain continence. A few

of these men have to have an Artificial Urinary Sphincter implanted

in order to control their urinary output.

But even if they do learn to control normal urinary functions by doing

Kegel exercises for this valve, when they try to have an erection or

become sexually aroused, this valve will open and they may have

leakage. This valve has always opened during sexual activities

and no amount of Kegel exercises will cause it do otherwise.

The primary valve is not involved in brachytherapy, or seed

implants so there is little or no incontinence.

The impotence rate is also very low. Some men will still have an

ejaculate, though it may be much less in volume. Some men are

even able to father children after brachytherapy. After a RP, one may

be able to have sperm aspirated from the testes and used to

impregnate a woman. But it is a difficult procedure, is expensive and

may not always be successful. If a man thinks he may want to father

children after a RP, he should consider banking some of his sperm.

For more information, you can read my book below my signature. Over

20 MDs and several survivors contributed to it. I wish you all the bestAubrey Pilgrim, DC (Ret.) Author ofA Revolutionary Approach to Prostate Cancer-Read the original book for FREE at: http://www.prostatepointers.org/prostate/lay/apilgrim/Read new edition for FREE at http://www.cancer.prostate-help.org/capilgr.htmDr. E. Crawford is co-author of the revision

Yes my oldest so meant don't worry about the cancer. But i have the cancer, Not him. Wednesday is my testing day for treadmill. and nuculer infusion. It will be about four to six hours in length. My cardiologist is trying to determine my risk factors, as my urologist want toach me without some type factor involved. I called and could not get a report on radiation somuch as cost etc. If I have that treatment it will be for 45 days. Medicare will pay 80%. The pellets is my other option. Does anyone know the cost of radiation.

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