Monday, November 16, 2009

Recovered prostate cancer patients?

I was recently diagnosed with prostate cancer. I have researched many web sites to help me determine which treatment(s) to choose. Has served to confuse rather than enlighten. Any advice?

Recovered prostate cancer patients?
Your first step is to find appropriate forums for your questions. Join the "newly diagnosed" forum at: http://www.prostatepointers.org/mlist/ml...





I would recommend going to www.yananow.net, and reviewing the information there as a start. You will find case histories listed by treatment modality, and you can contact their volunteers for more information. They also have good web forums where you can ask your questions. Other good places to look include www.ustoo.org, and www.prostatecancer.org.





For a comprehensive overview, you can pick up copies of the Mayo Clinic book, or Pat Walsh's book from any bookstore.





If you have a set of lab results, you can calculate various probabilities using the calculator at http://www.prostatecalculator.org





The simple fact of prostate cancer is that it moves slowly. The advantage of that is that you have time to research a decision you will be comfortable with. The bad news is that there are a lot of alternatives, and because the disease moves so slowly, they all appear equally effective at first.





There are several main classes of treatment:





1) Surgery, imho, the gold standard of care. The risks of surgery include impotence and incontinence, but modern robotic surgery can reduce those risks substantially.





2) Radiation. Two main types of radiation treatment include brachytherapy(seeding), and beam radaition. With seeding, tiny pellets of radioactive material are implanted in your prostate. If they care precisely placed, they will kill destroy the prostate with minimal damage to adjacent tissues. Beam radiation can be conventional x-ray or proton beam. Modern beam therapy attempts to conform the beam target as closely as possible to the prostate. The risks of radiation are collateral damage to adjacent areas, including the possiblility of damage to the colon and rectum. Over time, the rates of impotence and incontinence may be the same for radiation as for surgery, but these consequences tend to appear later following radiation. Radiation can be used as secondary therapy following surgery, but it's very difficult to apply surgery or another dose of radiation following a failed radiation treatment.





3) Hormone therapy. Early in it's progress, PCa requires testosterone to grow. Reducing testoterone via castration or drugs can often slow or stop it's progress. If your prostate is unusually large, a course of hormone treatment may be needed to make it manageable with first line therapies. Otherwise, hormone therapy is usually used for salvage treatment.





4) Waiting. Sometimes called "watchful waiting", "expectant management", or "active surveillance". Basically, this means that you maintain good diet and physical activity, and get lots of lab tests, until such time that your cancer absolutely must be treated with aggressive therapy. My personal feeling is that this is a dangerous game, and the statistics bear that out. But you can get a good argument to the contrary from it's supporters.





5) Other stuff. Including cryotherapy, HIFU, chemo. None of these should be considered first line therapy.





I hope that helps you. Do join one of the groups I pointed you to. You need to learn a lot, and you need to act deliberately. Good luck.
Reply:Depending on the degree of your PSA levels, which determines the inevitable degree of cancer, I would get two opinions- the one you already got from the doctor that diagnosed you, and the other should be from a big institution that is a CANCER INSTITUTE like NIH, Sloan Kettering, Cancer Institutes of America--- if any of these oh, MAYO clinic, if any of these are in your area- go see their top oncologist---and your age has a lot to do with what type of treatment you should choose--- they are THE experts- trust their opinions- and time is of essence so get appts. ASAP- GOOD LUCK TO YOU AND GOD BLESS YOU...............
Reply:There's a lot of information out there, and it can be very overwhelming. Add to that your new diagnosis and the inevitable issues and fears you're dealing with, and it's no wonder you are confused.





The initial response about contacting "the experts" is a good one to follow up on for information. There are also new treatments being developed all the time. You might ask your doctor if you qualify for any current clinical trials if that's of interest to you. My Dad participated in one of those and it gave him an extra year or more.





A lot depends on the severity of your cancer. Has it spread out of the prostate or is it still contained within the prostate?





My father was diagnosed back in 1997, and at the time of discovery it had already spread to his ribs and spine. He was with us until the end of last summer! Nine years he stayed with us, even though that first diagnosis carried with it a common survival rate of a year or less. I don't tell you this to discourage you, but to ENCOURAGE you. This is scary, but it doesn't mean you can't live a very long, happy life.





God bless and good luck!


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