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inthemindofanurse 08-08-2019 05:07 PM
Prostate Cancer
 
My father was just diagnosed with prostate cancer ☹️ He was told he can do radiation or surgery. I’m looking for pros and cons of each. Long and short term side effects. He was also diagnosed with melanoma a few years back. I’m wondering if that makes his chances of getting a 3rd or 4th type of cancer higher? Or is there any relevance? I also read that while rare, prostate cancer can metastasize and if so, bone is common. My grandfather passed from bone cancer. Does this increase my fathers chances? And finally, who is the best urologist and oncologist? I don’t think he wants to go anywhere local. Thank you gentlemen for any and all info!

raynan 08-08-2019 05:27 PM
Best urologist is Dr. Karavadia at Advanced Urology Institue. He'll have the answers to all of your questions. There are new treatments for prostate cancer all the time, several in the last couple of years.

red tail 08-08-2019 05:47 PM
prostate cancer
 
I had gleason 7 prostate cancer and was treated with radiation at robi institute and had no side effects and never missed a tee time all thru my treatments. that was 3 years ago and im still testing cancer free. absolutely no side effects other than the usual urination problems.
The Villages | Robert Boissoneault Oncology Institute | Radiation Oncology

jdarby2 08-08-2019 05:48 PM
I have prostrate cancer presently have had it now for a couple years. I did not have choices I had chemo therapy and now two years later taking chemo therapy pills at a rate of 1000 mg. A day. A good friend of mine had surgery and prostrate removed he has no problems now !
Best answer is a good urologist and an outstanding oncologist working together!

Edjkoz 08-08-2019 06:29 PM
A lot depends on how aggressive the cancer is and his age. I had a very aggressive type at a younger age so my only real choice was surgery. There are side effects such as incontinence and ED. Also, by having surgery first, I was still eligible for radiation if needed. You should have this discussion with his Dr. There is also a prostate cancer support group in the Villages with a wealth of info

drpepper 08-08-2019 06:38 PM
I also had prostate cancer and a year ago last October I had a procedure called H.I.F.U. , high intensity focused ultrasound. I still test for psa which is normal but my doctor tells me there is no cancer. It doesn't work for everyone but I'm happy that I chose it. One of the deciding factors for me was that you can have the procedure repeated if cancer was to return. I don't believe you can repeat radiation. My doctor was a pioneer of the procedure in Louisville, Ky. I believe there is a doctor that's well versed in the procedure in Orlando. I can come up with a name if interested.

biker1 08-08-2019 07:02 PM
I am not sure how old he is or what his Gleason score is. These matter, as well as his overall health. If he lives around here, and I am assuming he does, I would recommend he get an opinion from the Moffitt Cancer Center in Tampa. I went there and had a good outcome.

Quote:
Originally Posted by inthemindofanurse (Post 1671543)
My father was just diagnosed with prostate cancer ☹️ He was told he can do radiation or surgery. I’m looking for pros and cons of each. Long and short term side effects. He was also diagnosed with melanoma a few years back. I’m wondering if that makes his chances of getting a 3rd or 4th type of cancer higher? Or is there any relevance? I also read that while rare, prostate cancer can metastasize and if so, bone is common. My grandfather passed from bone cancer. Does this increase my fathers chances? And finally, who is the best urologist and oncologist? I don’t think he wants to go anywhere local. Thank you gentlemen for any and all info!

tophcfa 08-08-2019 09:33 PM
Quote:
Originally Posted by biker1 (Post 1671564)
I am not sure how old he is or what his Gleason score is. These matter, as well as his overall health. If he lives around here, and I am assuming he does, I would recommend he get an opinion from the Moffitt Cancer Center in Tampa. I went there and had a good outcome.
Quote:
Originally Posted by Edjkoz (Post 1671559)
A lot depends on how aggressive the cancer is and his age. I had a very aggressive type at a younger age so my only real choice was surgery. There are side effects such as incontinence and ED. Also, by having surgery first, I was still eligible for radiation if needed. You should have this discussion with his Dr. There is also a prostate cancer support group in the Villages with a wealth of info
Both of the above posts are good advise as I also am a 3 year prostate cancer survivor. I had a Gleason score of 7 at a relatively young age and opted to have my prostate removed. Good thing I did because the post operation pathology report showed the cancer had broken through the prostate wall (making it stage 3), but I was lucky it had not yet spread to my pelvic lymph nodes and the margins were clean. If I had waited, it was only a matter of time before it spread. My primary care physician saved my life finding the tumor during my annual physical. I get a PSA test every 6 months and so far the PSA levels have been undetectable, so far so good. I was lucky to have had one of the best urological surgeons in world, Dr. Francis McGovern, out of Massachusetts General Hospital in Boston. I would highly recommend him if it is logistically and insurance wise possible. Best of luck!

tophcfa 08-08-2019 10:48 PM
When I was diagnosed with prostate cancer I read a book by Dr. Patrick Walsh who is affiliated with Johns Hopkins, A guide to surviving prostate cancer. I found the information in the book to be very useful in helping me make the decisions that I now do not regret. Lots of good information in the book for a relatively cheap price on Amazon. Hope this helps.

bob47 08-09-2019 04:00 PM
If you hook up with only a urologist, you will most like be steered toward surgery. If you hook up with only a radiologist, you will most likely be steered toward radiation therapy. There is value in getting hooked up with a medical oncologist for an independent opinion. Many at Florida Cancer Specialists are very good.

B-flat 08-09-2019 04:59 PM
I had prostrate cancer in 2007. My prostrate was very enlarged and I was not a candidate for certain treatments. Actually before they could treat my cancer problem I had to have a hormone shot to reduce the size of the prostrate. Although you are probably not in Massachusetts, I highly recommend Dr. Francis McGovern. I did lots of research and he was the surgeon I chose for the radical prostatectomy. AT Mass General the other surgeons call him “the surgeon’s surgeon”. I have been cancer free since 2007.

P.S. I read Dr. Peter Scardino's Prostate Book, Revised Edition: The Complete Guide to Overcoming Prostate Cancer, Prostatitis, and BPH. Peter Scardino is the Chair At Memorial Sloane Kettering Cancer Center in NY.

Nucky 08-09-2019 08:44 PM
I give everyone who posted a whole lot of credit for sharing their stories. Thank You.

Over a year ago my blood work for my PSA went from .4 to 5.9 in 8 months. The Doctor said take this heavy antibiotic for two weeks and then two weeks after that we'll take blood and see where we are at.

So after the month of waiting and concern, the reading was .5. The bad thing there was someone walking around who was thinking they are in the clear and may not be. Since that day anytime I have Blood Drawn, the label goes on in my presence and naturally I check to be sure the info on the label is correct.

This subject is important to me as my people in my family up north have not kept up with taking care of the early testing. I get tested twice a year now.

l2ridehd 08-10-2019 05:54 AM
I was diagnosed with aggressive prostate cancer last year. Gleason 8 and PSA 8.5. I did extensive reading and research. I found the doctors here locally were focused on the cures that lined their pockets. My urologist was a surgeon so surgery was the only answer to my problem. I found a radiation oncologist and that was the only answer and it had to be the radiation machine owned by his practice which was photon radiation. An unbiased opinion was very difficult to find.

I read the book by Dr Patrick Walsh and 30 other books about the different types of prostate cancer treatment. I found out a lot of interesting things. Our daughter is a nurse practitioner and she got me access to every medicial paper published on prostate cancer. There are 100's and I read them all. Here is some stuff your doctor probably wont tell you.

Surgery. 30% of those that get their prostate removed (and this is very major surgery) end up doing radiation. And the side effects can be awful.

Photon radiation. (what is available locally) The collateral damage done by this type radiation is fairly extensive. A very high percentage of patients end up with incontinence, ED or both plus bowl and bladder problems.

After all my research I decided on Proton radiation. Very different than Photon radiation. There are only about 30 places in the country that have a cyclotron (cost for a cyclotron is in the 150 million range) that can offer this type treatment. And only about 5 of those that specialize in prostate cancer. Fortunately UF Health in Jacksonville has a cyclotron and is one of the top facilities in the world for treating prostate cancer. Loma Linda University in California, MD Anderson in Texas and Mass General are the others.

Side effects using proton radiation are significantly less than other types of prostate cancer treatment. I went to Jacksonville for 8 weeks for my treatment. My PSA has gone from 8.5 to <.01. I have zero side effects. No incontinence, no ED, no bowl or bladder issues. I call it my radiation vacation. I had to have 78 grays of radiation done with 39 treatments. Takes about 15 minutes for each session. The rest of the time I played golf, went to the beach, ate well, and enjoyed what Jacksonville and St Augustine have to offer. Deciding to go their for my treatment was the best medical decision I have ever made. You are treated like a guest there vs a patient. The doctors and staff are the best I have ever had anywhere.

If anyone wants to discuss this type of treatment more I will make myself available to you. PM me, send me a phone number, we can meet, however it will help you make the best decision for you.

biker1 08-10-2019 06:08 AM
If I am reading this correctly, you are asserting that your blood sample was mislabeled? A rapid rise in PSA can be triggered by infection or trauma. The standard protocol for a rapid rise in PSA appears to be a dose of antibiotics and then retesting. I believe it is more likely that you had an infection than your blood sample was mislabeled (unless they specifically told you that they suspected a mislabelling).

Quote:
Originally Posted by Nucky (Post 1671899)
I give everyone who posted a whole lot of credit for sharing their stories. Thank You.

Over a year ago my blood work for my PSA went from .4 to 5.9 in 8 months. The Doctor said take this heavy antibiotic for two weeks and then two weeks after that we'll take blood and see where we are at.

So after the month of waiting and concern, the reading was .5. The bad thing there was someone walking around who was thinking they are in the clear and may not be. Since that day anytime I have Blood Drawn, the label goes on in my presence and naturally I check to be sure the info on the label is correct.

This subject is important to me as my people in my family up north have not kept up with taking care of the early testing. I get tested twice a year now.

roob1 08-10-2019 06:31 AM
Robotic surgery performed by an experienced surgeon is far from very major surgery. You get about 4 very small incisions in the stomach area, one night in hospital and catheter for 10 days or so. It is generally done in under an hour.

Again, the operative word is "experienced"...find one who has done hundreds and hundreds. Side effects are also highly related to the experience of the surgeon (as well as other factors).


[QUOTE=l2ridehd;1671926]

Surgery. 30% of those that get their prostate removed (and this is very major surgery) end up doing radiation. And the side effects can be awful.

Nucky 08-10-2019 07:14 AM
Quote:
Originally Posted by biker1 (Post 1671932)
If I am reading this correctly, you are asserting that your blood sample was mislabeled? A rapid rise in PSA can be triggered by infection or trauma. The standard protocol for a rapid rise in PSA appears to be a dose of antibiotics and then retesting. I believe it is more likely that you had an infection than your blood sample was mislabeled (unless they specifically told you that they suspected a mislabelling).
Just going by what the Doctor said. He said not to get upset that over his years of being a Doctor he had seen the mislabeling many times. Nobody ever actually said they mislabeled. I did speak to the person in charge of The Facility that took my blood. I did it so they could try and find the other person who may have been mislabeled and think they are Ok but really still have a problem.

I read about infection and trauma also. I believe you're correct. I was guided by what the Doctor said.

tophcfa 08-10-2019 09:08 AM
[QUOTE=roob1;1671938]Robotic surgery performed by an experienced surgeon is far from very major surgery. You get about 4 very small incisions in the stomach area, one night in hospital and catheter for 10 days or so. It is generally done in under an hour.

Again, the operative word is "experienced"...find one who has done hundreds and hundreds. Side effects are also highly related to the experience of the surgeon (as well as other factors).


Quote:
Originally Posted by l2ridehd (Post 1671926)

Surgery. 30% of those that get their prostate removed (and this is very major surgery) end up doing radiation. And the side effects can be awful.
There are lots of opinions on the pros and cons of robotic vs open retro pubic radical prostatectomy surgery, and yes, the robitic surgery is less difficult on the patient with quicker recovery. However, there is no evidence that robitic surgery will yield better results. The patient is looking for "the trifecta" in terms of results. First, clean margins and complete cancer removal, second is continence control, and third is avoiding complete ED. Hospitals that invested heavily in robotic technology will push this meathod to get a return on their large investments. Also, most younger Doctors are only trained in robotic surgery.

All that said, what the robotic surgeons won't tell you is that without their hands actually doing the surgery, they can not feel the prostate and the tumor, and use that most important sense to help determine how much tissue to remove, giving the patient the best chance of clean margins. And with clean margins, no post operative radiation is needed.

I had the open surgery, and it is a major surgery, but in the grand scheme of life, a harder surgery and a few more weeks of recovery time was well worth it. Dr. McGovern is my hero, he gave me the trifecta : )

flyguy909 08-10-2019 10:23 AM
Bob47 is absolutely right. I was diagnosed at 58, urologist pushed surgery but I opted for radiation called Cyberknife after doing my own research. Very impressed with the procedure and the outcome as I am cancer free after 8 years. Another big plus is all the plumbing works. Three of my friends have had surgery... 2 had major complications. But that's too small a sample to derive anything.

With Cyberknife, a urologist implants 3 tiny gold seeds into your prostate using same technique as a standard biopsy. These are used by the robotic radiation machine for precise targeting. The oncologist uses MRI's and CT scans to develop a program to shoot many radiation beams into your prostate but at the same time avoiding as much collateral damage as possible. I layed on a table with my butt in a custom fitted cushion so I couldn't shift position while a big robotic arm went all around me shooting individual focused beam radiation shots. I did this 3 days for about 45 minutes a day.. and that was it.

You'll get many different answers as there are several options. I am happy with the path I chose.

tophcfa 08-10-2019 10:30 AM
Quote:
Originally Posted by l2ridehd (Post 1671926)
I was diagnosed with aggressive prostate cancer last year. Gleason 8 and PSA 8.5. I did extensive reading and research. I found the doctors here locally were focused on the cures that lined their pockets. My urologist was a surgeon so surgery was the only answer to my problem. I found a radiation oncologist and that was the only answer and it had to be the radiation machine owned by his practice which was photon radiation. An unbiased opinion was very difficult to find.

I read the book by Dr Patrick Walsh and 30 other books about the different types of prostate cancer treatment. I found out a lot of interesting things. Our daughter is a nurse practitioner and she got me access to every medicial paper published on prostate cancer. There are 100's and I read them all. Here is some stuff your doctor probably wont tell you.

Surgery. 30% of those that get their prostate removed (and this is very major surgery) end up doing radiation. And the side effects can be awful.

Photon radiation. (what is available locally) The collateral damage done by this type radiation is fairly extensive. A very high percentage of patients end up with incontinence, ED or both plus bowl and bladder problems.

After all my research I decided on Proton radiation. Very different than Photon radiation. There are only about 30 places in the country that have a cyclotron (cost for a cyclotron is in the 150 million range) that can offer this type treatment. And only about 5 of those that specialize in prostate cancer. Fortunately UF Health in Jacksonville has a cyclotron and is one of the top facilities in the world for treating prostate cancer. Lou Melinda University in California, MD Anderson in Texas and Mass General are the others.

Side effects using proton radiation are significantly less than other types of prostate cancer treatment. I went to Jacksonville for 8 weeks for my treatment. My PSA has gone from 8.5 to <.01. I have zero side effects. No incontinence, no ED, no bowl or bladder issues. I call it my radiation vacation. I had to have 78 grays of radiation done with 39 treatments. Takes about 15 minutes for each session. The rest of the time I played golf, went to the beach, ate well, and enjoyed what Jacksonville and St Augustine have to offer. Deciding to go their for my treatment was the best medical decision I have ever made. You are treated like a guest there vs a patient. The doctors and staff are the best I have ever had anywhere.

If anyone wants to discuss this type of treatment more I will make myself available to you. PM me, send me a phone number, we can meet, however it will help you make the best decision for you.
Thanks for the good information. Hopefully I will never need it, but if my PSA ever shows up as anything but undetectable, Proton radiation will be the next option for me.

CFrance 08-10-2019 03:26 PM
Quote:
Originally Posted by flyguy909 (Post 1672017)
Bob47 is absolutely right. I was diagnosed at 58, urologist pushed surgery but I opted for radiation called Cyberknife after doing my own research. Very impressed with the procedure and the outcome as I am cancer free after 8 years. Another big plus is all the plumbing works. Three of my friends have had surgery... 2 had major complications. But that's too small a sample to derive anything.

With Cyberknife, a urologist implants 3 tiny gold seeds into your prostate using same technique as a standard biopsy. These are used by the robotic radiation machine for precise targeting. The oncologist uses MRI's and CT scans to develop a program to shoot many radiation beams into your prostate but at the same time avoiding as much collateral damage as possible. I layed on a table with my butt in a custom fitted cushion so I couldn't shift position while a big robotic arm went all around me shooting individual focused beam radiation shots. I did this 3 days for about 45 minutes a day.. and that was it.

You'll get many different answers as there are several options. I am happy with the path I chose.
I am glad for your outcome. Where did you have your procedure done?

flyguy909 08-10-2019 03:34 PM
"I am glad for your outcome. Where did you have your procedure done?"

I had it done at a hospital in Hartford, CT before I moved down. The nearest one to here may be Tampa... not sure.

biker1 08-10-2019 10:59 PM
There are pros and cons to each treatment. I wound up choosing da Vinci robotic surgery for several reasons. The first was that I am relatively young, in good shape, and I have no other medical issues, so the prospects for success were good. However, the surgery is long and complicated - typically about 3 hours. I chose a surgeon who has performed this procedure many times. If I was older and/or had other medical issues I may not have opted for surgery. Secondly, the post-surgery pathology will tell you exactly how serious the issue was. Thirdly, if I had opted for one of the radiation treatments, I would not be able to be treated again. In addition, prostate removal after radiation is typically not an option. My PSA level is at the limit of detectability and I don't have incontinence or ED issues.

I did talk to several urologists. One pushed radiation. At Moffitt, where I had the procedure performed, they offered several treatment options and presented the pros and cons but did not push one treatment option over the other. They did, however, make it clear that doing nothing was a bad choice. My own research confirmed everything they told me.

Quote:
Originally Posted by flyguy909 (Post 1672017)
Bob47 is absolutely right. I was diagnosed at 58, urologist pushed surgery but I opted for radiation called Cyberknife after doing my own research. Very impressed with the procedure and the outcome as I am cancer free after 8 years. Another big plus is all the plumbing works. Three of my friends have had surgery... 2 had major complications. But that's too small a sample to derive anything.

With Cyberknife, a urologist implants 3 tiny gold seeds into your prostate using same technique as a standard biopsy. These are used by the robotic radiation machine for precise targeting. The oncologist uses MRI's and CT scans to develop a program to shoot many radiation beams into your prostate but at the same time avoiding as much collateral damage as possible. I layed on a table with my butt in a custom fitted cushion so I couldn't shift position while a big robotic arm went all around me shooting individual focused beam radiation shots. I did this 3 days for about 45 minutes a day.. and that was it.

You'll get many different answers as there are several options. I am happy with the path I chose.

Altavia 08-11-2019 07:14 AM
It is great to see all the success stories and information sharing and I hope all remain healthy.

The RedCross center that has a room where I donate granulocytes, also collect white cells from prostate cancer patients. These are processed and used for a relatively recently approved immuno therapy treatment.

If i understand correctly, the a cells are treated and become a drug call Provenge which is re-infused 72hrs later.

Immunotherapy for Prostate Cancer | Prostate Cancer Foundation


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