Is removal of lymph nodes an option?

July 22, 2010

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

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