Re: Re: Is removal of lymph nodes an option?

[Guest guest]

Also, a side effect of lymph node removal is accumulation of lymphatic fluid in the groin area. Because it is rare for lymph node involvement, it may be that avoidence of possible side effects could be a factor.

Louis. . .

To: ProstateCancerSupport Sent: Fri, July 23, 2010 7:24:16 AMSubject: Re: Is removal of lymph nodes an option?

Thanks Louis! I guess that's why it might be a good idea to talk to another surgeon or two. I kind of got the feeling that removal of the lymph nodes was standard procedure, but evidently not.The urologist did say they remove the seminal veiscle, but he did not say they biopsy it during the surgery to determine if the lymph nodes get removed - he just does not remove the lymph nodes because it's an additional surgical procedure.Sandy>> If the surgical treatment option is chosen, biopsy of the lymph node(s) is an > option. If the surgical access method is perineal (behind the rectum), the lymph > node is not taken (this method is considered to be relatively old-fashioned,

but > has healing speed comparable to robotic retropubic surgery). However, with any > of the surgical method, the seminal vesicle is removed and studied for spread. > Generally if the margins are clean, then lymph node removal is not done. If > there is spread past the margins.> > The need or preference for lymph node biopsy is generally up to the urologist or > urological surgeon.> > Louis. . . . > > > > > ________________________________> > To: ProstateCancerSupport > Sent: Thu, July 22, 2010 8:23:59 PM> Subject: Is removal of lymph nodes an option?> > Â > Hi Everyone. My husband was

diagnosed with prostate cancer 2 weeks ago. > Initially, we were pleased with his urologist - he was very kind and informative > when breaking the news to us. We went to see him last night with some additional > questions. We're leaning towards the robotic surgery. Everything I've read says > the lymph nodes should be removed and biopsied, but he says he does not do that. > I'm truly perplexed by this because how will we know whether the cancer has > spread?> > A little history (I don't have the exact numbers in front of me):> > My husbands PSA went from around a 2 - 4 from one year to the next. Then it > jumped from a 4 to 6+. The urologist did not think cancer would cause such a > jump, so he was treated for prostatitis. But after a month on antibiotics, the > PSA did not go down. So a biopsy was done, which showed he had prostate cancer. > Five cores had

definitive signs of cancer, one was suspiscious and one noted > chronic prostatitis. The Gleason was a mix of 6's and 7's, with the first number > being a 3 (I think for all or most). > > > I've made an appointment for another urologist for next Wednesday. I also have > an appointment with a surgical oncologist at Fox Chase, but could not get him in > for another 3 weeks. Of course I'm afraid that we are putting things off too > long - I don't want the cancer to spread, but I know we only have one shot at at > least trying to get this right the first time. > > > Not biopsying the lymph nodes causes me a lot of concern. Is that something that > should always be done? The urologist is saying that the cancer isn't aggressive > enough to warrant the removal of the lymph nodes.> > Any thoughts you can give me on this would be greatly

appreciated.> > Thanks so much!> > Sandy>

[Guest guest]

Sandy, just to clarify, my doctor did not remove all lymph nodes, just a sample to check for signs the cancer had spread.

Mike

Subject: Re: Is removal of lymph nodes an option?To: ProstateCancerSupport Date: Friday, July 23, 2010, 7:13 AM

Hi Mike. I'm glad to hear you are doing well after your surgery. And thank you for the information. As you know, it can be overwhelming trying to sort through everything. I've been checking out some of the websites like Mayo Clinic and Fox Chase. We recently found Yananow - it is a good website and it provides links to so much additional information. I'll definitely check out the Sloan Kettering website.I guess since they can't remove the prostate until 8-10 weeks after the biopsy, we do still have a little time to see doctors. When you had your surgery, did they remove the lymph nodes?Thanks again!Sandy> > > > Subject: Is removal of lymph nodes an option?> To: ProstateCancerSupport > Date: Thursday, July 22, 2010, 8:23 PM> > > Hi Everyone. My husband was diagnosed with prostate cancer 2 weeks ago. Initially, we were pleased with his urologist - he was very kind and informative when breaking the news to us. We went to see him last night with some additional

questions. We're leaning towards the robotic surgery. Everything I've read says the lymph nodes should be removed and biopsied, but he says he does not do that. I'm truly perplexed by this because how will we know whether the cancer has spread?> > A little history (I don't have the exact numbers in front of me):> > My husbands PSA went from around a 2 - 4 from one year to the next. Then it jumped from a 4 to 6+. The urologist did not think cancer would cause such a jump, so he was treated for prostatitis. But after a month on antibiotics, the PSA did not go down. So a biopsy was done, which showed he had prostate cancer. Five cores had definitive signs of cancer, one was suspiscious and one noted chronic prostatitis. The Gleason was a mix of 6's and 7's, with the first number being a 3 (I think for all or most). > > I've made an appointment for another

urologist for next Wednesday. I also have an appointment with a surgical oncologist at Fox Chase, but could not get him in for another 3 weeks. Of course I'm afraid that we are putting things off too long - I don't want the cancer to spread, but I know we only have one shot at at least trying to get this right the first time. > > Not biopsying the lymph nodes causes me a lot of concern. Is that something that should always be done? The urologist is saying that the cancer isn't aggressive enough to warrant the removal of the lymph nodes.> > Any thoughts you can give me on this would be greatly appreciated.> > Thanks so much!> > Sandy> > > > ------------------------------------> > There are just two rules for this group > 1 No Spam > 2 Be kind to others> > Please recognise that Prostate Cancerhas

different guises and needs different levels of treatment and in some cases no treatment at all. Some men even with all options offered chose radical options that you would not choose. We only ask that people be informed before choice is made, we cannot and should not tell other members what to do, other than look at other options. > > Try to delete old material that is no longer applying when clicking reply> Try to change the title if the content requires it

[Guest guest]

Thanks to all for the great posts.  I happen to have the accumulation

of lymphatic fluid in the groin, especially on the right side.  Lymph nodes

were removed from both sides and one was found to cancerous during the

attempted prostate removal.  This prompted the radiation treatments.  Not one

of the three Dr’s I am seeing mentioned this side effect.  My oncologist

suggested it was the result of a hernia.

Dave

 

Also, a side

effect of lymph node removal is accumulation of lymphatic fluid in the groin

area. Because it is rare for lymph node involvement, it may be that avoidence

of possible side effects could be a factor.

Louis. . .

From: s_l_toth

To: ProstateCancerSupport

Sent: Fri, July 23, 2010 7:24:16 AM

Subject: Re: Is removal of lymph nodes an

option?

Thanks Louis! I guess that's why it might be a

good idea to talk to another surgeon or two. I kind of got the feeling that

removal of the lymph nodes was standard procedure, but evidently not.

The urologist did say they remove the seminal veiscle, but he did not say they

biopsy it during the surgery to determine if the lymph nodes get removed - he

just does not remove the lymph nodes because it's an additional surgical

procedure.

Sandy

>

> If the surgical treatment option is chosen, biopsy of the lymph node(s) is

an

> option. If the surgical access method is perineal (behind the rectum), the

lymph

> node is not taken (this method is considered to be relatively

old-fashioned, but

> has healing speed comparable to robotic retropubic surgery). However, with

any

> of the surgical method, the seminal vesicle is removed and studied for

spread.

> Generally if the margins are clean, then lymph node removal is not done.

If

> there is spread past the margins.

>

> The need or preference for lymph node biopsy is generally up to the

urologist or

> urological surgeon.

>

> Louis. . . .

>

>

>

>

> ________________________________

>

> To: ProstateCancerSupport

> Sent: Thu, July 22, 2010 8:23:59 PM

> Subject: Is removal of lymph nodes an option?

>

> Â

> Hi Everyone. My husband was diagnosed with prostate cancer 2 weeks ago.

> Initially, we were pleased with his urologist - he was very kind and

informative

> when breaking the news to us. We went to see him last night with some

additional

> questions. We're leaning towards the robotic surgery. Everything I've read

says

> the lymph nodes should be removed and biopsied, but he says he does not do

that.

> I'm truly perplexed by this because how will we know whether the cancer

has

> spread?

>

> A little history (I don't have the exact numbers in front of me):

>

> My husbands PSA went from around a 2 - 4 from one year to the next. Then

it

> jumped from a 4 to 6+. The urologist did not think cancer would cause such

a

> jump, so he was treated for prostatitis. But after a month on antibiotics,

the

> PSA did not go down. So a biopsy was done, which showed he had prostate

cancer.

> Five cores had definitive signs of cancer, one was suspiscious and one

noted

> chronic prostatitis. The Gleason was a mix of 6's and 7's, with the first

number

> being a 3 (I think for all or most).

>

>

> I've made an appointment for another urologist for next Wednesday. I also

have

> an appointment with a surgical oncologist at Fox Chase, but could not get

him in

> for another 3 weeks. Of course I'm afraid that we are putting things off

too

> long - I don't want the cancer to spread, but I know we only have one shot

at at

> least trying to get this right the first time.

>

>

> Not biopsying the lymph nodes causes me a lot of concern. Is that

something that

> should always be done? The urologist is saying that the cancer isn't

aggressive

> enough to warrant the removal of the lymph nodes.

>

> Any thoughts you can give me on this would be greatly appreciated.

>

> Thanks so much!

>

> Sandy

>

No virus

found in this incoming message.

Checked by AVG - www.avg.com

Version: 9.0.851 / Virus Database: 271.1.1/3023 - Release Date: 07/23/10

01:36:00

[Guest guest]

Thanks to all for the great posts.  I happen to have the accumulation

of lymphatic fluid in the groin, especially on the right side.  Lymph nodes

were removed from both sides and one was found to cancerous during the

attempted prostate removal.  This prompted the radiation treatments.  Not one

of the three Dr’s I am seeing mentioned this side effect.  My oncologist

suggested it was the result of a hernia.

Dave

 

Also, a side

effect of lymph node removal is accumulation of lymphatic fluid in the groin

area. Because it is rare for lymph node involvement, it may be that avoidence

of possible side effects could be a factor.

Louis. . .

From: s_l_toth

To: ProstateCancerSupport

Sent: Fri, July 23, 2010 7:24:16 AM

Subject: Re: Is removal of lymph nodes an

option?

Thanks Louis! I guess that's why it might be a

good idea to talk to another surgeon or two. I kind of got the feeling that

removal of the lymph nodes was standard procedure, but evidently not.

The urologist did say they remove the seminal veiscle, but he did not say they

biopsy it during the surgery to determine if the lymph nodes get removed - he

just does not remove the lymph nodes because it's an additional surgical

procedure.

Sandy

>

> If the surgical treatment option is chosen, biopsy of the lymph node(s) is

an

> option. If the surgical access method is perineal (behind the rectum), the

lymph

> node is not taken (this method is considered to be relatively

old-fashioned, but

> has healing speed comparable to robotic retropubic surgery). However, with

any

> of the surgical method, the seminal vesicle is removed and studied for

spread.

> Generally if the margins are clean, then lymph node removal is not done.

If

> there is spread past the margins.

>

> The need or preference for lymph node biopsy is generally up to the

urologist or

> urological surgeon.

>

> Louis. . . .

>

>

>

>

> ________________________________

>

> To: ProstateCancerSupport

> Sent: Thu, July 22, 2010 8:23:59 PM

> Subject: Is removal of lymph nodes an option?

>

> Â

> Hi Everyone. My husband was diagnosed with prostate cancer 2 weeks ago.

> Initially, we were pleased with his urologist - he was very kind and

informative

> when breaking the news to us. We went to see him last night with some

additional

> questions. We're leaning towards the robotic surgery. Everything I've read

says

> the lymph nodes should be removed and biopsied, but he says he does not do

that.

> I'm truly perplexed by this because how will we know whether the cancer

has

> spread?

>

> A little history (I don't have the exact numbers in front of me):

>

> My husbands PSA went from around a 2 - 4 from one year to the next. Then

it

> jumped from a 4 to 6+. The urologist did not think cancer would cause such

a

> jump, so he was treated for prostatitis. But after a month on antibiotics,

the

> PSA did not go down. So a biopsy was done, which showed he had prostate

cancer.

> Five cores had definitive signs of cancer, one was suspiscious and one

noted

> chronic prostatitis. The Gleason was a mix of 6's and 7's, with the first

number

> being a 3 (I think for all or most).

>

>

> I've made an appointment for another urologist for next Wednesday. I also

have

> an appointment with a surgical oncologist at Fox Chase, but could not get

him in

> for another 3 weeks. Of course I'm afraid that we are putting things off

too

> long - I don't want the cancer to spread, but I know we only have one shot

at at

> least trying to get this right the first time.

>

>

> Not biopsying the lymph nodes causes me a lot of concern. Is that

something that

> should always be done? The urologist is saying that the cancer isn't

aggressive

> enough to warrant the removal of the lymph nodes.

>

> Any thoughts you can give me on this would be greatly appreciated.

>

> Thanks so much!

>

> Sandy

>

No virus

found in this incoming message.

Checked by AVG - www.avg.com

Version: 9.0.851 / Virus Database: 271.1.1/3023 - Release Date: 07/23/10

01:36:00

[Guest guest]

> Thanks Mike!

I'm a bit late, but hope that I might be able to help.

First: Objective, encyclopedic and reliable information is

available on the website of the Prostate Cancer Research

Institute (PCRI) at:

http://www.prostate-cancer.org/pcricms/

Start with " Newly Diagnosed. "

Second: I strongly recommend _A Primer on Prostate Cancer_ 2nd

ed., subtitled " The Empowered Patient's Guide " by medical

oncologist and PCa specialist B. Strum, MD and PCa

warrior Donna Pogliano. It is available from the PCRI website and

the like, as well as Amazon (30+ five-star reviews), &

Noble, and bookstores. A lifesaver, as I very well know.

Third: We are all different, which is why I do not post

information on my particular case. Do not rely upon anecdotes

from other patients, no matter how interesting.

Fourth: Here is a copy of my For the New Folks recommendations:

Welcome to the club no one wants to join.

I have some suggestions that will help to make well-informed

decisions.

Anecdotes contributed by other patients can be interesting, but

should never, ever, be relied upon as authority for one's own

decisions. In other words, what helps me might harm you and vice

versa.

" Find people who are more interested in helping you to learn than

teaching you what *they* think you need to know. "

-- Young, PCa Mentor

Phoenix 5

There is a lot to do.

(1) If applicable, I recommend having the biopsy specimens

examined by

a pathology lab that specializes in prostate cancer (PCa). Everything

that is done from here on depends upon the accuracy of the Gleason

scoring. Here is a list of such labs:

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.

(2) The authoritative website of the Prostate Cancer Research

Institute (PCRI) at http://www.prostate-cancer.org/pcricms/

is an excellent beginning.

See also http://www.prostate-cancer.org/pcricms/node/126 if newly

diagnosed.

Some access to medics who specialize in treatment (tx) of PCa are

listed via

this portal: http://www.prostate-cancer.org/pcricms/node/38

If a particular medic is not suitable due to distance (but there

are men who travel thousands of miles for treatment) or

otherwise, there is no harm and much possible gain in simply

asking for a referral.

There are also men whose primary medic is some distance away, but

who receive their routine treatment (tx) near home.

(3) Personal contact with other patients can be very helpful. Local

chapters of the international support group Us Too can be found via

their website at http://www.ustoo.com/chapter_nearyou.asp

Regards,

Steve J

" Empowerment: taking responsibility for and authority over one's own

outcomes based on education and knowledge of the consequences and

contingencies involved in one's own decisions. This focus

provides the

uplifting energy that can sustain in the face of crisis. "

--Donna Pogliano, co-author of _A Primer on Prostate Cancer_,

subtitled

" The Empowered Patient's Guide. "

>

> Sandy

>

>

> > >

> > >

> > > From: s_l_toth <s_l_toth@>

> > > Subject: Is removal of lymph nodes

> an option?

> > > To: ProstateCancerSupport

> <mailto:ProstateCancerSupport%40yahoogroups.com>

> > > Date: Thursday, July 22, 2010, 8:23 PM

> > >

> > >

> > > Hi Everyone. My husband was diagnosed with prostate cancer

> 2 weeks ago. Initially, we were pleased with his urologist - he

> was very kind and informative when breaking the news to us. We

> went to see him last night with some additional questions. We're

> leaning towards the robotic surgery. Everything I've read says

> the lymph nodes should be removed and biopsied, but he says he

> does not do that. I'm truly perplexed by this because how will

> we know whether the cancer has spread?

> > >

> > > A little history (I don't have the exact numbers in front of

> me):

> > >

> > > My husbands PSA went from around a 2 - 4 from one year to

> the next. Then it jumped from a 4 to 6+. The urologist did not

> think cancer would cause such a jump, so he was treated for

> prostatitis. But after a month on antibiotics, the PSA did not

> go down. So a biopsy was done, which showed he had prostate

> cancer. Five cores had definitive signs of cancer, one was

> suspiscious and one noted chronic prostatitis. The Gleason was a

> mix of 6's and 7's, with the first number being a 3 (I think for

> all or most).

> > >

> > > I've made an appointment for another urologist for next

> Wednesday. I also have an appointment with a surgical oncologist

> at Fox Chase, but could not get him in for another 3 weeks. Of

> course I'm afraid that we are putting things off too long - I

> don't want the cancer to spread, but I know we only have one shot

> at at least trying to get this right the first time.

> > >

> > > Not biopsying the lymph nodes causes me a lot of concern.

> Is that something that should always be done? The urologist is

> saying that the cancer isn't aggressive enough to warrant the

> removal of the lymph nodes.

> > >

> > > Any thoughts you can give me on this would be greatly

> appreciated.

> > >

> > > Thanks so much!

> > >

> > > Sandy

> > >

> > >

> > >

> > > ------------------------------------

> > >

> > > There are just two rules for this group

> > > 1 No Spam

> > > 2 Be kind to others

> > >

> > > Please recognise that Prostate Cancerhas different guises

> and needs different levels of treatment and in some cases no

> treatment at all. Some men even with all options offered chose

> radical options that you would not choose. We only ask that

> people be informed before choice is made, we cannot and should

> not tell other members what to do, other than look at other options.

> > >

> > > Try to delete old material that is no longer applying when

> clicking reply

> > > Try to change the title if the content requires it Yahoo!

> Groups Links

> > >

> >

> >

> >

> >

> > ------------------------------------

> >

> > There are just two rules for this group

> > 1 No Spam

> > 2 Be kind to others

> >

> > Please recognise that Prostate Cancerhas different guises and

> needs different levels of treatment and in some cases no

> treatment at all. Some men even with all options offered chose

> radical options that you would not choose. We only ask that

> people be informed before choice is made, we cannot and should

> not tell other members what to do, other than look at other options.

> >

> > Try to delete old material that is no longer applying when

> clicking reply

> > Try to change the title if the content requires it Yahoo!

> Groups Links

> >

>

>

[Guest guest]

> Thanks Mike!

I'm a bit late, but hope that I might be able to help.

First: Objective, encyclopedic and reliable information is

available on the website of the Prostate Cancer Research

Institute (PCRI) at:

http://www.prostate-cancer.org/pcricms/

Start with " Newly Diagnosed. "

Second: I strongly recommend _A Primer on Prostate Cancer_ 2nd

ed., subtitled " The Empowered Patient's Guide " by medical

oncologist and PCa specialist B. Strum, MD and PCa

warrior Donna Pogliano. It is available from the PCRI website and

the like, as well as Amazon (30+ five-star reviews), &

Noble, and bookstores. A lifesaver, as I very well know.

Third: We are all different, which is why I do not post

information on my particular case. Do not rely upon anecdotes

from other patients, no matter how interesting.

Fourth: Here is a copy of my For the New Folks recommendations:

Welcome to the club no one wants to join.

I have some suggestions that will help to make well-informed

decisions.

Anecdotes contributed by other patients can be interesting, but

should never, ever, be relied upon as authority for one's own

decisions. In other words, what helps me might harm you and vice

versa.

" Find people who are more interested in helping you to learn than

teaching you what *they* think you need to know. "

-- Young, PCa Mentor

Phoenix 5

There is a lot to do.

(1) If applicable, I recommend having the biopsy specimens

examined by

a pathology lab that specializes in prostate cancer (PCa). Everything

that is done from here on depends upon the accuracy of the Gleason

scoring. Here is a list of such labs:

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.

(2) The authoritative website of the Prostate Cancer Research

Institute (PCRI) at http://www.prostate-cancer.org/pcricms/

is an excellent beginning.

See also http://www.prostate-cancer.org/pcricms/node/126 if newly

diagnosed.

Some access to medics who specialize in treatment (tx) of PCa are

listed via

this portal: http://www.prostate-cancer.org/pcricms/node/38

If a particular medic is not suitable due to distance (but there

are men who travel thousands of miles for treatment) or

otherwise, there is no harm and much possible gain in simply

asking for a referral.

There are also men whose primary medic is some distance away, but

who receive their routine treatment (tx) near home.

(3) Personal contact with other patients can be very helpful. Local

chapters of the international support group Us Too can be found via

their website at http://www.ustoo.com/chapter_nearyou.asp

Regards,

Steve J

" Empowerment: taking responsibility for and authority over one's own

outcomes based on education and knowledge of the consequences and

contingencies involved in one's own decisions. This focus

provides the

uplifting energy that can sustain in the face of crisis. "

--Donna Pogliano, co-author of _A Primer on Prostate Cancer_,

subtitled

" The Empowered Patient's Guide. "

>

> Sandy

>

>

> > >

> > >

> > > From: s_l_toth <s_l_toth@>

> > > Subject: Is removal of lymph nodes

> an option?

> > > To: ProstateCancerSupport

> <mailto:ProstateCancerSupport%40yahoogroups.com>

> > > Date: Thursday, July 22, 2010, 8:23 PM

> > >

> > >

> > > Hi Everyone. My husband was diagnosed with prostate cancer

> 2 weeks ago. Initially, we were pleased with his urologist - he

> was very kind and informative when breaking the news to us. We

> went to see him last night with some additional questions. We're

> leaning towards the robotic surgery. Everything I've read says

> the lymph nodes should be removed and biopsied, but he says he

> does not do that. I'm truly perplexed by this because how will

> we know whether the cancer has spread?

> > >

> > > A little history (I don't have the exact numbers in front of

> me):

> > >

> > > My husbands PSA went from around a 2 - 4 from one year to

> the next. Then it jumped from a 4 to 6+. The urologist did not

> think cancer would cause such a jump, so he was treated for

> prostatitis. But after a month on antibiotics, the PSA did not

> go down. So a biopsy was done, which showed he had prostate

> cancer. Five cores had definitive signs of cancer, one was

> suspiscious and one noted chronic prostatitis. The Gleason was a

> mix of 6's and 7's, with the first number being a 3 (I think for

> all or most).

> > >

> > > I've made an appointment for another urologist for next

> Wednesday. I also have an appointment with a surgical oncologist

> at Fox Chase, but could not get him in for another 3 weeks. Of

> course I'm afraid that we are putting things off too long - I

> don't want the cancer to spread, but I know we only have one shot

> at at least trying to get this right the first time.

> > >

> > > Not biopsying the lymph nodes causes me a lot of concern.

> Is that something that should always be done? The urologist is

> saying that the cancer isn't aggressive enough to warrant the

> removal of the lymph nodes.

> > >

> > > Any thoughts you can give me on this would be greatly

> appreciated.

> > >

> > > Thanks so much!

> > >

> > > Sandy

> > >

> > >

> > >

> > > ------------------------------------

> > >

> > > There are just two rules for this group

> > > 1 No Spam

> > > 2 Be kind to others

> > >

> > > Please recognise that Prostate Cancerhas different guises

> and needs different levels of treatment and in some cases no

> treatment at all. Some men even with all options offered chose

> radical options that you would not choose. We only ask that

> people be informed before choice is made, we cannot and should

> not tell other members what to do, other than look at other options.

> > >

> > > Try to delete old material that is no longer applying when

> clicking reply

> > > Try to change the title if the content requires it Yahoo!

> Groups Links

> > >

> >

> >

> >

> >

> > ------------------------------------

> >

> > There are just two rules for this group

> > 1 No Spam

> > 2 Be kind to others

> >

> > Please recognise that Prostate Cancerhas different guises and

> needs different levels of treatment and in some cases no

> treatment at all. Some men even with all options offered chose

> radical options that you would not choose. We only ask that

> people be informed before choice is made, we cannot and should

> not tell other members what to do, other than look at other options.

> >

> > Try to delete old material that is no longer applying when

> clicking reply

> > Try to change the title if the content requires it Yahoo!

> Groups Links

> >

>

>

[Guest guest]

PS, Sandy, I have had no fluid build up in the groin area that others report. Go figure.

Subject: Re: Is removal of lymph nodes an option?To: ProstateCancerSupport Date: Friday, July 23, 2010, 6:15 PM

Thanks Mike!Sandy> > > > > > From: s_l_toth <s_l_toth@>> > Subject: Is removal of lymph nodes an option?> > To: ProstateCancerSupport > > Date: Thursday, July 22, 2010, 8:23 PM> > > > > > Hi Everyone. My husband was diagnosed with prostate cancer 2 weeks ago. Initially, we were pleased with his urologist - he was very kind and informative when breaking the news to us. We

went to see him last night with some additional questions. We're leaning towards the robotic surgery. Everything I've read says the lymph nodes should be removed and biopsied, but he says he does not do that. I'm truly perplexed by this because how will we know whether the cancer has spread?> > > > A little history (I don't have the exact numbers in front of me):> > > > My husbands PSA went from around a 2 - 4 from one year to the next. Then it jumped from a 4 to 6+. The urologist did not think cancer would cause such a jump, so he was treated for prostatitis. But after a month on antibiotics, the PSA did not go down. So a biopsy was done, which showed he had prostate cancer. Five cores had definitive signs of cancer, one was suspiscious and one noted chronic prostatitis. The Gleason was a mix of 6's and 7's, with the first number being a 3 (I think for all or

most). > > > > I've made an appointment for another urologist for next Wednesday. I also have an appointment with a surgical oncologist at Fox Chase, but could not get him in for another 3 weeks. Of course I'm afraid that we are putting things off too long - I don't want the cancer to spread, but I know we only have one shot at at least trying to get this right the first time. > > > > Not biopsying the lymph nodes causes me a lot of concern. Is that something that should always be done? The urologist is saying that the cancer isn't aggressive enough to warrant the removal of the lymph nodes.> > > > Any thoughts you can give me on this would be greatly appreciated.> > > > Thanks so much!> > > > Sandy> > > > > > > > ------------------------------------> > > >

There are just two rules for this group > > 1 No Spam > > 2 Be kind to others> > > > Please recognise that Prostate Cancerhas different guises and needs different levels of treatment and in some cases no treatment at all. Some men even with all options offered chose radical options that you would not choose. We only ask that people be informed before choice is made, we cannot and should not tell other members what to do, other than look at other options. > > > > Try to delete old material that is no longer applying when clicking reply> > Try to change the title if the content requires it

[Guest guest]

PS, Sandy, I have had no fluid build up in the groin area that others report. Go figure.

Subject: Re: Is removal of lymph nodes an option?To: ProstateCancerSupport Date: Friday, July 23, 2010, 6:15 PM

Thanks Mike!Sandy> > > > > > From: s_l_toth <s_l_toth@>> > Subject: Is removal of lymph nodes an option?> > To: ProstateCancerSupport > > Date: Thursday, July 22, 2010, 8:23 PM> > > > > > Hi Everyone. My husband was diagnosed with prostate cancer 2 weeks ago. Initially, we were pleased with his urologist - he was very kind and informative when breaking the news to us. We

went to see him last night with some additional questions. We're leaning towards the robotic surgery. Everything I've read says the lymph nodes should be removed and biopsied, but he says he does not do that. I'm truly perplexed by this because how will we know whether the cancer has spread?> > > > A little history (I don't have the exact numbers in front of me):> > > > My husbands PSA went from around a 2 - 4 from one year to the next. Then it jumped from a 4 to 6+. The urologist did not think cancer would cause such a jump, so he was treated for prostatitis. But after a month on antibiotics, the PSA did not go down. So a biopsy was done, which showed he had prostate cancer. Five cores had definitive signs of cancer, one was suspiscious and one noted chronic prostatitis. The Gleason was a mix of 6's and 7's, with the first number being a 3 (I think for all or

most). > > > > I've made an appointment for another urologist for next Wednesday. I also have an appointment with a surgical oncologist at Fox Chase, but could not get him in for another 3 weeks. Of course I'm afraid that we are putting things off too long - I don't want the cancer to spread, but I know we only have one shot at at least trying to get this right the first time. > > > > Not biopsying the lymph nodes causes me a lot of concern. Is that something that should always be done? The urologist is saying that the cancer isn't aggressive enough to warrant the removal of the lymph nodes.> > > > Any thoughts you can give me on this would be greatly appreciated.> > > > Thanks so much!> > > > Sandy> > > > > > > > ------------------------------------> > > >

There are just two rules for this group > > 1 No Spam > > 2 Be kind to others> > > > Please recognise that Prostate Cancerhas different guises and needs different levels of treatment and in some cases no treatment at all. Some men even with all options offered chose radical options that you would not choose. We only ask that people be informed before choice is made, we cannot and should not tell other members what to do, other than look at other options. > > > > Try to delete old material that is no longer applying when clicking reply> > Try to change the title if the content requires it

[Guest guest]

This syndrome is common and is called lymphedema T NowakTypos by IPhone

Dave,

My friend had breast cancer and had her lymph nodes removed. This caused continuing collection of fluid. She has to wear a pressure bandage on her arm at times to prevent swelling. She has been told that this is normal and will not go away. (She was also told to stay away from wine and alcohol.) No information on this "side effect" was given to her before the surgery.

So, it seems to be a secret about lymph node removal!

Lynn

> >

> > If the surgical treatment option is chosen, biopsy of the lymph node(s) is an

> > option. If the surgical access method is perineal (behind the rectum), the lymph

> > node is not taken (this method is considered to be relatively old-fashioned, but

> > has healing speed comparable to robotic retropubic surgery). However, with any

> > of the surgical method, the seminal vesicle is removed and studied for spread.

> > Generally if the margins are clean, then lymph node removal is not done. If

> > there is spread past the margins.

> >

> > The need or preference for lymph node biopsy is generally up to the urologist or

> > urological surgeon.

> >

> > Louis. . . .

> >

> >

> >

> >

> > ________________________________

> > From: s_l_toth <s_l_toth@>

> > To: ProstateCancerSupport <mailto:ProstateCancerSupport%40yahoogroups.com>

> > Sent: Thu, July 22, 2010 8:23:59 PM

> > Subject: Is removal of lymph nodes an option?

> >

> > Â

> > Hi Everyone. My husband was diagnosed with prostate cancer 2 weeks ago.

> > Initially, we were pleased with his urologist - he was very kind and informative

> > when breaking the news to us. We went to see him last night with some additional

> > questions. We're leaning towards the robotic surgery. Everything I've read says

> > the lymph nodes should be removed and biopsied, but he says he does not do that.

> > I'm truly perplexed by this because how will we know whether the cancer has

> > spread?

> >

> > A little history (I don't have the exact numbers in front of me):

> >

> > My husbands PSA went from around a 2 - 4 from one year to the next. Then it

> > jumped from a 4 to 6+. The urologist did not think cancer would cause such a

> > jump, so he was treated for prostatitis. But after a month on antibiotics, the

> > PSA did not go down. So a biopsy was done, which showed he had prostate cancer.

> > Five cores had definitive signs of cancer, one was suspiscious and one noted

> > chronic prostatitis. The Gleason was a mix of 6's and 7's, with the first number

> > being a 3 (I think for all or most).

> >

> >

> > I've made an appointment for another urologist for next Wednesday. I also have

> > an appointment with a surgical oncologist at Fox Chase, but could not get him in

> > for another 3 weeks. Of course I'm afraid that we are putting things off too

> > long - I don't want the cancer to spread, but I know we only have one shot at at

> > least trying to get this right the first time.

> >

> >

> > Not biopsying the lymph nodes causes me a lot of concern. Is that something that

> > should always be done? The urologist is saying that the cancer isn't aggressive

> > enough to warrant the removal of the lymph nodes.

> >

> > Any thoughts you can give me on this would be greatly appreciated.

> >

> > Thanks so much!

> >

> > Sandy

> >

>

>

>

> No virus found in this incoming message.

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>

[Guest guest]

HI..and I did the same with the research..and ended up with the hormone and external radiation. So far so good with it..and as of now..would certainly do the same procedure. No invasive

surgery..no catherization bags...or chances of infection in there. I had to go to the hospital for

28 days in a row...but not a problem either. You just got used to making it a stop for the day.

Aside from the annoying hot flashes from the hormone shot, and then the excesive having to pee for a couple weeks after...eveything turning out good. Just finished the radiation..and now

will have the first psa test after in September. Will assess ..and MAYBE have to have one

more Lupron shot. HOPE NOT..but that is not difficult to handle .

Subject: Re: Is removal of lymph nodes an option?To: ProstateCancerSupport Date: Sunday, July 25, 2010, 3:23 PM

Hi Larry. Thank you for sharing that information. I wish you the best with your treatment.One of the most common things I've seen is that the patient should do a lot of research. The first urologist/surgeon we saw seemed like he did not encourage us to do our own research. Although he was supportive of us getting a 2nd opinion when he sensed we weren't satisified with his reponses. When we first got the news, we wanted to rush headlong into just having the surgery done. We've calmed down enough to at least try to gather more information and hopefully make the best decision regarding tretament.Thanks again!Sandy>> Removing the

lymph nodes is an option of the surgeon. Typically they don't> remove all of them since it can be difficult to find all of them. More usual> is they will take out a couple and send them to pathology with the rest of> the tissue removed. The lymph node biopsy typically will add on about 30> minutes to the surgery. At least for robotic surgery. Most surgeon won't> do this unless there is a suspicion that the cancer has spread outside the> prostate envelope. From the sounds of your husband's situation you have> caught the cancer in the early stages and a lymp node biopsy may not be> warranted. (FYI I am not a medical doctor).> > > > Prostate cancer is typically a slow growing cancer and you have caught it> early enough you do have some time to explore your options. Do your> research (like you are doing now) and get your second and third opinions.> Make

sure you talk with a Urologist (surgery), Oncologist (radiation) and> Medical Oncologist (Chemo and others).> > > > I did have surgery and did have my lymph nodes biopsied but I have a much> more aggressive and advanced cancer (Gleason 9 with perineural invasion and> all samples showed signs of cancer), I did have positive margins outside> the prostate but my lymph nodes came back as negative. I am now going> through radiation to treat the cancer in the pelvic area. During> discussions with my Oncologist we talked about radiating my lymph nodes.> The biggest concern was; is treating the lymph nodes worth the side effects> from the radiation. Comparing my case with your husband's doesn't surprise> me the doctors don't want to effect the lymph nodes yet.> > > > PS I read in an older article on prostate cancer they used to biopsy

the> lymph nodes first before beginning the prostectomy. The thought was if the> lymph nodes were invaded then surgery wasn't going to help. I think> advances in PC detection has made this more obsolete.> > > > _____ > > From: ProstateCancerSupport > [mailto:ProstateCancerSupport ] On Behalf Of s_l_toth> Sent: Thursday, July 22, 2010 8:24 PM> To: ProstateCancerSupport > Subject: Is removal of lymph nodes an option?> > > > > > Hi Everyone. My husband was diagnosed with prostate cancer 2 weeks ago.> Initially, we were pleased with his urologist - he was very kind and> informative when breaking the news to us. We went to see him last night with> some additional questions. We're leaning towards the robotic surgery.> Everything I've read says the lymph nodes should be removed and biopsied,> but he says he does not do that. I'm truly perplexed by this because how> will we know whether the cancer has spread?> > A little history (I don't have the exact numbers in front of me):> > My husbands PSA went from around a 2 - 4 from one year to the next. Then it> jumped from a 4 to 6+. The

urologist did not think cancer would cause such a> jump, so he was treated for prostatitis. But after a month on antibiotics,> the PSA did not go down. So a biopsy was done, which showed he had prostate> cancer. Five cores had definitive signs of cancer, one was suspiscious and> one noted chronic prostatitis. The Gleason was a mix of 6's and 7's, with> the first number being a 3 (I think for all or most). > > I've made an appointment for another urologist for next Wednesday. I also> have an appointment with a surgical oncologist at Fox Chase, but could not> get him in for another 3 weeks. Of course I'm afraid that we are putting> things off too long - I don't want the cancer to spread, but I know we only> have one shot at at least trying to get this right the first time. > > Not biopsying the lymph nodes causes me a lot of concern. Is that something> that

should always be done? The urologist is saying that the cancer isn't> aggressive enough to warrant the removal of the lymph nodes.> > Any thoughts you can give me on this would be greatly appreciated.> > Thanks so much!> > Sandy>

[Guest guest]

Sandy,

I would expect that Fox Chase has a pathology department that can evaluate

the slides. I suggest you call the department where your appointment is

set and talk to them about it. It would be useful if the doctor you are

meeting with has already got the pathology report when he meets with you.

Best of luck.

--

Alan Meyer

ameyer2@...

Is removal of lymph nodes

> > > an option?

> > > > > To: ProstateCancerSupport

> > > <mailto:ProstateCancerSupport%40yahoogroups.com>

> > > > > Date: Thursday, July 22, 2010, 8:23 PM

> > > > >

> > > > >

> > > > > Hi Everyone. My husband was diagnosed with prostate cancer

> > > 2 weeks ago. Initially, we were pleased with his urologist - he

> > > was very kind and informative when breaking the news to us. We

> > > went to see him last night with some additional questions. We're

> > > leaning towards the robotic surgery. Everything I've read says

> > > the lymph nodes should be removed and biopsied, but he says he

> > > does not do that. I'm truly perplexed by this because how will

> > > we know whether the cancer has spread?

> > > > >

> > > > > A little history (I don't have the exact numbers in front of

> > > me):

> > > > >

> > > > > My husbands PSA went from around a 2 - 4 from one year to

> > > the next. Then it jumped from a 4 to 6+. The urologist did not

> > > think cancer would cause such a jump, so he was treated for

> > > prostatitis. But after a month on antibiotics, the PSA did not

> > > go down. So a biopsy was done, which showed he had prostate

> > > cancer. Five cores had definitive signs of cancer, one was

> > > suspiscious and one noted chronic prostatitis. The Gleason was a

> > > mix of 6's and 7's, with the first number being a 3 (I think for

> > > all or most).

> > > > >

> > > > > I've made an appointment for another urologist for next

> > > Wednesday. I also have an appointment with a surgical oncologist

> > > at Fox Chase, but could not get him in for another 3 weeks. Of

> > > course I'm afraid that we are putting things off too long - I

> > > don't want the cancer to spread, but I know we only have one shot

> > > at at least trying to get this right the first time.

> > > > >

> > > > > Not biopsying the lymph nodes causes me a lot of concern.

> > > Is that something that should always be done? The urologist is

> > > saying that the cancer isn't aggressive enough to warrant the

> > > removal of the lymph nodes.

> > > > >

> > > > > Any thoughts you can give me on this would be greatly

> > > appreciated.

> > > > >

> > > > > Thanks so much!

> > > > >

> > > > > Sandy

> > > > >

> > > > >

> > > > >

> > > > > ------------------------------------

> > > > >

> > > > > There are just two rules for this group

> > > > > 1 No Spam

> > > > > 2 Be kind to others

> > > > >

> > > > > Please recognise that Prostate Cancerhas different guises

> > > and needs different levels of treatment and in some cases no

> > > treatment at all. Some men even with all options offered chose

> > > radical options that you would not choose. We only ask that

> > > people be informed before choice is made, we cannot and should

> > > not tell other members what to do, other than look at other options.

> > > > >

> > > > > Try to delete old material that is no longer applying when

> > > clicking reply

> > > > > Try to change the title if the content requires it Yahoo!

> > > Groups Links

> > > > >

> > > >

> > > >

> > > >

> > > >

> > > > ------------------------------------

> > > >

> > > > There are just two rules for this group

> > > > 1 No Spam

> > > > 2 Be kind to others

> > > >

> > > > Please recognise that Prostate Cancerhas different guises and

> > > needs different levels of treatment and in some cases no

> > > treatment at all. Some men even with all options offered chose

> > > radical options that you would not choose. We only ask that

> > > people be informed before choice is made, we cannot and should

> > > not tell other members what to do, other than look at other options.

> > > >

> > > > Try to delete old material that is no longer applying when

> > > clicking reply

> > > > Try to change the title if the content requires it Yahoo!

> > > Groups Links

> > > >

> > >

> > >

> >

>

>

>

>

> ------------------------------------

>

> There are just two rules for this group

> 1 No Spam

> 2 Be kind to others

>

> Please recognise that Prostate Cancerhas different guises and needs different

>levels of treatment and in some cases no treatment at all. Some men even with

>all options offered chose radical options that you would not choose. We only

>ask that people be informed before choice is made, we cannot and should not

>tell other members what to do, other than look at other options.

>

>

> Try to delete old material that is no longer applying when clicking reply

> Try to change the title if the content requires it Yahoo! Groups Links

>

>

>

>

[Guest guest]

We ended up going with a 3 opinions after

initial diagnosis and took those opinions to my GP and a couple of other knowledgeable

people before making decisions on which treatments and doctor(s) to go with.

My wife still confers with some of the initial doctors about their opinions as

we continue on our journey. When choosing a therapy path make sure you are not

just talking to doctors waiting for one of them to say something you want to

hear. What you want is to return to the best health with side effects that you

are willing to live with. I am also surprised at how certain side effects that were

a big issue are not so important now.

With my aggressive cancer like I almost

jumped at the surgery. I then calmed down and took the time to research and

get other opinions so I knew where I was going and what I had to do.

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

Sent: Sunday, July 25, 2010 11:23

AM

To: ProstateCancerSupport

Subject:

Re: Is removal of lymph nodes an option?

Hi Larry. Thank you for sharing that information. I

wish you the best with your treatment.

One of the most common things I've seen is that the patient should do a lot of

research. The first urologist/surgeon we saw seemed like he did not encourage

us to do our own research. Although he was supportive of us getting a 2nd

opinion when he sensed we weren't satisified with his reponses.

When we first got the news, we wanted to rush headlong into just having the

surgery done. We've calmed down enough to at least try to gather more

information and hopefully make the best decision regarding tretament.

Thanks again!

Sandy

[Guest guest]

s_l_toth wrote:

> Hi Alan. I have to say, so far I am very happy with Fox Chase.

> No sooner had the appointment been clarified did I receive a

> call asking to have the slides sent to their pathology

> department. In addition, they wanted CDs of the actual bone

> scan and CT scan as well as any other blood tests, reports that

> we had. I like that they will have all this information for

> review before our appointment.

The National Cancer Institute has designated a total of 40

hospitals in the United States as " Comprehensive Cancer Centers " .

That's NCI's highest rating for a hospital for cancer treatment.

With only 40 in the country, many states don't have even one.

Pennsylvania has three.

I think there are a lot of hospitals that aren't on NCI's list

that still give excellent care, but I should think you can't

really do any better than Fox Chase. It's rated right up there

with MD , Sloan-Kettering, s Hopkins, the Mayo

Clinic, etc.

You should be in good hands there. Best of luck with them.

Alan