Re: Just curious as to what to do

[Guest guest]

Lots of people say we have time. For my part, as one who had capsular penatration I prefer to get it out as quickly as I could. That is my opinion, I am not a doctor.

Harry

Subject: Just curious as to what to doTo: ProstateCancerSupport Date: Sunday, September 5, 2010, 2:57 PM

Been diagnosed with prostate cancer. 3 positive samples 2 with gleason score 7. PSA 6.9. Of course the doctors want to do treatment and best option I've seen is the robotic surgery. Honestly, I have no issues right now with anything, no trouble urinating, no trouble with erections. I had planned a trip overseas for November, but doctors want surgery as soon as possible, schedule for Sept. 21. I'd like to wait til January.I just don't like the quality of life after surgery. I feel I'm being pressured into quick treatment. Love to hear from you people what u think.

[Guest guest]

If the Gleason score was 6 or below, then a decision would be far less urgent. However, I recall that 7 or above is considered to be signs of possible aggressive cancer. You will want to get a second opinion of the biopsy. There is a listing in the files section of some recommended pathology labs for that second opinion. Depending on your insurance and financial situation, you may want to look into proton beam therapy. The has been a recent paper in which carbon dioxide laser to perform the separation of the nerve tissue from the prostate in an effort to reduce erectile damage. Louis. . . . To: ProstateCancerSupport Sent: Sun, September 5, 2010 2:57:55 PMSubject: Just curious as to what to do

Been diagnosed with prostate cancer. 3 positive samples 2 with gleason score 7. PSA 6.9.

Of course the doctors want to do treatment and best option I've seen is the robotic surgery. Honestly, I have no issues right now with anything, no trouble urinating, no trouble with erections.

I had planned a trip overseas for November, but doctors want surgery as soon as possible, schedule for Sept. 21. I'd like to wait til January.

I just don't like the quality of life after surgery. I feel I'm being pressured into quick treatment. Love to hear from you people what u think.

[Guest guest]

If the Gleason score was 6 or below, then a decision would be far less urgent. However, I recall that 7 or above is considered to be signs of possible aggressive cancer. You will want to get a second opinion of the biopsy. There is a listing in the files section of some recommended pathology labs for that second opinion. Depending on your insurance and financial situation, you may want to look into proton beam therapy. The has been a recent paper in which carbon dioxide laser to perform the separation of the nerve tissue from the prostate in an effort to reduce erectile damage. Louis. . . . To: ProstateCancerSupport Sent: Sun, September 5, 2010 2:57:55 PMSubject: Just curious as to what to do

Been diagnosed with prostate cancer. 3 positive samples 2 with gleason score 7. PSA 6.9.

Of course the doctors want to do treatment and best option I've seen is the robotic surgery. Honestly, I have no issues right now with anything, no trouble urinating, no trouble with erections.

I had planned a trip overseas for November, but doctors want surgery as soon as possible, schedule for Sept. 21. I'd like to wait til January.

I just don't like the quality of life after surgery. I feel I'm being pressured into quick treatment. Love to hear from you people what u think.

[Guest guest]

>

>

> If the Gleason score was 6 or below, then a decision would be far

> less urgent. However, I recall that 7 or above is considered to

> be signs of possible aggressive cancer. You will want to get a

> second opinion of the biopsy. There is a listing in the files

> section of some recommended pathology labs for that second

> opinion.

Here is information re: second opinions:

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.

Regards,

Steve J

[Guest guest]

Hi

You don't give your age.

Have you had PSA tests before? Has it changed much?

Just curious as to what to do

Been diagnosed with prostate cancer. 3 positive samples 2 with gleason score 7. PSA 6.9. Of course the doctors want to do treatment and best option I've seen is the robotic surgery. Honestly, I have no issues right now with anything, no trouble urinating, no trouble with erections. I had planned a trip overseas for November, but doctors want surgery as soon as possible, schedule for Sept. 21. I'd like to wait til January.I just don't like the quality of life after surgery. I feel I'm being pressured into quick treatment. Love to hear from you people what u think.

[Guest guest]

, my experience ( and that of many of the 950+ men who

have contributed their experiences on my website YANA – You Are Not Alone

Now at http://www.yananow.net ) is that the

pressure to ‘do something’ immediately is not often in the best

interests of the man who has been diagnosed with prostate cancer. In my

opinion, given the wide variety of options available, it is in your best

interests to gain a good understanding of our diagnosis, how it may affect your

future and what you would feel most comfortable with as a treatment option. That

may well be surgery after you have explored these options, but it may well be

something else - it may even be my choice of Active Surveillance.

Can I suggest as a first step that you visit my site at YANA – You Are Not Alone Now at http://www.yananow.net

which was set up for newly diagnosed people. The first section gives some basic

information in plain language with links to more complex and technical sites. There

is one link to the NCCN Guidelines at http://www.nccn.org/professionals/physician_gls/f_guidelines.asp

- downloading those guidelines will give you a good decision path. Many people

have found that the booklet “A

Strange Place” has been helpful –

that’s at http://www.yananow.net/StrangePlace/index.html

The second section of the site is where men are invited to tell

their prostate cancer stories and how they arrived at their decisions regarding

treatment. Many people have mailed to say how useful they have found this,

especially because most of the men are happy to respond to specific questions.

The section of the site can be found by clicking the link labelled Experiences

or going to http://www.yananow.net/Experiences.html

There is a section dealing with the management of the

disease, including some dietary hints at http://www.yananow.net/MyersManagement.htm

there is also a section suggesting the questions that you should seek answers

to before making any treatment decision at http://www.yananow.net/questions.htm

None of us can tell you what to do or indeed what is best

for your particular situation, but I can say that if I were in your position I

would not have surgery next month and I would have my overseas trip. But then I

love to travel – and have done so extensively since my diagnosis 14 years

ago. You can consider having your surgery in January, if surgery is still your

choice without any real increase in risk, according to many studies.

All the best

Terry Herbert

I have no medical

qualifications but I was diagnosed in ‘96: and have learned a bit since

then.

My sites are at www.yananow.net and www.prostatecancerwatchfulwaiting.co.za

Dr

“Snuffy” Myers : " As a physician, I am painfully aware that

most of the decisions we make with regard to prostate cancer are made with inadequate

data "

From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of robertw1962

Sent: Monday, 6 September 2010

4:58 AM

To: ProstateCancerSupport

Subject:

Just curious as to what to do

Been diagnosed with prostate cancer. 3 positive

samples 2 with gleason score 7. PSA 6.9.

Of course the doctors want to do treatment and best option I've seen is the

robotic surgery. Honestly, I have no issues right now with anything, no trouble

urinating, no trouble with erections.

I had planned a trip overseas for November, but doctors want surgery as soon as

possible, schedule for Sept. 21. I'd like to wait til January.

I just don't like the quality of life after surgery. I feel I'm being pressured

into quick treatment. Love to hear from you people what u think.

[Guest guest]

Did

you really give seeds enough consideration ? Did you research the problems that

surgery could cause ? Do you know the success percentage ?

I

am sure some of our group are qualified to give you some advice.

Please

state your age as requested it is important ?

I

have similar numbers and I opted for Watch and Wait after seeing three

Urologists and four oncologists consider doing research and listen and

Realize

you are in contact with guys who have had to deal with your problems

Best

Dick

From:

ProstateCancerSupport

[mailto:ProstateCancerSupport ] On Behalf Of

Metcalf

Sent: Sunday, September 05, 2010 5:48 PM

To: ProstateCancerSupport

Subject: Re: Just curious as to what to do

Hi

You don't give your age.

Have you had PSA tests

before? Has it changed much?

-----

Original Message -----

From: robertw1962

To: ProstateCancerSupport

Sent: Sunday, September

05, 2010 7:57 PM

Subject:

Just curious as to what to do

Been diagnosed with prostate cancer. 3 positive

samples 2 with gleason score 7. PSA 6.9.

Of course the doctors want to do treatment and best option I've seen is the

robotic surgery. Honestly, I have no issues right now with anything, no trouble

urinating, no trouble with erections.

I had planned a trip overseas for November, but doctors want surgery as soon as

possible, schedule for Sept. 21. I'd like to wait til January.

I just don't like the quality of life after surgery. I feel I'm being pressured

into quick treatment. Love to hear from you people what u think.

[Guest guest]

Your numbers and score do not shout

urgency loud enough to just jump into surgery. My scores were much higher

than yours and I still took the time to get second and third opinions. Make

sure you don’t just go to other Urologists; see one or two Oncologists

too. Also spend some time educating yourself with all of the options

before moving forward with your choice. Then make your decision. In the

FWIW department, worst case you get a hormone shot (Lupron) that will slow the

cancer growth until you get back from your trip.

From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of robertw1962

Sent: Sunday, September 05, 2010

2:58 PM

To: ProstateCancerSupport

Subject:

Just curious as to what to do

Been diagnosed with prostate cancer. 3 positive

samples 2 with gleason score 7. PSA 6.9.

Of course the doctors want to do treatment and best option I've seen is the

robotic surgery. Honestly, I have no issues right now with anything, no trouble

urinating, no trouble with erections.

I had planned a trip overseas for November, but doctors want surgery as soon as

possible, schedule for Sept. 21. I'd like to wait til January.

I just don't like the quality of life after surgery. I feel I'm being pressured

into quick treatment. Love to hear from you people what u think.

[Guest guest]

Larry, Very good post & I agree 100%-----

Subject: RE: Just curious as to what to doTo: ProstateCancerSupport Date: Sunday, September 5, 2010, 7:38 PM

Your numbers and score do not shout urgency loud enough to just jump into surgery. My scores were much higher than yours and I still took the time to get second and third opinions. Make sure you don’t just go to other Urologists; see one or two Oncologists too. Also spend some time educating yourself with all of the options before moving forward with your choice. Then make your decision. In the FWIW department, worst case you get a hormone shot (Lupron) that will slow the cancer growth until you get back from your trip.

From: ProstateCancerSupport [mailto: ProstateCancerSupport ] On Behalf Of robertw1962Sent: Sunday, September 05, 2010 2:58 PMTo: ProstateCancerSupport Subject: Just curious as to what to do

Been diagnosed with prostate cancer. 3 positive samples 2 with gleason score 7. PSA 6.9. Of course the doctors want to do treatment and best option I've seen is the robotic surgery. Honestly, I have no issues right now with anything, no trouble urinating, no trouble with erections. I had planned a trip overseas for November, but doctors want surgery as soon as possible, schedule for Sept. 21. I'd like to wait til January.I just don't like the quality of life after surgery. I feel I'm being pressured into quick treatment. Love to hear from you people what u think.

[Guest guest]

,

I was dx 3 yr ago. PSA 20 Gleason 7. In other word,

intermediate stage and fixing to be advanced.

I read, read and then read some more. There are several good

books on PCa. I finally settled on Proton treatment. Now at 3

years psa is down to less than .o1. From the Proton treatments I

have no side effects or after effects. I did have Lupron and

Taxatere during the Proton treatment. For me and many others

Protons is the way to go.. In most cases Medicare and insurance

will cover most all cost. d.

Been diagnosed with prostate cancer. 3 positive samples 2

with gleason score 7. PSA 6.9.

Of course the doctors want to do treatment and best option

I've seen is the robotic surgery. Honestly, I have no

issues right now with anything, no trouble urinating, no

trouble with erections.

I had planned a trip overseas for November, but doctors

want surgery as soon as possible, schedule for Sept. 21.

I'd like to wait til January.

I just don't like the quality of life after surgery. I

feel I'm being pressured into quick treatment. Love to

hear from you people what u think.

[Guest guest]

,

I agree with the others who have advised you not to rush. Get more opinions. When I was diagnosed with Gleason 7 (3+4), seven samples out of 12 positive, and two more inconclusive, my urologist told me to take my time, learn all I could, get opinions on other treatments than surgery. He said I could delay the decision for a time, but he wouldn't recommend waiting 6 months. I did as he suggested, waited two months and decided on robotic surgery. I suspect you could wait until after your trip. A friend, with almost identical PSA to you and the same number of samples positive, was advised by his uro at Sloan Kettering to wait and watch. After a second biopsy after 3 months showed the number of cancerous samples had doubled, and the new samples were more aggressive, he decided on surgery, and is progressing well. His pathology report showed no sign the cancer had spread

outside the prostate. You can't make a decision based on anecdotes such as this. I suggest it only to encourage you not to make a decision too quickly.

Mike

Subject: Just curious as to what to doTo: ProstateCancerSupport Date: Sunday, September 5, 2010, 2:57 PM

Been diagnosed with prostate cancer. 3 positive samples 2 with gleason score 7. PSA 6.9. Of course the doctors want to do treatment and best option I've seen is the robotic surgery. Honestly, I have no issues right now with anything, no trouble urinating, no trouble with erections. I had planned a trip overseas for November, but doctors want surgery as soon as possible, schedule for Sept. 21. I'd like to wait til January.I just don't like the quality of life after surgery. I feel I'm being pressured into quick treatment. Love to hear from you people what u think. ------------------------------------There are just two rules for this group 1 No Spam 2 Be kind to othersPlease 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 replyTry to change the title if the content requires it

[Guest guest]

>

> Been diagnosed with prostate cancer. 3 positive samples 2 with gleason score

7. PSA 6.9.

>

> Of course the doctors want to do treatment and best option I've seen is the

robotic surgery. Honestly, I have no issues right now with anything, no trouble

urinating, no trouble with erections.

>

> I had planned a trip overseas for November, but doctors want surgery as soon

as possible, schedule for Sept. 21. I'd like to wait til January.

>

> I just don't like the quality of life after surgery. I feel I'm being

pressured into quick treatment. Love to hear from you people what u think.

>

Sorry for the lack of information. My age is 48. Never had a PSA test done

before so no background data. My bone scan is clear. Of the samples, one gleason

7 was 60% infected, other 7 was 70%. Gleason 6 was 30%. Sample was sent to

another lab.

[Guest guest]

> >

> > Been diagnosed with prostate cancer. 3 positive samples 2 with gleason score

7. PSA 6.9.

> >

> > Of course the doctors want to do treatment and best option I've seen is the

robotic surgery. Honestly, I have no issues right now with anything, no trouble

urinating, no trouble with erections.

> >

> > I had planned a trip overseas for November, but doctors want surgery as soon

as possible, schedule for Sept. 21. I'd like to wait til January.

> >

> > I just don't like the quality of life after surgery. I feel I'm being

pressured into quick treatment. Love to hear from you people what u think.

> >

> Sorry for the lack of information. My age is 48. Never had a PSA test done

before so no background data. My bone scan is clear. Of the samples, one gleason

7 was 60% infected, other 7 was 70%. Gleason 6 was 30%. Sample was sent to

another lab.

>

Further side note. I asked about delaying until January and was told it wasn't a

good idea. I also asked how long I would live if I didn't get treatment and was

told 5-8 years. I did look at radiation treatment, seeds, etc, but doctors think

surgery better option because you can get radiation should there be a

reoccurance. The more I read on this, the more I realize that this is going way

too fast.

[Guest guest]

The major problem with radiation are these:1. Should reoccurnce happens, salvage surgery is so difficult that few surgeons will do it.2. Side effects are less than after with surgery initially, but increases and are permanent like ED and urinary issues. Proton beam treatment is the very major exception and should be sought out as an alternate to surgery.To:

ProstateCancerSupport Sent: Mon, September 6, 2010 11:51:37 AMSubject: Re: Just curious as to what to do

> >

> > Been diagnosed with prostate cancer. 3 positive samples 2 with gleason score 7. PSA 6.9.

> >

> > Of course the doctors want to do treatment and best option I've seen is the robotic surgery. Honestly, I have no issues right now with anything, no trouble urinating, no trouble with erections.

> >

> > I had planned a trip overseas for November, but doctors want surgery as soon as possible, schedule for Sept. 21. I'd like to wait til January.

> >

> > I just don't like the quality of life after surgery. I feel I'm being pressured into quick treatment. Love to hear from you people what u think.

> >

> Sorry for the lack of information. My age is 48. Never had a PSA test done before so no background data. My bone scan is clear. Of the samples, one gleason 7 was 60% infected, other 7 was 70%. Gleason 6 was 30%. Sample was sent to another lab.

>

Further side note. I asked about delaying until January and was told it wasn't a good idea. I also asked how long I would live if I didn't get treatment and was told 5-8 years. I did look at radiation treatment, seeds, etc, but doctors think surgery better option because you can get radiation should there be a reoccurance. The more I read on this, the more I realize that this is going way too fast.

[Guest guest]

,

I suspect the reason the doctor urged you not to delay too long is your age. There is some evidence that the younger the age, the more agressive the cancer. Before you decide, though, talk to an oncologist who specializes in prostate cancer. Check out the great information on the Prostate Cancer Research Institute website, and also the Memorial Sloan Kettering website. I'm sure others can suggest even more sources of great information.

Mike

Subject: Re: Just curious as to what to doTo: ProstateCancerSupport Date: Monday, September 6, 2010, 11:51 AM

> >> > Been diagnosed with prostate cancer. 3 positive samples 2 with gleason score 7. PSA 6.9. > > > > Of course the doctors want to do treatment and best option I've seen is the robotic surgery. Honestly, I have no issues right now with anything, no trouble urinating, no trouble with erections. > > > > I had planned a trip overseas for November, but doctors

want surgery as soon as possible, schedule for Sept. 21. I'd like to wait til January.> > > > I just don't like the quality of life after surgery. I feel I'm being pressured into quick treatment. Love to hear from you people what u think.> >> Sorry for the lack of information. My age is 48. Never had a PSA test done before so no background data. My bone scan is clear. Of the samples, one gleason 7 was 60% infected, other 7 was 70%. Gleason 6 was 30%. Sample was sent to another lab.>Further side note. I asked about delaying until January and was told it wasn't a good idea. I also asked how long I would live if I didn't get treatment and was told 5-8 years. I did look at radiation treatment, seeds, etc, but doctors think surgery better option because you can get radiation should there be a reoccurance. The more I read on this, the more I realize that this is going way too fast.

------------------------------------There are just two rules for this group 1 No Spam 2 Be kind to othersPlease 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 replyTry to change the title if the content requires it

[Guest guest]

Though you are probably a candidate for treatment and presumably the Doctors

have a rationale for " rushing " , I would ask them to tell you VERY CLEARLY what

the urgency (no pun intended) is?

Is it for valid Clinical reasons or is it a way to amortize the cost of their

DaVinci Robot?

Seriously, when I was first diagnosed 3+ years ago a read voraciously and saw

how complex a field this is and the lack of unanimity even among experts on many

issues.

Moreover, it became quite clear to me early on that there is massive

overtreatment or unnecessary treatment with Prostate Cancer. I believe that

this will morph into a scandal if it already isn't. A recent article in the

N.Y. Times really highlighted this problem with one expert saying that of the

50,000 procedures performed last year about 80% were not necessary.

Caveat emptor.

Sy

>

> Been diagnosed with prostate cancer. 3 positive samples 2 with gleason score

7. PSA 6.9.

>

> Of course the doctors want to do treatment and best option I've seen is the

robotic surgery. Honestly, I have no issues right now with anything, no trouble

urinating, no trouble with erections.

>

> I had planned a trip overseas for November, but doctors want surgery as soon

as possible, schedule for Sept. 21. I'd like to wait til January.

>

> I just don't like the quality of life after surgery. I feel I'm being

pressured into quick treatment. Love to hear from you people what u think.

>

[Guest guest]

, you say

<snip> I asked about delaying

until January and was told it wasn't a good idea. <snip> I was

diagnosed in August 1996. I spent a good deal of time reading, talking etc and

finally saw an expert urologist surgeon in March 1997 in the US. He was

shocked that I had not had surgery and suggested that he could rectify this the

following week, failing which I would undoubtedly die of the disease. I haven’t

yet done so and I may at some time in the future, but either way it is 14

years. And I know that is only a personal example and one cannot rely on

examples of one – but see next para.

<snip> I also asked how long I

would live if I didn't get treatment and was told 5-8 years. <snip>

That is an improvement (marginal) on my forecast of 3 – 5 years. I

didn’t know enough to ask for the data that demonstrated this shortened

span, but you might like to ask for it – and perhaps read The Elephant In

The Room at http://www.yananow.net/elephant.htm

Bearing in mind that one study shows a 100% disease specific survival at

10 years for early stage disease and a number of others show disease specific

mortality rates of les than 5% at 10 years, your doctor should tell you why he

thinks that you fall into a different category.

<snip> I did look at radiation

treatment, seeds, etc, but doctors think surgery better option because you can

get radiation should there be a reoccurance. <snip> I think you’ll

find that it is mainly surgeons that think surgery is a better option. One

aspect of this view that has always puzzled me is that the doctors who put

forward this view apparently anticipate that their best option of surgery will

fail and that sondary treatment of radiation will ‘cure’ where

their surgery has failed!! Hmmmm…..then why not have radiation as primary

treatment if it is more likely to cure failed surgery? The truth is of course

that there are no guarantees with any treatement.

<snip> The more I read on this, the

more I realize that this is going way too fast. <snip> Yes, Yes YES! Slow

down. Get out of the panic mode induced by people whose agenda may differ from

yours. Don’t be the pheasant flying onto guns before the beaters. Take a

deep breath. Study and learn. Go on your trip and when you get back you may be

in a better position to make a decision that is best for you, be it surgery,

radiation, cryotherapy, HIFU, or simply Active Surveillance

All the best

Terry Herbert

in Melbourne

Australia

Diagnosed ‘96: Age

54: Stage T2b: PSA 7.2: Gleason 7: No treatment. Jun '07 PSA 42.0 - Bony

Metastasis: Aug '07: Intermittent ADT: PSA 2.3 Aug '10

My site is at www.prostatecancerwatchfulwaiting.co.za

It is a

tragedy of the world that no one knows what he doesn’t know, and the less

a man knows, the more sure he is that he knows everything. Joyce

Carey

From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of robertw1962

Sent: Tuesday, 7 September 2010

1:52 AM

To: ProstateCancerSupport

Subject:

Re: Just curious as to what to do

> >

> > Been diagnosed with prostate cancer. 3 positive samples 2 with

gleason score 7. PSA 6.9.

> >

> > Of course the doctors want to do treatment and best option I've seen

is the robotic surgery. Honestly, I have no issues right now with anything, no

trouble urinating, no trouble with erections.

> >

> > I had planned a trip overseas for November, but doctors want surgery

as soon as possible, schedule for Sept. 21. I'd like to wait til January.

> >

> > I just don't like the quality of life after surgery. I feel I'm being

pressured into quick treatment. Love to hear from you people what u think.

> >

> Sorry for the lack of information. My

age is 48. Never had a PSA test done before so no background data. My bone scan is clear. Of the samples, one gleason 7

was 60% infected, other 7 was 70%. Gleason 6 was 30%. Sample was sent to

another lab.

>

Further side note. I asked about delaying until January and was told it wasn't

a good idea. I also asked how long I would live if I didn't get treatment and

was told 5-8 years. I did look at radiation treatment, seeds, etc, but doctors

think surgery better option because you can get radiation should there be a

reoccurance. The more I read on this, the more I realize that this is going way

too fast.

[Guest guest]

FWIW (I'm rushing to answer, just as your doctor is rushing to treat you) --

1a. Is the " Gleason 7 " composed of " 3+4 " or " 4+3 " ?

" 4+3 " means more " 4 " cells than " 3 " cells, and is likely to be a faster-growing

cancer.

1b. How long were the cancerous sections of the biopsy samples that showed

cancer? That will give you a hint about how large the tumor is.

.. . . Small tumor --> lots of time to think;

.. . . Large tumor --> less time to think.

The risk is that, while you're thinking, the tumor grows out of the prostate.

2. Your PSA doubling time is important -- if you know it. Slow PSA doubling

time indicates less-aggressive cancer.

3. I agree with other posts -- take the time to _fully evaluate all your

options_. You _cannot_ do that before 21 September !!!!!

_DO NOT_ rush into surgery, whether open or robotic. Brachytherapy may be a

reasonable option for you; some studies show it having better long-term results

than surgery. And -- while many surgeons love robotic surgery -- I don't know

if there's good evidence that it has better long-term results, or fewer

sexual/urinary side-effects, than open surgery. [it certainly has quicker

post-surgical recovery -- that's _not_ the same thing.]

4. Assume every medical professional who offers you advice is an " interested

party " , in the sense of having some bias. You'll have to do some of your own

research.

5. I don't know if most " active surveillance " programs will accept men with

Gleason 7 cancer. You can investigate.

Your PSA isn't really high, and your Gleason score isn't really high. Use the

" Prostate Cancer Prediction Tool " on the MSKCC website to see what your future

may hold:

http://www.mskcc.org/mskcc/html/10088.cfm

Take the time to learn more; whatever treatment (or non-treatment) you choose,

you'll be living with the side-effects for a long time.

General comments:

My favorite source for general protate cancer info (besides the MSKCC website,

and the USTOO website

www.ustoo.org

is:

" Prostate Cancer: The Empowered Patient's Guide " -- Strum and Donna

Pogliano

On sexual side-effects of PCa treatments:

" Saving Your Sex Life: A Guide to Men with Prostate Cancer " --

Dr. P. Mulhall.

Mulhall also has several long videos on the MSKCC website -- you may have to dig

a bit to find them.

Good luck, and keep us informed --

>

> Been diagnosed with prostate cancer. 3 positive samples 2 with gleason score

7. PSA 6.9.

>

> Of course the doctors want to do treatment and best option I've seen is the

robotic surgery. Honestly, I have no issues right now with anything, no trouble

urinating, no trouble with erections.

>

> I had planned a trip overseas for November, but doctors want surgery as soon

as possible, schedule for Sept. 21. I'd like to wait til January.

>

> I just don't like the quality of life after surgery. I feel I'm being

pressured into quick treatment. Love to hear from you people what u think.

>

[Guest guest]

I'm not a doctor, but to do your homework and get a second opinion (about

waiting). There are some different types of actions that can be taken.

1. Watching.

2. Surgery - Radical, Robotic. Lapscopic

3. Radiation Therapy - Also with this CyberKnife (more precise and shorter

duration. Fewer centers across US).

4. Hormones. This can even be an after treatment type of surgery and/or

radiation.

I don't know what your choice will be. But you must study your biopsy report and

figure out what is in your best interest. Can you wait, what did your second

opinion say, what is best for you may not be what's best for someone else. Does

the doctor say that you have an agressive fast developing cancer? My choice was

Robotic Lapiscopic surgery. Mine either developed within 2 years or the biopsy 2

years earlier missed detecting the cancer. I am the 1st in my family for

Prostate Cancer. So my primary care doctor and my Urologist did not put much

information in that I could have cancer, even though it wasn't showing up at

that time. I found out since then that the biopsy on Jun 07 they could've missed

the cancer cells.