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In general, I tell them that pre-operative function is one of the most important predictors of post-operative function. The old saying, "use it or lose it" actually does apply.
More recently, there is mounting evidence that prophylactic PDE5 inhibitors (Viagra, Levitra, Cialis, etc.) even in small doses every other day may help increase blood flow to the penile region and hasten recovery of erectile function.
I would encourage you to ask your surgeon if they or their colleagues have a program of "rehabiliation" for erectile function following surgery.View Thread
last year i finished my treatments about this time this year and about a month after treatments i had to take 3 weeks off of work because of diarha and i was worn out from it.
my diarha did start to slow down and is manageable most of the time now,but when it first started i needed to know where the bathroom was where ever i went.
anyway i still have some issues but it does get a lot better.View Thread
I find it a great source to ask real doctors questions and get a 2nd or 3rd opinions. Best of luck!View Thread
Another factor to consider is the lab. Some labs will do an ultrasensitive PSA (to the one-hundreth of a point) and others will not be so precise.
Regardless, you need time and to follow the PSA. If it continues to rise this suggests a recurrence and then the question will become whether it is local or distant. (fast rise suggests distant).
If the PSa stays the same over time, this suggests PSA from benign tissue and is typically not worrisome.
Good luck.View Thread
It sounds like your father has a very slow growing type of prostate cancer that I'm presuming is low risk. (Gleason 6, PSA < 10) and if you think about it, he's now had 4 biopies (I'm assuming at least 48 cores taken) of which only the most recent showed a few cores (1 or 2?) of low risk prostate cancer. I think by all accounts active surveillance is a reasonable option in these types of cases. In many cases, its not that he may never get treated, but he may be able to safely delay treatment for 5, 10 or more years if the cancer is not progressing. The key to active surveillance is close monitoring by a urologist with regular exams, PSA checks, and repeat biopsies.
Bladder and prostate cancer are typically not related. Statistically speaking, if a patient has a high grade bladder cancer (even Stage I) and a low risk prostate cancer, there is no doubt that the bladder cancer is the more worrisome disease in terms of risk of progression, metastatic disease, etc.
It sounds like you and your father are on top of things. If you are uncomfortable or have doubts, by all means get a second opinion and I always advise patients to bring at least one other family member (extra set of ears) to such visits.
Good luck.View Thread
"Should you radiate all men such as your father (adjuvant RT) to get the maximum chance of cure at the expense of treating a large percentage of men unnecessarily" (Radiation, like any treatment, can have side effects)
Another approach is to treat with radiation after surgery after the first signs of PSA rise.
I typically prefer to check a PSA intially and only treat if the PSA is detectable. (anything detectable on an ultrasensitive PSA).
If the initial Psa at the 6 week followup is zero, I think it is reasonable to wait until the 3 month followup to check a 2nd PSA.
Best of luck to your father.
View Thread
Ironically, prior to the blood tests, giving me a psa of 27, (up by 20 over fifteen years) I had no symptoms at all
The specialists say pain very unusual, but I have since learned that it's actually common. I cannot get the truth from any medical person, and I have to say, it feels like a conspiracy to maintain the multi-billion-dollar prostate industry.
If anyone out there is experiencing pelvic pain after radiotherapy, I'd love to hear from you. According to my urologist it's as rare as hens' teeth.View Thread
I'm seeking this information here because there must be others who've experienced this.....I am having low PSA readings though.View Thread
Good luck!View Thread
Here is a thread that mentions some of the basics.
http://forums.webmd.com/3/prostate-cancer-exchange/forum/1120/4
In most cases PC is slow growing and does not always need treatment.
It depends on the age and health of the person and the Gleason score, the number of biopsy sample with PC, etc.View Thread
Thank you for starting this thread. My father was going through a similar situation and this was very helpful to me.
Wishing you all the best of health & life.View Thread
In GENERAL, however, confirmed PSA readings that exceed 0.1 to 0.2 ng/ml are highly suspicious of a recurrence, which is further supported if 3 consecutive PSA results (preferably from the same Lab) indicate a rising trend.
Continued monitoring at 3 to 6 month intervals are often suggested to establish such trends. If a recurrence appears after 2 to 3 years following surgery, it may be a recurrence that is "localized" and could POSSIBLY be successfully treated with Salvage Radiation Therapy (SRT) but this needs to be determined by professional advisors. The post surgical Pathology Report may hold important information that should be reviewed.
Hormone Therapy (HT) is not usually a curative solution and does depress actual PSA readings, making monitoring to determine recurrence more difficult and unreliable.
Good luck and don't hesitate to consider a second opinion on what appropriate action should be taken. I am not a Physician! - John@newPCa.org (aka) az4peaksView Thread
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"Survivngcancer"..Best of luck to you and hopes for big improvement!The artificial spinchter didnt work??Oh no..We were thinking of that since my hubby had open radical surgery on June 2nd and is still incontinent.Very little improvement in the last 10 months.He was only a 6.one core of 12,enlarged prostate.PSA 7.9 on Avodart..The Dr did not spare the nerve bundles and removed everything.Yesterday he went for fis PSA check-up and after the 1st 2 0PSA..it is now .07..Next check-up in Nov..No idea why it went from 0 to .07 with no prostate! Dr said NOT to worry but still its hard not to think of it.Sure hope things improve.I think your outcome really depends on a good Dr with LOTS of experience.You cant go back and do over once its done.Very disappointed in the local Dr he had.My hubby is 61 now.View Thread
Read the full WebMD blog entry:
Warren Buffet's Prostate Cancer Treatment
What advice would you give him?View Thread
Thanks for your reply.
what is the line of treatment for the above case: a) stentingb) or neurectomyc) or removal of prostate may be req at a later staged) n wat r d complications of stenting
does that later on affect bladder controlor cause reccurent uti
papa was on traject and magnax for antibiotics and is presently on urinary cathetorbut still got high fever once every daytoday he was finethey will try puttin a stent through urethrahow does that help in hydronephrosisView Thread
I think you are taking the right steps by getting all the information. I often send my patients to see a radiation oncologist just for completeness since that is the other standard treatment option other than surgery.
In a 49 year old one downside to radiation is that with G9 disease you will undergo hormonal therapy along with the radiation. If the radiation fails, surgery is not a very feasible option in most cases.
If you undergo surgery, however, its possible that you may be able to avoid hormonal therapy altogether and in the event that there is persistent disease, positive margins, or recurrence, radiation is still an option down the road.
Best of luck and I'm sure once you have finishes your due diligence you and your doctors will make a decision that you are comfortable with.View Thread
There's no magic treatment for radiation cystitis or radiation proctitis. Typically it involves conservative treatment with medications and it sounds like your doctors are doing all the appropriate things.
In some severe cases I have done a more aggressive workup for these symptoms which includes a cystoscopy to look in the bladder for potential brachytherapy seeds (unlikely at 3 years after treatment) or an MRI/CT to rule out an abscess.
These are extremely rare, however.
Best of luck.View Thread
These are not tests that are routinely done in a prostate cancer workup and I'm not sure they are related to his prostate. I would check with your regular primary care physician who can probably give you more insight as to if the values are truly abnormal and what it may mean, if anything.View Thread
I'm not sure what to make of your symptoms without knowing more about the surgery. In some cases with prolonged catheter drainage it takes a while for the bladder to "re-train" itself and start cycling again.
In other cases, some men with longstanding obstruction from an enlarged prostate have a very trabeculated bladder which doesn't contract well. Your urologist could probably give you an idea if you may be at risk for this based on your pre-operative urinary symptoms.
Hopefully the situation will resolve itself soon. If not, disuss with your surgeon whether a cystoscopy should be done to rule out any anatomical reasons for obstruction. (bladder neck contracture or stricture -- although this is unlikely to occur so early after surgery)
Best of luck.View Thread
I'm not sure what to think now. Had an appointment with a urologist at Hopkins and he recommended open RP over robotic. I asked if I could get an opinion from a radiation oncologist too just to make sure I had heard from all the experts before making a decision. He said I would be just as good a candidate for radiation (preferring brachtherapy). Then I got good news/bad news on the second opinion on the biopsy slides.
Their pathologist downgraded the Gleason score from 7 to 6. The bad news was they said perineural invasion was present. Walsh says not to worry about it but I've seen a couple of studies that indicate it may be a predictor for recurrence. I was leaning towards the surgery and not sure if this has any implications for which treatment option to pursue first or urgency. I guess I'll have to go back and ask.
GregView Thread
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