New Membership In The Club: RRP vs. Rad Dilemma

I hear instead of a membership pin, I can get 25 surgical staples from
my belly button to my penis!
Diagnosed a couple of weeks ago from my biopsy:
Age 60. PSA: 4.8, Free PSA: 19%, Gleason 3+3=6, 15 core samples, 2
small volume tumors, one 10% on left lobe, one 5%. on right lobe.
T1c.

The irony is that for years, I've been a near vegetarian, consumed 1
quart of green tea a day & taken selenium, lycopene, grapeseed, & fish
oil tabs to ward off PCa, but here it is, my unwelcome intruder
sleeping on my couch & opening my refrigerator door looking to grow. I
have a 70gm prostate w/ BPH, so for years have lurked in a BPH
newsgroup and now I've begun to read thousands of posts here back to
2003!!! What a wonderful resource this is. My (common, I know)
predicament: RP or Radiation.
I know I'm a candidate for either, with good chances. My uro is VERY
experienced with 2000 RRPs & his team has done 5200. My cousin is a
radiologist & says if it were him, he'd not let a uro get his scalpel
within 100 miles of his prostate, so he's pushing me toward radiation
(seeds or beam or both). My strongest feeling is that I want the
prostate OUT of me & a pathology report on it. I have full confidence
in him, but have a consultation with a radiologist this Thursday. I've
read the Scardino book, and Dr. Torrey's very good "Surviving
Prostate Cancer" and a lot of other things & know my chances are good
with either treatment, but certainly am leaning toward RRP. I fear
incontinence more than impotence, but mostly would love to have
another 30 years in my wife's arms. Considering my large prostate, I
assume the radiologist would want to try to shrink it down before
planting seeds, but I'm very concerned about it swelling. What do you
know about radiation effects on a guy with a 72gm prostate. Will my
BPH continue after radiation treatments a couple years down the road?
Any other pertinent questions I could ask the radiologist? I'm REALLY
leaning toward a RRP, but am trying to keep an open mind about
radiation.

Thanks for being here,
Zoom

Hello, Zoom:

Sorry you had to join the club. But you've started doing your
homework, and that's good.

If you're leaning towards RRP then you will probably not be opened
from belly button to penis. I had LRP at Johns Hopkins, and have a
total of four small scars: a 1.25" scar right below my navel, two .5"
scars about 4" on either side and lower, and a fourth one close to my
groin on the right side -- that one's only about 0.25 inches. I lost
100 cc of blood during thr procedure. If you're having a robotic
procedure you' might lose even less.

>From you're numbers, you sound as if you're a good candidate for
either procedure. I was, too. I chose surgery for similar reasons to
the ones you stated: if the procedure was going to fail, then I'd
want to know as soon as possible, and I think that happens more
quickly with surgery than with radiation.

I think that being healthy does not necessarily prevent cancer, but if
you've taken care of yourself and stayed fit, then your battle against
the disease will probably be that much easier.

Expect to have a long time in your wife's arms. Sex is possible and
even satisfying for the both of you without erections. And erections
do often come back.

Other men on the group will share their experiences about radiation,
but I think that the goal of the radiation treatment is to destroy
most/all the prostate tissue -- so I believe that after a couple of
years, you'd have no BPH, either. The radiation oncologist would
likely give you a hormone shot -- Lupron or something like it --
before you have the radiation. This not only shrinks the prostate,
but also locks the cells in a state in which they are more susceptible
to the radiation effects.

Like surgeons, there are radiation oncologists who are very good and
those who are not so good. Find out the rad onc's experience and
track record, the record of side effects (incontinence, impotence,
etc.) for his/her patients, talk to men in a local support group about
him/her, consult the national data bases about the doctor's rating.

Good, luck, and please keep us posted on your progress.

All the best,

charlie

Zoom wrote:

> The irony is that for years, I've been a near vegetarian

My uro told me PC probably takes decades to "mature".

> My cousin is a
> radiologist & says if it were him, he'd not let a uro get his scalpel
> within 100 miles of his prostate

Your cousin's ignoring statistics gathered over many years from many
scores of thousands of PC patients, still reinforced in 2007 by a little
place called Johns-Hopkins: surgery is still the gold standard
everything else is trying to match or beat. That's not to say it's the
best choice for each patient, but overall his statement significantly
contradicts the J-H consensus.

> My strongest feeling is that I want the
> prostate OUT of me & a pathology report on it.

Generally, yes . . . but if I had had a 6 and a T1 going in instead of
an 8 and a T2, I'd (probably) have placed less importance on the
pathology report.

> I have a consultation with a radiologist this Thursday.

A no-brainer. Talk's cheap and educational. I'd add a med onc in case
your first "treater" recommends adjuvant ADT just in case, as mine did.


> I've read the Scardino book, and Dr. Torrey's very good "Surviving
> Prostate Cancer" and a lot of other things

IMO, every book and portion thereof I read helped me reach and support
my final decision, to the point I productively debated a whole oncology
team's treatment recommendation.

> I fear incontinence more than impotence

Now add the odds and impact of fecal problems, including incontinence,
into the equation.

> but mostly would love to have another 30 years in my wife's arms.

Then consider the odds not only of curing your PC, but of causing
subsequent bowel cancer.

> Any other pertinent questions I could ask the radiologist?

Not just questions. When I told me rad onc I'd infinitely prefer a leaky
bladder to a leaky bowel, she recommended surgery.

I'm REALLY
> leaning toward a RRP, but am trying to keep an open mind about
> radiation.

I kept reading and reading and reading until my own clear choice
emerged, both for my initial and secondary treatments. I feel this led
to the best decisions I could make, which in turn should avert a lot of
second-guessing if and when I face this again.

I.P.

On April 23, "Zoom" wrote:

> I hear instead of a membership pin, I can get 25 surgical staples from
> my belly button to my penis!
> Diagnosed a couple of weeks ago from my biopsy:
> Age 60. PSA: 4.8, Free PSA: 19%, Gleason 3+3=6, 15 core samples, 2
> small volume tumors, one 10% on left lobe, one 5%. on right lobe.
> T1c.
>
> The irony is that for years, I've been a near vegetarian, consumed 1
> quart of green tea a day & taken selenium, lycopene, grapeseed, & fish
> oil tabs to ward off PCa, but here it is, my unwelcome intruder
> sleeping on my couch & opening my refrigerator door looking to grow. I
> have a 70gm prostate w/ BPH, so for years have lurked in a BPH
> newsgroup...

(snip)

Well, well, another poor soul who did all the right things and developed
PCa anyway. I don't want to seem sarcastic, as this is a serious concern
to "Zoom" and is not to be lightly dismissed. However, we see here,
there, practically everywhere solemn admonitions to do or not to do this
or that; to eat or not to eat this or that, and so far as I can see, it
makes absolutely no difference at all. Either we are going to develop
PCa or we aren't. No one yet knows why.

> My (common, I know) predicament: RP or Radiation.

Whoa! What's the hurry?

"Zoom" says that he has either a 70 or a 72-gram prostate (both numbers
are included in his post). According to the authoritative website of the
Prostate Cancer Research Institute (PCRI) the amount of *benign* PSA
expressed by a prostate gland is calculated as follows: volume x .066 =
benign PSA. Using that formula, 72-gram prostate will express 4.752
ng/mL of *benign* PSA. A 70-gram gland will express 4.62 ng/mL of benign
PSA.

"Zoom's" PSA is 4.8, which I suspect is well within the margin of error
of the test protocol.

The reported free PSA (fPSA) of 19% is higher than the <15% that has
been established as the cutpoint for concern about, *not* diagnosis of, PCa.

> I know I'm a candidate for either, with good chances.

Zoom just might be a candidate for *neither.*

I believe that the biopsy results just might place "Zoom" within that
cohort of men who are eligible to proceed with active surveillance, once
called "watchful waiting."

I most earnestly recommend that "Zoom" learn for himself what is best.
The way to do that is:

(1) Consult the PCRI website at: http://prostate-cancer.org/index.html
and search on topics that are of interest. Frex, he will find
documentation of what I wrote above re: calculation of benign PSA at:
http://www.prostate-cancer.org/educa...fSuccess2.html

(2) Buy and study the premier text on PCa, _A Primer on Prostate Cancer_
2nd ed., subtitled "The Empowered Patient's Guide" by medical oncologist
and PCa specialist Stephen 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), Barnes & Noble, and bookstores. A lifesaver. I
know.

Study, Learn, Take Charge! We are each of us our own best advocates.

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."

On Mon, 23 Apr 2007 17:29:59 -0500, Zoom <OneDay@aTime.net> wrote:

>I hear instead of a membership pin, I can get 25 surgical staples from
>my belly button to my penis!
>Diagnosed a couple of weeks ago from my biopsy:
>Age 60. PSA: 4.8, Free PSA: 19%, Gleason 3+3=6, 15 core samples, 2
>small volume tumors, one 10% on left lobe, one 5%. on right lobe.
>T1c.
>
>The irony is that for years, I've been a near vegetarian, consumed 1
>quart of green tea a day & taken selenium, lycopene, grapeseed, & fish
>oil tabs to ward off PCa, but here it is, my unwelcome intruder
>sleeping on my couch & opening my refrigerator door looking to grow. I
>have a 70gm prostate w/ BPH, so for years have lurked in a BPH
>newsgroup and now I've begun to read thousands of posts here back to
>2003!!! What a wonderful resource this is. My (common, I know)
>predicament: RP or Radiation.
>I know I'm a candidate for either, with good chances. My uro is VERY
>experienced with 2000 RRPs & his team has done 5200. My cousin is a
>radiologist & says if it were him, he'd not let a uro get his scalpel
>within 100 miles of his prostate, so he's pushing me toward radiation
>(seeds or beam or both). My strongest feeling is that I want the
>prostate OUT of me & a pathology report on it. I have full confidence
>in him, but have a consultation with a radiologist this Thursday. I've
>read the Scardino book, and Dr. Torrey's very good "Surviving
>Prostate Cancer" and a lot of other things & know my chances are good
>with either treatment, but certainly am leaning toward RRP. I fear
>incontinence more than impotence, but mostly would love to have
>another 30 years in my wife's arms. Considering my large prostate, I
>assume the radiologist would want to try to shrink it down before
>planting seeds, but I'm very concerned about it swelling. What do you
>know about radiation effects on a guy with a 72gm prostate. Will my
>BPH continue after radiation treatments a couple years down the road?
>Any other pertinent questions I could ask the radiologist? I'm REALLY
>leaning toward a RRP, but am trying to keep an open mind about
>radiation.
>
>Thanks for being here,
>Zoom


I was in a very similar situation. It was a close call for me but I
ultimately chose surgery. That was 14 months ago and I am still
dealing with ED. It would be nice to be able to try both options and
then pick the one that works best but you only get one shot at it. I
had a concern over the radiation creating more urinary urgency then I
already had at the time combined with the long term outlook (I was
planning on another 25 years). One of the options I don't see
mentioned very often, but that would have been my radiation choice if
I had gone the radiation route, is High Dosage Radiation. They do it
over a two day period and sometimes a second round two weeks later.

The place I was looking at is http://www.cetmc.com/index.html and it's
one more possible option to consider.

Best wishes to you as you embark on this little adventure.

"Zoom" <OneDay@aTime.net> wrote in message
news:ugaq231a4ffk9371k2uv9e96bva3l6a7hf@4ax.com...
>I hear instead of a membership pin, I can get 25 surgical staples from
> my belly button to my penis!
> Diagnosed a couple of weeks ago from my biopsy:
> Age 60. PSA: 4.8, Free PSA: 19%, Gleason 3+3=6, 15 core samples, 2
> small volume tumors, one 10% on left lobe, one 5%. on right lobe.
> T1c.
>
> The irony is that for years, I've been a near vegetarian, consumed 1
> quart of green tea a day & taken selenium, lycopene, grapeseed, & fish


No irony. There's no evidence that anything other than genetics may make
a difference. I went with RP 4 1/2 years ago, and am happy with my decision.
I liked my young and experienced surgeon, and like you I wanted it out as
completely as possible with pathology all over the area. Lastly.... I was a
dribbler and weak streamed for years which also helped make my choice
easier. Seeds seem to often cause side effects that are not so much fun
either.


--
JK Sinrod
www.SinrodStudios.com
www.MyConeyIslandMemories.com

First, I spend as much time as I can on the PCa groups, but rarely add
a comment (maybe when I retire I can do more). I did want to offer up
one perspective. I had a 4.8 PSA going in but a higher Gleason (4+3)
and chose RRP from an excellent Uro team. After surgery they
discovered my Gleason's was actually higher (5+3) (a common
occurrence). My point - I felt more comfortable knowing what was
inside and felt my Medical team could make informed decisions
afterwards.

There are so many pros and cons to the decision of RRP vs. Rad; my
point above is only one point.

Good luck and keep investigating until you're satisfied.

Rich

Hello Zoom,
You came to the right place to get insight on prostate cancer and
treatments.......
I was scheduled for Radiation in 1999 (Oct.) I learned a lot and had a few
more opinions from Prostate Cancer Specialists.
I had RP Nov. 1999 and I was 49 at the time. I had a PSA if 7 . I am 57
now and go every Aug. for my PSA and I have been very fortunate to come up
with less than 0.01...........
I do not wet myself, and can have an erection (75%)and with viagra the
erection is normal.
Good wishes to you. Keep us posted.
John Loomis

"Zoom" <OneDay@aTime.net> wrote in message
news:ugaq231a4ffk9371k2uv9e96bva3l6a7hf@4ax.com...
>I hear instead of a membership pin, I can get 25 surgical staples from
> my belly button to my penis!
> Diagnosed a couple of weeks ago from my biopsy:
> Age 60. PSA: 4.8, Free PSA: 19%, Gleason 3+3=6, 15 core samples, 2
> small volume tumors, one 10% on left lobe, one 5%. on right lobe.
> T1c.
>
> The irony is that for years, I've been a near vegetarian, consumed 1
> quart of green tea a day & taken selenium, lycopene, grapeseed, & fish
> oil tabs to ward off PCa, but here it is, my unwelcome intruder
> sleeping on my couch & opening my refrigerator door looking to grow. I
> have a 70gm prostate w/ BPH, so for years have lurked in a BPH
> newsgroup and now I've begun to read thousands of posts here back to
> 2003!!! What a wonderful resource this is. My (common, I know)
> predicament: RP or Radiation.
> I know I'm a candidate for either, with good chances. My uro is VERY
> experienced with 2000 RRPs & his team has done 5200. My cousin is a
> radiologist & says if it were him, he'd not let a uro get his scalpel
> within 100 miles of his prostate, so he's pushing me toward radiation
> (seeds or beam or both). My strongest feeling is that I want the
> prostate OUT of me & a pathology report on it. I have full confidence
> in him, but have a consultation with a radiologist this Thursday. I've
> read the Scardino book, and Dr. Torrey's very good "Surviving
> Prostate Cancer" and a lot of other things & know my chances are good
> with either treatment, but certainly am leaning toward RRP. I fear
> incontinence more than impotence, but mostly would love to have
> another 30 years in my wife's arms. Considering my large prostate, I
> assume the radiologist would want to try to shrink it down before
> planting seeds, but I'm very concerned about it swelling. What do you
> know about radiation effects on a guy with a 72gm prostate. Will my
> BPH continue after radiation treatments a couple years down the road?
> Any other pertinent questions I could ask the radiologist? I'm REALLY
> leaning toward a RRP, but am trying to keep an open mind about
> radiation.
>
> Thanks for being here,
> Zoom
>

glassman wrote:

> No irony. There's no evidence that anything other than genetics may make
> a difference.

"The China Study" contradicts dramatically with that, and Johns Hopkins
strongly suspects otherwise. They differ in that the former lays the
blame squarely on animal protein, while J-H doesn't know what to blame
it on besides maybe animal fats. I, like many Americans, ate huge
quantities of both for 40 years.

I.P.

On 23 Apr 2007 16:27:40 -0700, chasjac <chjacobson@elmira.edu> wrote:
>Good, luck, and please keep us posted on your progress.

Thanks, Charlie, I will.

Zoom wrote:
>> but mostly would love to have another 30 years in my wife's arms.
I.P wrote:
>Then consider the odds not only of curing your PC, but of causing
>subsequent bowel cancer.

Thanks, I.P - I assume you're talking about radiation causing this?
Another possibility nudging me toward RRP.

Zoom wrote:
> I know I'm a candidate for either, with good chances.
Steve wrote:
>Zoom just might be a candidate for *neither.*
Thanks Steve, but the thought of these cancer cells wanting to spread
to my spine is pretty frightening!
Steve wrote:
>(1) Consult the PCRI website at: http://prostate-cancer.org/index.html
>(2) Buy and study the premier text on PCa, _A Primer on Prostate Cancer

Thanks Steve, I'm on the case!

DoubleOwSeven wrote:
>I had a concern over the radiation creating more urinary urgency then I
>already had at the time combined with the long term outlook (I was
>planning on another 25 years).

YES, exactly what I feel! Thanks, DoubleOw

Glassman wrote:
> I was a dribbler and weak streamed for years
>which also helped make my choice easier.

Yes, me too, J.K, I've used a little toilet paper diaper for 10 years,
so I think I can deal with this RRP continence issue, thanks.

I.P wrote:
>I, like many Americans, ate huge quantities of (animal fats & proteins) for 40 years.

Right! I was the cheeseburger & milkshake KING of the upper midwest
for my first 20 years.

Richbro wrote:
>I felt more comfortable knowing what was inside and felt my Medical
>team could make informed decisions afterwards.

Thanks Rich; my gut feelings as well.

jloo wrote:
>Hello Zoom, You came to the right place to get insight on prostate cancer
>and treatments.

Thanks, John. I've been reading MANY hours of postings of the
newsgroup back to 2003. This is a WONDERFUL place to be.
Thank you, all my brother members. This is not the road we imagined
ourselves traveling on, but thank you for the roadmaps & signposts
along the way.
Zoom

UCLA Jonsson Cancer Center Study Examines Quality of Life After Common
Treatments for Prostate Cancer
LOS ANGELES, April 23 (AScribe Newswire) -- A rigorous, long-
term study of quality of life in patients who underwent one of the
three most common treatments for prostate cancer found that each
affected men's lives in different ways. The findings provide
invaluable information for men with prostate cancer who are facing
vital treatment decisions.

Researchers studied quality of life in men who either underwent
radical prostatectomy, implantation of radioactive seeds in their
prostate gland or had external beam radiation therapy. The three
treatment options rank about equally in survival outcomes for most
men, so specific impacts on quality of life become paramount in making
treatment decisions, said Dr. Mark Litwin, the study's lead author and
a researcher at UCLA's Jonsson Cancer Center.

"The good news is that overall mental and physical well-being
were not profoundly affected by any of the three treatment choices,"
Litwin said. "That's good news for men with the sword of prostate
cancer hanging over their heads. In general, they'll be OK no matter
which of the three options they choose."

However, each of the three options did negatively affect
quality of life, at least temporarily, with problems ranging from
erectile dysfunction and minor incontinence to urinary and bowel
irritation.

The study tracked 580 men for five years. The study results,
published in the June 1, 2007 issue of the peer-reviewed journal
CANCER, represent data from the first two years of the study. Those
years, Litwin said, are when most of the negative impacts surface and
resolve.

Seed implantation, also known as brachytherapy, has been touted
in marketing campaigns as the best of the three options with the
shortest recovery time and the fewest sexual dysfunction side effects,
Litwin said.

"These campaigns say 'Get your seed implants on Monday, play
golf on Tuesday' and that's just not true," said Litwin, a professor
of urology and health services. "Men need to have the most accurate
information when making vital decisions about what type to treatment
they'll get. They need facts, not hype."

The study found that brachytherapy patients often experience
obstructive and irritating urinary symptoms such as frequency of
urination and feeling an urgent need to urinate. They also reported
bowel dysfunction such as frequency and urgency, diarrhea and pain
with stool. External beam radiation patients suffered from urinary
irritation and bowel dysfunction similar to brachytherapy patients.

Surgery patients more often reported incontinence symptoms such
as urine leakage when coughing or sneezing as well loss of sexual
dysfunction, although this was mitigated when the surgeon was able to
spare the patient's erectile nerves.

The impacts caused by brachytherapy and external beam radiation
were most similar and patients who choose those options suffered less
erectile dysfunction. While they had more erectile dysfunction,
surgery patients did not suffer from bowel dysfunction as often.

"Different men are bothered by different things, so it depends
on what their baseline function is," Litwin said. "If a man is already
impotent, for example, loss of sexual function won't be an issue in
making a treatment decision."

Litwin said the study is unique in that it took baseline
measurements before the patients, all cared for at UCLA, underwent any
treatment. It did not ask patients to recall what their function and
quality of life were prior to treatment, as many studies do. That
resulted in a more accurate baseline measurement, Litwin said. The
study also was unique in that it assessed and tracked individuals
using their own baselines, not a "mean" or "median" ranking determined
by looking at group statistics.

"This is important because these treatments can have
significant effects on sexual, urinary and bowel function," Litwin
said. "It's critical to be able to say as accurately as possible what
percentage of men got back to the pre-treatment baseline, as well as
the percentage that did not. This information helps the next man that
comes along. He can use the data to weigh his chances of returning to
his own pre-treatment baseline in terms of function and quality of
life."

Additionally, the study used the most rigorous methodology
available and employed established instruments to measure quality of
life factors, tools that have been used for years on thousands of
patients from around the world and "are known to be valid
measurements," Litwin said. The data also were collected by a third
party, not the surgeon or radiation oncologist involved in the
treatment. That also allowed for collection of more accurate
information.

"Patients have an unconscious desire to please their doctor and
we wanted to ensure they were as forthcoming as possible in discussing
problems related to their treatment," Litwin said.

The study also was novel in that is used a specially designed
web-based data collection system that allowed participants to complete
surveys online.

Litwin and his team will continue to analyze the study data out
through the five-year point. However, he expects little to change as
most symptoms surface early on and typically begin to improve after
the two-year mark.

Litwin said it is important for men to make treatment decisions
based on their individual needs. It's also vital, he said, to find the
best doctor to administer the treatment.

"The experience of the doctor and the institution do matter,"
he said. "Results can vary."

Prostate Cancer is the most frequently diagnosed cancer in men
and the leading cause of cancer death in men. About 218,890 cases of
prostate cancer will be diagnosed this year alone, according to the
American Cancer Society. About 27,050 men will die.

UCLA's Jonsson Comprehensive Cancer Center comprises more than
240 researchers and clinicians engaged in disease research,
prevention, detection, control, treatment and education. One of the
nation's largest comprehensive cancer centers, the Jonsson center is
dedicated to promoting research and translating basic science into
leading-edge clinical studies. In July 2006, the Jonsson Cancer Center
was named the best cancer center in California by U.S. News & World
Report, a ranking it has held for seven consecutive years.

For more information on the

On Mon, 23 Apr 2007 17:20:50 -0700, Steve Jordan <mycroftscj1@cox.net>
wrote:

>> I know I'm a candidate for either, with good chances.
>
>Zoom just might be a candidate for *neither.*
>
>I believe that the biopsy results just might place "Zoom" within that
>cohort of men who are eligible to proceed with active surveillance, once
>called "watchful waiting."
>

Zoom, as Steve says, you are eligible also for a watchful waiter club
card. If you're of a mind to be rid of your prostate by any means,
then of course it won't appeal to you at all, but it would certainly
be well worth your time - and you've the luxury of a little more of
this than many newly diagnosed - to get a balance on the stats and
prospects for WW, reading them in your own way and in relation to your
own figures which are highly favourable. At the very least you can
hang out in the WW lobby for as long it takes you to pick a course of
action.
Best of luck with decision and treatment.

> leaning toward a RRP, but am trying to keep an open mind about
> radiation.

When I was at the same stage as you I happened to chat with a
radiologist at a party. He chose an RP over seeds because of his age
(ability to heal), because of the salvage radiation that can be
performed if needed after surgery and because the ajoining lymph nodes
can be biopsied at the same time. That conversation stuck with me and
I'm sure influenced my decision. My numbers were almost identical to
you except for my age at time of diagnosis, 52 and my gleason of 4+4.
I had an RP and now that its 16 months later, the staples are long
gone, the scar has 80% faded, and I rarely drip or leak (thank you Dr.
McGuire) and I don't regret my decision.

WSF

Rosbif, thanks, it's nice to know I have a little elbow room, but I do
feel that clock ticking . . .
Zoom

On Tue, 24 Apr 2007 08:13:13 +0100, rosbif wrote:
>On Mon, 23 Apr 2007 17:20:50 -0700, Steve Jordan <mycroftscj1@cox.net>
>wrote:
>
>>> I know I'm a candidate for either, with good chances.
>>Zoom just might be a candidate for *neither.*
>>
>>I believe that the biopsy results just might place "Zoom" within that
>>cohort of men who are eligible to proceed with active surveillance, once
>>called "watchful waiting."
>
>Zoom, as Steve says, you are eligible also for a watchful waiter club
>card. If you're of a mind to be rid of your prostate by any means,
>then of course it won't appeal to you at all, but it would certainly
>be well worth your time - and you've the luxury of a little more of
>this than many newly diagnosed - to get a balance on the stats and
>prospects for WW, reading them in your own way and in relation to your
>own figures which are highly favourable. At the very least you can
>hang out in the WW lobby for as long it takes you to pick a course of
>action.
>Best of luck with decision and treatment.

Dick, thanks, this confirms my thoughts . . .
Zoom

On 23 Apr 2007 22:02:08 -0700, Dick Smith <smith_bp101@hotmail.com>
wrote:

>UCLA Jonsson Cancer Center Study Examines Quality of Life After Common
>Treatments for Prostate Cancer
> LOS ANGELES, April 23 (AScribe Newswire) -- A rigorous, long-
>term study of quality of life in patients who underwent one of the
>three most common treatments for prostate cancer found that each
>affected men's lives in different ways. The findings provide
>invaluable information for men with prostate cancer who are facing
>vital treatment decisions.
>
> Researchers studied quality of life in men who either underwent
>radical prostatectomy, implantation of radioactive seeds in their
>prostate gland or had external beam radiation therapy. The three
>treatment options rank about equally in survival outcomes for most
>men, so specific impacts on quality of life become paramount in making
>treatment decisions, said Dr. Mark Litwin, the study's lead author and
>a researcher at UCLA's Jonsson Cancer Center.
>
> "The good news is that overall mental and physical well-being
>were not profoundly affected by any of the three treatment choices,"
>Litwin said. "That's good news for men with the sword of prostate
>cancer hanging over their heads. In general, they'll be OK no matter
>which of the three options they choose."
>
> However, each of the three options did negatively affect
>quality of life, at least temporarily, with problems ranging from
>erectile dysfunction and minor incontinence to urinary and bowel
>irritation.
>
> The study tracked 580 men for five years. The study results,
>published in the June 1, 2007 issue of the peer-reviewed journal
>CANCER, represent data from the first two years of the study. Those
>years, Litwin said, are when most of the negative impacts surface and
>resolve.
>
> Seed implantation, also known as brachytherapy, has been touted
>in marketing campaigns as the best of the three options with the
>shortest recovery time and the fewest sexual dysfunction side effects,
>Litwin said.
>
> "These campaigns say 'Get your seed implants on Monday, play
>golf on Tuesday' and that's just not true," said Litwin, a professor
>of urology and health services. "Men need to have the most accurate
>information when making vital decisions about what type to treatment
>they'll get. They need facts, not hype."
>
> The study found that brachytherapy patients often experience
>obstructive and irritating urinary symptoms such as frequency of
>urination and feeling an urgent need to urinate. They also reported
>bowel dysfunction such as frequency and urgency, diarrhea and pain
>with stool. External beam radiation patients suffered from urinary
>irritation and bowel dysfunction similar to brachytherapy patients.
>
> Surgery patients more often reported incontinence symptoms such
>as urine leakage when coughing or sneezing as well loss of sexual
>dysfunction, although this was mitigated when the surgeon was able to
>spare the patient's erectile nerves.
>
> The impacts caused by brachytherapy and external beam radiation
>were most similar and patients who choose those options suffered less
>erectile dysfunction. While they had more erectile dysfunction,
>surgery patients did not suffer from bowel dysfunction as often.
>
> "Different men are bothered by different things, so it depends
>on what their baseline function is," Litwin said. "If a man is already
>impotent, for example, loss of sexual function won't be an issue in
>making a treatment decision."
>
> Litwin said the study is unique in that it took baseline
>measurements before the patients, all cared for at UCLA, underwent any
>treatment. It did not ask patients to recall what their function and
>quality of life were prior to treatment, as many studies do. That
>resulted in a more accurate baseline measurement, Litwin said. The
>study also was unique in that it assessed and tracked individuals
>using their own baselines, not a "mean" or "median" ranking determined
>by looking at group statistics.
>
> "This is important because these treatments can have
>significant effects on sexual, urinary and bowel function," Litwin
>said. "It's critical to be able to say as accurately as possible what
>percentage of men got back to the pre-treatment baseline, as well as
>the percentage that did not. This information helps the next man that
>comes along. He can use the data to weigh his chances of returning to
>his own pre-treatment baseline in terms of function and quality of
>life."
>
> Additionally, the study used the most rigorous methodology
>available and employed established instruments to measure quality of
>life factors, tools that have been used for years on thousands of
>patients from around the world and "are known to be valid
>measurements," Litwin said. The data also were collected by a third
>party, not the surgeon or radiation oncologist involved in the
>treatment. That also allowed for collection of more accurate
>information.
>
> "Patients have an unconscious desire to please their doctor and
>we wanted to ensure they were as forthcoming as possible in discussing
>problems related to their treatment," Litwin said.
>
> The study also was novel in that is used a specially designed
>web-based data collection system that allowed participants to complete
>surveys online.
>
> Litwin and his team will continue to analyze the study data out
>through the five-year point. However, he expects little to change as
>most symptoms surface early on and typically begin to improve after
>the two-year mark.
>
> Litwin said it is important for men to make treatment decisions
>based on their individual needs. It's also vital, he said, to find the
>best doctor to administer the treatment.
>
> "The experience of the doctor and the institution do matter,"
>he said. "Results can vary."
>
> Prostate Cancer is the most frequently diagnosed cancer in men
>and the leading cause of cancer death in men. About 218,890 cases of
>prostate cancer will be diagnosed this year alone, according to the
>American Cancer Society. About 27,050 men will die.
>
> UCLA's Jonsson Comprehensive Cancer Center comprises more than
>240 researchers and clinicians engaged in disease research,
>prevention, detection, control, treatment and education. One of the
>nation's largest comprehensive cancer centers, the Jonsson center is
>dedicated to promoting research and translating basic science into
>leading-edge clinical studies. In July 2006, the Jonsson Cancer Center
>was named the best cancer center in California by U.S. News & World
>Report, a ranking it has held for seven consecutive years.
>
> For more information on the

WSF,
Thanks much! I'm leaning in this direction also.
A fair weather Twins fan,
Zoom

On 24 Apr 2007 08:02:08 -0700, WhiteSoxFan <leicam13@comcast.net>
wrote:
>> leaning toward a RRP, but am trying to keep an open mind about
>> radiation.
>
>When I was at the same stage as you I happened to chat with a
>radiologist at a party. He chose an RP over seeds because of his age
>(ability to heal), because of the salvage radiation that can be
>performed if needed after surgery and because the ajoining lymph nodes
>can be biopsied at the same time. That conversation stuck with me and
>I'm sure influenced my decision. My numbers were almost identical to
>you except for my age at time of diagnosis, 52 and my gleason of 4+4.
>I had an RP and now that its 16 months later, the staples are long
>gone, the scar has 80% faded, and I rarely drip or leak (thank you Dr.
>McGuire) and I don't regret my decision.
>
>WSF

"Zoom" <OneDay@aTime.net> wrote in message
news:ugaq231a4ffk9371k2uv9e96bva3l6a7hf@4ax.com...
>I hear instead of a membership pin, I can get 25 surgical staples from
> my belly button to my penis!

Super glue is best!

> Diagnosed a couple of weeks ago from my biopsy:
> Age 60. PSA: 4.8, Free PSA: 19%, Gleason 3+3=6, 15 core samples, 2
> small volume tumors, one 10% on left lobe, one 5%. on right lobe.
> T1c.

You've done quite a bit already, Zoom. I'm am impressed.

Keep working on that effort. Judging from your diet, I'd say you can easily
afford some surgery. Your radiological contact notwithstanding, if you can
survive surgery, there seems to be a slight edge in cures (statistically).

But, as you mentioned, the fact that you want it out is probably the best
reason of all.




--
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32 PSAD .056 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.4 years
Casodex added daily 07/06
PSA <0.04, <0.05
Non Illegitimi Carborundum

I.P. wrote:
> Generally, yes . . . but if I had had a 6 and a T1 going in instead
> of an 8 and a T2, I'd (probably) have placed less importance on the
> pathology report.


I was a 6 and T1 at the clinical stage but ended up a 7 after the
pathology report. Remember, a biopsy is only an educated guess as to
what the true pathology really is and it can only be known for certain
after surgery.
I chose to go in with both barrels blazing.

B.A.

> Well, well, another poor soul who did all the right things and
> developed PCa anyway.


You hit the nail on the head. This is a very frustrating disease in so
many different ways. No way to know how the PCa developed, so far
anyway. Some guy does everything "wrong" and has undetectable PSA
levels, while someone else agonizes over his overall health for many
years and does most things "right" gets Pca despite his efforts.

B.A.

"I.P. Freely" <fuhgheddaboutit@noway.nohow> wrote in message
news:tKdXh.258$iE3.0@newsfe04.lga...
> glassman wrote:
>
>> No irony. There's no evidence that anything other than genetics may
>> make a difference.
>
> "The China Study" contradicts dramatically with that, and Johns Hopkins
> strongly suspects otherwise. They differ in that the former lays the blame
> squarely on animal protein, while J-H doesn't know what to blame it on
> besides maybe animal fats. I, like many Americans, ate huge quantities of
> both for 40 years.
>
> I.P.


I don't know too many men that didn't/don't eat that way that are our
age. Our ancestors ate animals, but we live so much longer, so maybe all
these cancers are simply a symptom of living too long? We all know strict
vegans and pro athletes that have/died of PCa. I as well as my wife, a
medical professional, read all the studies as you do. Not one has me
convinced of any dietary link to PCa. We are more likely to have it if our
dads had it. All of us that are afflicted have one thing in common.... we
are men.


--
JK Sinrod
www.SinrodStudios.com
www.MyConeyIslandMemories.com

The medical community is a long way from figuring out everything that causes
PCa -- even the association with genetics is merely an association. I
haven't read anywhere about causal links between PCa and any other factor,
established or suspected.

And if/when an association is found between PCa and something else -- say
diet -- what does that mean? It may mean that there's something in the
diet that's causing the PCa, but it could also indicate some other variable
at work that's influencing diet (or whatever) and PCa incidence.

Statistical associations are never stated with certainty by anyone who uses
them responsibly. For example, there is a strong, positive association
between the number of homework problems my students do (correctly or not),
and the score they get on their exams. But there are a few students who
turn in every bit of homework and do poorly on exams, and a few students
who turn in very little and yet do very well on exams. Doing homework
explains some of the variation I see in the test scores in my courses, but
not all of it. This is the sort of thing any association tells you, and
it's all an association by itself tells you.

All those things that Zoom or any of us do to stay healthy are helpful, in
that those practices can make our bodies and minds better equipped to fight
off diseases when they _inevitably_ occur. Whether they actually help to
prevent cancers is a question that I don't believe the medical community
can answer yet.

--charlie

Thanks much, JK & Charlie,
Since I've been actively trying to shield against PCa for many years
now with my vegan/lycopene/gr.tea/low fat/omega-3/etc. diet, I know
this question of "Why Me?" is always in the back of my mind, but I
REALLY appreciate your responses. After kvetching to my uro about
this, he says, "Perhaps that's why your cancer volume is so small." I
accept the consolation prize. So, I'm continuing to eat my raw
broccoli breakfast and you can be sure I'm not consuming the
artificial flavor-color laden Jell-O when they serve that stuff to me
in the hospital after my RRP in two weeks!
Thank you for being here.
Z.

2003: PSA: 3.0, FreePSA: 17%
2007: PSA: 4.8, FreePSA: 19%
4/5/07: Biopsy: Gleason: 3+3=6, Stage T1c
Two small tumors: 5% on R base, 10% on L base
5/22/07: scheduled RRP


JK wrote:
>I don't know too many men that didn't/don't eat that way that are our
>age. Our ancestors ate animals, but we live so much longer, so maybe all
>these cancers are simply a symptom of living too long? We all know strict
>vegans and pro athletes that have/died of PCa. I as well as my wife, a
>medical professional, read all the studies as you do. Not one has me
>convinced of any dietary link to PCa. We are more likely to have it if our
>dads had it. All of us that are afflicted have one thing in common.... we
>are men.

chasjac too <chazjac@chazjac.com> wrote:
>The medical community is a long way from figuring out everything that causes
>PCa -- even the association with genetics is merely an association. I
>haven't read anywhere about causal links between PCa and any other factor,
>established or suspected.
>And if/when an association is found between PCa and something else -- say
>diet -- what does that mean? It may mean that there's something in the
>diet that's causing the PCa, but it could also indicate some other variable
>at work that's influencing diet (or whatever) and PCa incidence.
>Statistical associations are never stated with certainty by anyone who uses
>them responsibly. For example, there is a strong, positive association
>between the number of homework problems my students do (correctly or not),
>and the score they get on their exams. But there are a few students who
>turn in every bit of homework and do poorly on exams, and a few students
>who turn in very little and yet do very well on exams. Doing homework
>explains some of the variation I see in the test scores in my courses, but
>not all of it. This is the sort of thing any association tells you, and
>it's all an association by itself tells you.
>All those things that Zoom or any of us do to stay healthy are helpful, in
>that those practices can make our bodies and minds better equipped to fight
>off diseases when they _inevitably_ occur. Whether they actually help to
>prevent cancers is a question that I don't believe the medical community
>can answer yet.

"Zoom" <OneDay@aTime.net> wrote in message
news:llto339284v8s9rtll9prcp7i40d3i2ilh@4ax.com...

> 5/22/07: scheduled RRP

Well, then it's done, Zoom. And, you have gotten through what just might be
the hardest part of prostate cancer. 4.8, T1c, and 3+3 are really good
numbers when going in for an RRP. You have a great chance of coming out
cancer-free (not that you'll know for sure for a couple of decades).

So, sit back... relax... maybe take a cruise (that's what I did), and then
walk into the hospital a cancer patient and walk out a survivor.



--
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32 PSAD .056 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.4 years
Casodex added daily 07/06
PSA <0.04, <0.05
Non Illegitimi Carborundum

Since I've been actively trying to shield against PCa for many years now
with my vegan/lycopene/gr.tea/low fat/omega-3/etc. diet, I know this
question of "Why Me?" is always in the back of my mind, but I REALLY
appreciate your responses. After kvetching to my uro about this, he
says, "Perhaps that's why your cancer volume is so small." I accept the
consolation prize. So, I'm continuing to eat my raw broccoli breakfast
and you can be sure I'm not consuming the artificial flavor-color laden
Jell-O when they serve that stuff to me in the hospital after my RRP in
two weeks!

====> for what's worth dept - you know what they say about tomatoes to
help prevent pca......

i've always loved tomatoes and have eaten a pound or so minimum a week
for years. yet, i got pca. i would like to think that i did the right
thing on my eating and diet to help give myself the best chance in life
and in preventing disease and cancer.

yet, on the flip side - i saw my mother in law literally light one
cigarette off of the one she was putting down. 3, 4, 5 packs a day
habit. didn't exercise or work out , ate chips and the wrong foods and
did not develop lung cancer, but did develop breast cancer at age 90.
go figure....

~ curtis

knowledge is power - growing old is mandatory - growing wise is optional
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."
http://community.webtv.net/PALMER_ENT/doc