Re: Radiation after surgery. Was: Men's Health Network ...

[Guest guest]

We are thinking a lot of the same things. It's what we've been playing through our heads.

We figure he has a little time to wait on the radiation, and my hubby just got laid off on the day he got the 3 month PSA test results, our 15 year old daughter was diagnosed with a very serious daughter like Parkinson's disease, and our son is graduating high school.

We've been a little bombarded and wanted to take a little more time to think and research his options.

The doctor did say that the PSA test is much more accurate now and he believes we can tell if there is a problem when it is in the beginning stages. The doctor feels like we can wait and just watch the PSA.

> I just want to say that I am very thankful for a doctor that> ordered PSA testing for my husband as part of his regular 50> year old testing. My husband was asymptomatic.> > The path report following surgery said that my husband has> Gleason 4+3 stage 3 cancer with the cancer spreading just> outside the prostate (they think they got everything in> surgery). > > I think he would have died for sure if he didn't have that> test. > > As it is, his 3 month post surgery PSA was undetectable, and> he'll get his next test done in a few weeks. We're still> debating whether or not he should have radiation.Hello

Suzi,I'm not a doctor or expert of any kind and I'm not qualified togive you any advice. What I say is purely the thought of alayman. However, I think if it were me I'd seriously investigateradiation.The doctors apparently know that the cancer had spread justoutside the prostate. I can see how they can determine that.But I'm not sure how they can determine that they "got it all".A pathologist examines the prostate after it is removed, but hedoesn't examine every square millimeter of it. That would takedays of difficult examination with a microscope and, even if theydid it, individual tumor cells are much smaller than can be seenwith the naked eye and even in a microscope it can be hard spotevery one. I believe that a pathologist can get a pretty goodidea of what's going on, but I don't think he can be certain and,if cancer is found outside the prostate

in some places, it's veryhard to be sure there aren't tiny spots of cancer elsewherearound the prostate.Whether or not you decide to get radiation, I think it's a goodidea to consult with a radiation oncologist. Find the very bestone that you can since radiation can only be done once and it isessential to get a doctor who is smart, experienced with prostatecancer, and committed to his patients the first time.Show him the pathology report from the surgery and all otherrecords that you can. Ask him if he thinks radiation isadvisable now. He may think it's a good idea only if the PSAbegins to rise again, or he may think it's a good idea to do itwithout waiting. Get his opinion on how often your husbandshould have his PSA checked. Get his opinion on what PSA shouldtrigger radiation if he doesn't think it should be done now.The reasons I'm recommending this

are: 1. Age 50 is young to be diagnosed with prostate cancer. PCa often takes 15 or more years to kill a man, but at age 50 15 years comes around at age 65 (being 66 myself, age 65 doesn't seem as old to me as it used to seem.) 2. Stage 3, Gleason 4+3, especially at age 50, is an aggressive disease. 3. Killing the cancer before it spreads is tremendously easier than after it spreads. Current medical practice has no way to kill all of the cancer once it has left the vicinity of the prostate. 4. There may be very little warning that the disease is spreading.I don't like to be an alarmist, and I don't want to offer myideas as if they were expert opinion. I think you need to find the very best radiation

oncologist in your area and get an expertopinion from him or her. The urologist you have is probably veryknowledgeable but, at this point, I'd want to get a radiationexpert's opinion on whether radiation is warranted at this time.Best of luck to you. Alan

[Guest guest]

Everything happened at once.  I can guess how awful this must be.

As far as the doctor's opinion about waiting to see what the PSA

does, that seems very reasonable to me.  He's trying to avoid

over-treatment.  He knows more about than I do and he may well be

right.

Has he said how often he wants PSA tests done?  My impression is

that, from the day that you decide that the PSA is rising to the

day radiation actually starts, at least 30 days, and more like

60-90 will pass.  It can take that long to get all of the

appointments and tests complete.  So at least for the first

couple of years, I think it is desirable to have PSA tests ever

three months so that you'll spot any undesirable rise as early as

practical.

It may also be a good idea to to see a rad onc for a second

opinion.  I know it's a pain to see more doctors, but second

opinions on big decisions are often worth getting.

Best of luck.

    Alan

Suzi Knowles wrote:

> We are thinking a lot of the same things.  It's what we've been

> playing through our heads.

>

> We figure he has a little time to wait on the radiation, and my

> hubby just got laid off on the day he got the 3 month PSA test

> results, our 15 year old daughter was diagnosed with a very

> serious daughter like Parkinson's disease, and our son is

> graduating high school.

>

> We've been a little bombarded and wanted to take a little more

> time to think and research his options.

>

> The doctor did say that the PSA test is much more accurate now

> and he believes we can tell if there is a problem when it is in

> the beginning stages.  The doctor feels like we can wait and

> just watch the PSA.

>> I'm not a doctor or expert of any kind and I'm not qualified

>> to give you any advice.  What I say is purely the thought of a

>> layman.  However, I think if it were me I'd seriously

>> investigate radiation.

>> ...