Re: Gleason 7 3+4 considering surgery

[Guest guest]

Have you checked out the Katten nomogram on the Sloan Kettering website? It's a statistical model that will give you the probabilities of 5 and 10 year cancer freedom for the various treatments. It's based on the latest results and is constantly updated. You plug in your age, PSA, Gleason etc. and it gives you the probabilities. I found it helpful in deciding what treatment to go for (DaVinci prostatectomy). Go to the Sloan Kettering website, got to the prostate cancer section and you will see the portal to the calculator on the right hand side. BTW, all of the urologists I consulted with plugged my scores into the nomogram as I was meeting with them. One of them referred me to it.

I chose surgery because according to the nomogram it gave me slightly better probabilities than the other treatments. The reason I chose DaVinci robotic surgery is that one urologist (not the one who did my surgery) told me the advantage of DaVinci is that he could see what he was doing while with open surgery he had to do it by feel because there are organs in front of the prostate. That sounded good to me. I have ED (after 8 weeks) but the incontinence is rapidly improving now and I'm down to one pad a day and tempted to go to zero for at least the morning hours (when I have problems it's usually after mid-afternoon).

There was virtually no pain from the surgery (another plus for me). I have seen studies that suggest there is little real difference in outcome between open and robotic. You have to decide what you are most comfortable with, and who you are most comfortable with.

Good luck with your treatment. If I can give you any more info, email or call me. 614/891-0695.

Mike

Subject: Gleason 7 3+4 considering surgeryTo: ProstateCancerSupport Date: Sunday, April 11, 2010, 11:21 AM

HelloI am recently diagnosed from a biopsy with cancer in 11 out of 12 cores, all Gleason 6 except one 7 3+4 volume 30% 8 have volumes below 20% 2 others are at 30% These all being Gleason 6.I was recommended because of my age 49 to have open surgery. I'm at Memorial Sloan Kettering and Doctor is Eastham, a highly recommended nerve sparing specialist surgeon. I've had two long consultations with him where he explained his pov and answered all my questions quite candidly. He doesn't think I should wait too long of course and recommends open because he can feel the tissue and make better decisions. I have been following the posts on Joe with Gleason 7 and read a quick email from Sheri? who says her husband was treated alternatively from Gleason 7 and it has been successful so far. I cant find any of the posts relating to this in the archives. Maybe someone can point me to them with names of her husband and her actual name because Sheri

or Sherri or her partial email are yielding nothing in the search.I have seen that my Surgeon's advice about surgery has been backed up in the numerous yahoogroups I've read because of my age and quantity of Cancer. Does anyone beg to differ? My surgeon claimed I believe 95% great outcome for patients my age in recovery ( in terms of ED and incontinence, recurrence) Any other points of view would be most welcome as I have a small window to make this decision.For One Year after a PSA 4.7 and believing Biopsy dangerous reading various alternative sources, I had been treated by Dr. Bard who used 4D doppler Ultrasound and his own Prostate supplement pills consisting of Beta-sitosterol, Querticin, Revestarol , lycopene.These pills haven't been cheap. Bard initially found 2 small tumors One shrunk from 4X5 to 3X3mm the other disappeared and then another appeared in a different location but had stabilized at 3X2 mmMy GP did another PSA

in November and tried to scare the heck out of me as it came back 5.2 Bard recommends MRI with his scans which my GP would not authorize so I went through changing insurance and finallly in late January I got the MRI which didn't turn out so good showing a dark shadow on one side of the prostate. Bard rescanned me and said it was possibly erroneous but in conversation with him, he said I could try a biopsy. Dr. Eastham feels that I have a diffuse Cancer and feels that the MRI was correct as Color Doppler cannot see cells before they form tumors. Any comments on the accuracy of Color Doppler as opposed to Biopsy? Bard seems to indicate that I don't have that much Cancer and with his Pills and scans, most do quite well. Though he is concerned about my age , recommended maybe a second opinion on the slides and possibly HIFU which I can't afford and don't believe is good in my case. He has been a responsive MD and I respect that he indicated a Doctor

such as Eastham who does not share his POV. My feeling right now is after a year of vegan diet and scans, I don't think I want to wait and Ive discovered that my family is riddled with cousins(plus my Dad) who've had or have Prostate Cancer.All comments welcome. Thanks to all for the opinions and info I've received in the short time I've been reading this groupall the bestBill

[Guest guest]

Bill,

I was Dx’d also at the age of 49. This

was 11 years ago. My Dx was almost the same case as yours. I had a PSA of 5.2

at the time the Doctor decided to do a biopsy. As everyone will advise, the decision

of what form of treatment you should follow is totally yours with inputs from

your loved ones. In my case, I chose RP (open surgery). My results have been

excellent so far. Had ED for about the first 10 months of the recovery process

and had very little problems with incontinence for the first month. My only

problem after surgery was strictures that required three small follow up

interventions. The doctor indicated this was due to scar tissue due to surgery.

All has been OK after that.

I arrived at my decision after reading,

obtaining inputs in different forums, chatting with Doctors and most

importantly, discussion with my children and wife. RP (open surgery) certainly

has its risks but at that age, but I did not want to include probabilities of successful

treatment into my future.

I would also like to add that in my

family, we are 9 brothers. 5 have already have had PC. One chose faith and

herbal healing treatment and died three years after his decision. One chose to

do nothing. He died 2 years after his decision. Two chose seeds and they are still

alive about 5 years after start of treatment with no indications of additional

problems. They had the DX when they were 65 and 62 years old. I chose open

surgery and my PSA is undetectable.

Wish you well in your process.

Your brother in arms,

From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of tadikinathom

Sent: Sunday, April 11, 2010 8:22

AM

To: ProstateCancerSupport

Subject:

Gleason 7 3+4 considering surgery

Hello

I am recently diagnosed from a biopsy with cancer in 11 out of 12 cores, all

Gleason 6 except one 7 3+4 volume 30% 8 have volumes below 20% 2 others are at

30% These all being Gleason 6.

I was recommended because of my age 49 to have open surgery. I'm at Memorial

Sloan Kettering and Doctor is Eastham, a highly recommended nerve sparing

specialist surgeon. I've had two long consultations with him where he explained

his pov and answered all my questions quite candidly. He doesn't think I should

wait too long of course and recommends open because he can feel the tissue and

make better decisions. I have been following the posts on Joe with Gleason 7

and read a quick email from Sheri? who says her husband was treated

alternatively from Gleason 7 and it has been successful so far. I cant find any

of the posts relating to this in the archives. Maybe someone can point me to

them with names of her husband and her actual name because Sheri or Sherri or

her partial email are yielding nothing in the search.

I have seen that my Surgeon's advice about surgery has been backed up in the

numerous yahoogroups I've read because of my age and quantity of Cancer. Does

anyone beg to differ? My surgeon claimed I believe 95% great outcome for

patients my age in recovery ( in terms of ED and incontinence, recurrence) Any

other points of view would be most welcome as I have a small window to make

this decision.

For One Year after a PSA 4.7 and believing Biopsy dangerous reading various

alternative sources, I had been treated by Dr. Bard who used 4D doppler

Ultrasound and his own Prostate supplement pills consisting of Beta-sitosterol,

Querticin, Revestarol , lycopene.

These pills haven't been cheap. Bard initially found 2 small tumors One shrunk

from 4X5 to 3X3mm the other disappeared and then another appeared in a

different location but had stabilized at 3X2 mm

My GP did another PSA in November and tried to scare the heck out of me as it

came back 5.2 Bard recommends MRI with his scans which my GP would not

authorize so I went through changing insurance and finallly in late January I

got the MRI which didn't turn out so good showing a dark shadow on one side of

the prostate. Bard rescanned me and said it was possibly erroneous but in

conversation with him, he said I could try a biopsy. Dr. Eastham feels that I

have a diffuse Cancer and feels that the MRI was correct as Color Doppler

cannot see cells before they form tumors. Any comments on the accuracy of Color

Doppler as opposed to Biopsy?

Bard seems to indicate that I don't have that much Cancer and with his Pills

and scans, most do quite well. Though he is concerned about my age ,

recommended maybe a second opinion on the slides and possibly HIFU which I can't

afford and don't believe is good in my case. He has been a responsive MD and I

respect that he indicated a Doctor such as Eastham who does not share his POV.

My feeling right now is after a year of vegan diet and scans, I don't think I

want to wait and Ive discovered that my family is riddled with cousins(plus my

Dad) who've had or have Prostate Cancer.

All comments welcome. Thanks to all for the opinions and info I've received in

the short time I've been reading this group

all the best

Bill

[Guest guest]

tadikinathom wrote:

> I am recently diagnosed from a biopsy with cancer in 11 out of 12 cores,

> all Gleason 6 except one 7 3+4 volume 30% 8 have volumes below 20% 2

> others are at 30% These all being Gleason 6.

> I was recommended because of my age 49 to have open surgery.

....

Bill,

If I were you I'd be reluctant to spend any more time with

" alternative " therapies. Although your Gleason scores and PSA

are " low risk " , the fact that you have cancer in many areas of

the prostate and that you are only 49 years old suggests to me

that you could develop a very dangerous cancer before you're old

enough to die of something else.

If you think that one of the primary treatments - radiation or

surgery - is in your future, you might very well want to do it

now. The reason is that these treatments are only effective if

all of the cancer is contained in or very near the prostate.

Once it escapes, they don't work. If you are going to have to do

it anyway, it would seem to be a good idea to do it now, while

the chance of all the cancer being contained is greater. The

longer you wait, the more the risk that it will not be contained.

Personally, I think there are a number of pretty effective

treatments for localized cancer, including open surgery, robotic

surgery, and many types of radiation. Each has advantages and

disadvantages, but a key characteristic of all of them is that

they can be done very well or very poorly. So in my mind, a big

part of the solution to a prostate cancer problem is not choosing

one particular therapy over another, but choosing the best

surgeon or radiation oncologist, that you can find to do

the work.

It sounds like you've got a good surgeon.

Many cancer specialists recommend surgery for younger patients

and radiation for older ones. However you may wish to consult

with a radiation oncologist just to see what he has to say.

To the best of my knowledge, results with HIFU and cryotherapy,

are not yet as good, though the techniques may be developed and

improved over time. I know that with cryotherapy, the side

effects have often been worse than with radiation or surgery, but

I don't know about HIFU.

Sloan-Kettering is one of the top cancer centers in the world.

The Director of Sloan-Kettering, Harold Varmus, is a Nobel Prize

winner and former Director of the National Institutes of Health.

He is said to be planning to return to NIH as Director of the

National Cancer Institute. Bad things can happen anywhere, but

S-K is a place where a lot of good things happen.

Good luck.

Alan

[Guest guest]

Bill:

As has indicated, you must make you own choice with help from your loved ones. For me, surgery was also my preferred option. My father died from PCa at age 84. I had the traditional open manual retro-pubic procedure for a well recommended Uro with over 500 procedures to his credit. I was dx'd at age 55 on April 11, 2008. My internist detected a problem with my annual DRE. Uro confirmed this situation with a biopsy. Presurgery - Gleason 3+4. PSA 1.43. Radiology and MRI showed no detectible spread. Date of surgery, June 11, 2008. Post-surgery, Gleason was 3+3 based on pathology of excised prostate. Tumor staged T2B NO MX. Surgical margins clear. No perinural invasion present. Both sets of nerves spared. No seminal vesicle invasion. Post surgery, PSA history 0.06 at three months; 0.03 at five months, and 0.01 at 9, 12, and 18 months. I will be tested again in about 45 days. Had ED issues pre-surgery, due to weight and blood pressure issues. This has continued, but is handled with Cialis. Except for physical stress related instances, I was continent by about 30 days after surgery, and this has improved to the point where I don't think about it anymore. My physical activity is not at all limited.

Again, your results will vary. My situation is not at all predictive of what you may experience. I gently suggest you take note of the data I've reported about my situation. As you take charge of your treatment, you should have all of this sort of information and medical history in your possession, in order to adequately monitor your progress as you cope with this disease. If you are ready tracking you personal data, good-on-ya!

From you post, it sounds to me like you have been and are continuing to carefully consider your options. Well done!

Coy

, Michigan USA

RE: Gleason 7 3+4 considering surgery

Bill,

I was Dx’d also at the age of 49. This was 11 years ago. My Dx was almost the same case as yours. I had a PSA of 5.2 at the time the Doctor decided to do a biopsy. As everyone will advise, the decision of what form of treatment you should follow is totally yours with inputs from your loved ones. In my case, I chose RP (open surgery). My results have been excellent so far. Had ED for about the first 10 months of the recovery process and had very little problems with incontinence for the first month. My only problem after surgery was strictures that required three small follow up interventions. The doctor indicated this was due to scar tissue due to surgery. All has been OK after that.

I arrived at my decision after reading, obtaining inputs in different forums, chatting with Doctors and most importantly, discussion with my children and wife. RP (open surgery) certainly has its risks but at that age, but I did not want to include probabilities of successful treatment into my future.

I would also like to add that in my family, we are 9 brothers. 5 have already have had PC. One chose faith and herbal healing treatment and died three years after his decision. One chose to do nothing. He died 2 years after his decision. Two chose seeds and they are still alive about 5 years after start of treatment with no indications of additional problems. They had the DX when they were 65 and 62 years old. I chose open surgery and my PSA is undetectable.

Wish you well in your process.

Your brother in arms,

From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of tadikinathomSent: Sunday, April 11, 2010 8:22 AMTo: ProstateCancerSupport Subject: Gleason 7 3+4 considering surgery

HelloI am recently diagnosed from a biopsy with cancer in 11 out of 12 cores, all Gleason 6 except one 7 3+4 volume 30% 8 have volumes below 20% 2 others are at 30% These all being Gleason 6.I was recommended because of my age 49 to have open surgery. I'm at Memorial Sloan Kettering and Doctor is Eastham, a highly recommended nerve sparing specialist surgeon. I've had two long consultations with him where he explained his pov and answered all my questions quite candidly. He doesn't think I should wait too long of course and recommends open because he can feel the tissue and make better decisions. I have been following the posts on Joe with Gleason 7 and read a quick email from Sheri? who says her husband was treated alternatively from Gleason 7 and it has been successful so far. I cant find any of the posts relating to this in the archives. Maybe someone can point me to them with names of her husband and her actual name because Sheri or Sherri or her partial email are yielding nothing in the search.I have seen that my Surgeon's advice about surgery has been backed up in the numerous yahoogroups I've read because of my age and quantity of Cancer. Does anyone beg to differ? My surgeon claimed I believe 95% great outcome for patients my age in recovery ( in terms of ED and incontinence, recurrence) Any other points of view would be most welcome as I have a small window to make this decision.For One Year after a PSA 4.7 and believing Biopsy dangerous reading various alternative sources, I had been treated by Dr. Bard who used 4D doppler Ultrasound and his own Prostate supplement pills consisting of Beta-sitosterol, Querticin, Revestarol , lycopene.These pills haven't been cheap. Bard initially found 2 small tumors One shrunk from 4X5 to 3X3mm the other disappeared and then another appeared in a different location but had stabilized at 3X2 mmMy GP did another PSA in November and tried to scare the heck out of me as it came back 5.2 Bard recommends MRI with his scans which my GP would not authorize so I went through changing insurance and finallly in late January I got the MRI which didn't turn out so good showing a dark shadow on one side of the prostate. Bard rescanned me and said it was possibly erroneous but in conversation with him, he said I could try a biopsy. Dr. Eastham feels that I have a diffuse Cancer and feels that the MRI was correct as Color Doppler cannot see cells before they form tumors. Any comments on the accuracy of Color Doppler as opposed to Biopsy? Bard seems to indicate that I don't have that much Cancer and with his Pills and scans, most do quite well. Though he is concerned about my age , recommended maybe a second opinion on the slides and possibly HIFU which I can't afford and don't believe is good in my case. He has been a responsive MD and I respect that he indicated a Doctor such as Eastham who does not share his POV. My feeling right now is after a year of vegan diet and scans, I don't think I want to wait and Ive discovered that my family is riddled with cousins(plus my Dad) who've had or have Prostate Cancer.All comments welcome. Thanks to all for the opinions and info I've received in the short time I've been reading this groupall the bestBill

[Guest guest]

Just for the record, I also had the prostatectomy and have not regretted it. I was 58 at the time.

Subject: Re: Gleason 7 3+4 considering surgeryTo: ProstateCancerSupport Date: Sunday, April 11, 2010, 2:44 PM

Bill:

As has indicated, you must make you own choice with help from your loved ones. For me, surgery was also my preferred option. My father died from PCa at age 84. I had the traditional open manual retro-pubic procedure for a well recommended Uro with over 500 procedures to his credit. I was dx'd at age 55 on April 11, 2008. My internist detected a problem with my annual DRE. Uro confirmed this situation with a biopsy. Presurgery - Gleason 3+4. PSA 1.43. Radiology and MRI showed no detectible spread. Date of surgery, June 11, 2008. Post-surgery, Gleason was 3+3 based on pathology of excised prostate. Tumor staged T2B NO MX. Surgical margins clear. No perinural invasion present. Both sets of nerves spared. No seminal vesicle invasion. Post surgery, PSA history 0.06

at three months; 0.03 at five months, and 0.01 at 9, 12, and 18 months. I will be tested again in about 45 days. Had ED issues pre-surgery, due to weight and blood pressure issues. This has continued, but is handled with Cialis. Except for physical stress related instances, I was continent by about 30 days after surgery, and this has improved to the point where I don't think about it anymore. My physical activity is not at all limited.

Again, your results will vary. My situation is not at all predictive of what you may experience. I gently suggest you take note of the data I've reported about my situation. As you take charge of your treatment, you should have all of this sort of information and medical history in your possession, in order to adequately monitor your progress as you cope with this disease. If you are ready tracking you personal data, good-on-ya!

From you post, it sounds to me like you have been and are continuing to carefully consider your options. Well done!

Coy

, Michigan USA

[ProstateCancerSupp ort] Gleason 7 3+4 considering surgery

HelloI am recently diagnosed from a biopsy with cancer in 11 out of 12 cores, all Gleason 6 except one 7 3+4 volume 30% 8 have volumes below 20% 2 others are at 30% These all being Gleason 6.I was recommended because of my age 49 to have open surgery. I'm at Memorial Sloan Kettering and Doctor is Eastham, a highly recommended nerve sparing specialist surgeon. I've had two long consultations with him where he explained his pov and answered all my questions quite candidly. He doesn't think I should wait too long of course and recommends open because he can feel the tissue and make better decisions. I have been following the posts on Joe with Gleason 7 and read a quick email from Sheri? who says her husband was treated alternatively from Gleason 7 and it has been successful so far. I cant find any of the posts relating to this in the archives. Maybe someone can point me to

them with names of her husband and her actual name because Sheri or Sherri or her partial email are yielding nothing in the search.I have seen that my Surgeon's advice about surgery has been backed up in the numerous yahoogroups I've read because of my age and quantity of Cancer. Does anyone beg to differ? My surgeon claimed I believe 95% great outcome for patients my age in recovery ( in terms of ED and incontinence, recurrence) Any other points of view would be most welcome as I have a small window to make this decision.For One Year after a PSA 4.7 and believing Biopsy dangerous reading various alternative sources, I had been treated by Dr. Bard who used 4D doppler Ultrasound and his own Prostate supplement pills consisting of Beta-sitosterol, Querticin, Revestarol , lycopene.These pills haven't been cheap. Bard initially found 2 small tumors One shrunk from 4X5 to 3X3mm the other disappeared and then another appeared in a different

location but had stabilized at 3X2 mmMy GP did another PSA in November and tried to scare the heck out of me as it came back 5.2 Bard recommends MRI with his scans which my GP would not authorize so I went through changing insurance and finallly in late January I got the MRI which didn't turn out so good showing a dark shadow on one side of the prostate. Bard rescanned me and said it was possibly erroneous but in conversation with him, he said I could try a biopsy. Dr. Eastham feels that I have a diffuse Cancer and feels that the MRI was correct as Color Doppler cannot see cells before they form tumors. Any comments on the accuracy of Color Doppler as opposed to Biopsy? Bard seems to indicate that I don't have that much Cancer and with his Pills and scans, most do quite well. Though he is concerned about my age , recommended maybe a second opinion on the slides and possibly HIFU which I can't afford and don't believe is good in my case. He has

been a responsive MD and I respect that he indicated a Doctor such as Eastham who does not share his POV. My feeling right now is after a year of vegan diet and scans, I don't think I want to wait and Ive discovered that my family is riddled with cousins(plus my Dad) who've had or have Prostate Cancer.All comments welcome. Thanks to all for the opinions and info I've received in the short time I've been reading this groupall the bestBill

[Guest guest]

> Bill,

>

> If I were you I'd be reluctant to spend any more time with

> " alternative " therapies. Although your Gleason scores and PSA

> are " low risk " , the fact that you have cancer in many areas of

> the prostate and that you are only 49 years old suggests to me

> that you could develop a very dangerous cancer before you're old

> enough to die of something else.

(snip)

I second Alan's motion.

Dammit, he's far east of me and gets to say what I want to say

before I'm awake :-(

Fundamentally, the so-called " alternative " treatments do little

but enrich the conscienceless snake-oil purveyors while

distracting desperate patients from txs of known efficacy.

Side effects can usually be dealt with. Consider the SE of

failure to treat per science rather than per the greed of someone

who has zero education in medical science. It's called Death.

Think: If such txs were so wonderful, why are they not part of

the armamentarium now employed against our disease? And please

don't start a lecture about some vast conspiracy. That's moo poo.

Science is our salvation, and even that sometime is ineffective.

I knew a brilliant man who in effect had a PhD in prostate cancer

and fought the good fight for many years. But the bear finally

ate him about a month ago. RIP.

Regards,

Steve J

Kyrie eleison.

O Lord, have mercy.

[Guest guest]

Addendum to previous message:

There is no test, none, other than biopsy, that is accepted as

definitive for PCa.

The biopsy specimens should be examined by an expert, other than

the local guy/gal who examines scores of other specimens.

Here is a list:

Bostwick Laboratories [800] 214-6628

Dianon Laboratories [800] 328-2666 (select 5 for client services)

Jon Epstein (s Hopkins) [410] 955-5043 or [410] 955-2162

Jon Oppenheimer (Tennessee) [800] 881-0470

Lucia (303)724-3470

This is a " second opinion " and should be covered by

insurance/Medicare. The cost, last I heard, was about $500. More

if further tests, which might be prudent, are ordered.

The chosen lab can give instructions on shipment arrangements.

In civilized jurisdictions, those specimens are the property of the

patient and not the medic, not the lab. Sometimes it is necessary to

educate them on that point.

Regards,

Steve J

[Guest guest]

I appreciate the timely responses given to my post.

I'll be reading if anyone else wants to give their views and keep you posted

as to my situation

Thanks

Bill

>

> Addendum to previous message:

>

> There is no test, none, other than biopsy, that is accepted as

> definitive for PCa.

>

> The biopsy specimens should be examined by an expert, other than

> the local guy/gal who examines scores of other specimens.

>

> Here is a list:

>

> Bostwick Laboratories [800] 214-6628

> Dianon Laboratories [800] 328-2666 (select 5 for client services)

> Jon Epstein (s Hopkins) [410] 955-5043 or [410] 955-2162

> Jon Oppenheimer (Tennessee) [800] 881-0470

> Lucia (303)724-3470

>

> This is a " second opinion " and should be covered by

> insurance/Medicare. The cost, last I heard, was about $500. More

> if further tests, which might be prudent, are ordered.

>

> The chosen lab can give instructions on shipment arrangements.

>

> In civilized jurisdictions, those specimens are the property of the

> patient and not the medic, not the lab. Sometimes it is necessary to

> educate them on that point.

>

> Regards,

>

> Steve J

>

[Guest guest]

Hi Bill,

First, I got in touch with Sherri (couldn't find archives) by sending her a

direct email by clicking the little email icon.

OK,

1. Your psa went from 4.7 to 5.2 after a year of vegan diet and not inexpensive

supplements.

2. Follow up of the 5.2 psa showed the MRI was abnormal and the biopsy showed

cancer in 11/12 cores—10 were GS 6, 1 was GS7. Dr Eastham felt you had diffuse

PCa.

3. I can't make sense from your report of Dr Bard's serial ultrasounds—he thinks

" you don't have that much cancer " , but is concerned.

4. You have a strong family history of PCa.

5. Your feeling right now is you don't want to wait.

My situation: high PSA (6.9) led to biopsy which showed benign tissue in

7/10cores; 3 had cancer; in one vol<10%; in one 40%; in one 60%. The cancer was

seen only in right cores. GS= 3+4. Don't know distribution.

My strategy, as I gather more info about risk, is to do A.S. for 6 months while

doing intensive diet/lifestyle changes. If psa indices and possibly repeat

biopsy indicate progression, then I will go for the big guns, and because of my

age, not wait.

I'm a beginner here, so you have to take that into consideration in evaluating

my comments but, if in 6 months my biopsy looked like yours, I would follow

through on my plan.

Best wishes,

Joe

>

> Hello

> I am recently diagnosed from a biopsy with cancer in 11 out of 12

cores, all Gleason 6 except one 7 3+4 volume 30% 8 have volumes below 20% 2

others are at 30% These all being Gleason 6.

> I was recommended because of my age 49 to have open surgery. I'm at Memorial

Sloan Kettering and Doctor is Eastham, a highly recommended nerve sparing

specialist surgeon. I've had two long consultations with him where he explained

his pov and answered all my questions quite candidly. He doesn't think I should

wait too long of course and recommends open because he can feel the tissue and

make better decisions. I have been following the posts on Joe with Gleason 7 and

read a quick email from Sheri? who says her husband was treated alternatively

from Gleason 7 and it has been successful so far. I cant find any of the posts

relating to this in the archives. Maybe someone can point me to them with names

of her husband and her actual name because Sheri or Sherri or her partial email

are yielding nothing in the search.

> I have seen that my Surgeon's advice about surgery has been backed up in

the numerous yahoogroups I've read because of my age and quantity of Cancer.

Does anyone beg to differ? My surgeon claimed I believe 95% great outcome for

patients my age in recovery ( in terms of ED and incontinence, recurrence) Any

other points of view would be most welcome as I have a small window to make this

decision.

> For One Year after a PSA 4.7 and believing Biopsy dangerous reading

various alternative sources, I had been treated by Dr. Bard who used 4D

doppler Ultrasound and his own Prostate supplement pills consisting of

Beta-sitosterol, Querticin, Revestarol , lycopene.

> These pills haven't been cheap. Bard initially found 2 small tumors One

shrunk from 4X5 to 3X3mm the other disappeared and then another appeared in a

different location but had stabilized at 3X2 mm

> My GP did another PSA in November and tried to scare the heck out of me as it

came back 5.2 Bard recommends MRI with his scans which my GP would not

authorize so I went through changing insurance and finallly in late January I

got the MRI which didn't turn out so good showing a dark shadow on one side of

the prostate. Bard rescanned me and said it was possibly erroneous but in

conversation with him, he said I could try a biopsy. Dr. Eastham feels that I

have a diffuse Cancer and feels that the MRI was correct as Color Doppler cannot

see cells before they form tumors. Any comments on the accuracy of Color

Doppler as opposed to Biopsy?

> Bard seems to indicate that I don't have that much Cancer and with his Pills

and scans, most do quite well. Though he is concerned about my age , recommended

maybe a second opinion on the slides and possibly HIFU which I can't afford and

don't believe is good in my case. He has been a responsive MD and I respect that

he indicated a Doctor such as Eastham who does not share his POV. My feeling

right now is after a year of vegan diet and scans, I don't think I want to wait

and Ive discovered that my family is riddled with cousins(plus my Dad) who've

had or have Prostate Cancer.

> All comments welcome. Thanks to all for the opinions and info I've received

in the short time I've been reading this group

> all the best

> Bill

>

[Guest guest]

Hi Bill,

I won't endorse one treatment over another but will add my endorsement of you

getting a solution ot ridding yourself of the cancer versus alternative

treatments to subdue it.

I was diagnosed and had a robotic prostatecomy just after my 57th birthday about

two and a half years ago. I chose that after a lot of reading and getting three

opinions. My wife and I peppered all of the docs with questions before making

this decision.

Remember that no solution is perfect and you have to determine what's best for

you. By the way, do you live in the US? That may mean a lot in terms of how

you go about it.

In my case, the surgery was bearable. There was some pain, soreness for awhile,

and that damned catheter for a week. But all of that passes and you feel fine

physically. I had no incontinence. My surgery was nerve sparing but I still

have ED. ED seems to be totally unpredicatable, some guys get over it fast and

it's permanent for others. Therefore, if you choose surgery (or brachytherapy),

assume that ED will follow and maybe for good.

In my case, I tried pills, VED, and finally injections. My function is

partially back but not enough for sex without help. Injections scare many men

but after I got used to them, they work very well.

Some guys prefer an implant but you do burn all of your other bridges by doing

so.

Best of luck to you. This might be a little discouraging but I'm trying to be

totally realistic here.

Be sure to ask questions here as they come up.

Dwayne

> >

> > Addendum to previous message:

> >

> > There is no test, none, other than biopsy, that is accepted as

> > definitive for PCa.

> >

> > The biopsy specimens should be examined by an expert, other than

> > the local guy/gal who examines scores of other specimens.

> >

> > Here is a list:

> >

> > Bostwick Laboratories [800] 214-6628

> > Dianon Laboratories [800] 328-2666 (select 5 for client services)

> > Jon Epstein (s Hopkins) [410] 955-5043 or [410] 955-2162

> > Jon Oppenheimer (Tennessee) [800] 881-0470

> > Lucia (303)724-3470

> >

> > This is a " second opinion " and should be covered by

> > insurance/Medicare. The cost, last I heard, was about $500. More

> > if further tests, which might be prudent, are ordered.

> >

> > The chosen lab can give instructions on shipment arrangements.

> >

> > In civilized jurisdictions, those specimens are the property of the

> > patient and not the medic, not the lab. Sometimes it is necessary to

> > educate them on that point.

> >

> > Regards,

> >

> > Steve J

> >

>