HealingWell
Search Close Search
☰

Visit with RO - now officially confused

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
1 23 4
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 12/8/2014 10:55 PM (GMT -5)
turn skull
Posted 12/8/2014 10:56 PM (GMT -5)
Im jealous, that you will be treated in Manhatten.
Posted 12/8/2014 10:59 PM (GMT -5)
Brachy! To me this is a slam-dunk. I've had both open RP and SRT. In my case these were my best options,given my pathology and that brachy was still pretty unproven in 2002. But if I had as good a shot as you do with brachy I'd do it, and take the equal chance of successful treatment without very high probability of SE's from surgery or EBRT
Jim
Posted 12/9/2014 5:17 AM (GMT -5)

InTheShop said...

Pratoman said...
Don thanks for your thoughts, I agree.

Max, thanks for the idea, I think if I throw one more choice into the decision making process, my head will literally explode and my brains will be scraped off the ceiling LOL

maybe you should stand outside to do your thinking.
at least then it could just be hosed off the sidewalk...

Andrew


No Andrew. His remains must be carefully retrieved from the sidewalk so they can be sent to the path lab for the final biopsy report. Then we can have the numbers placed on his headstone turn
Posted 12/9/2014 5:32 AM (GMT -5)

Tudpock18 said...
Hi Prato:

Rarely has anyone arrived here so out-of-control-hair-on-fire-gotta-get-it-out as you were when you showed up last month. However, I am really happy to seriously commend and congratulate you on your approach. Despite your initial bias you read the right books, took the right tests, saw the right doctors and did your due diligence the way it needs to be done. Way to go.

At this point, I think it's simply a matter of identifying your priorities. Both surgery and brachy are very (and equally) likely to cure you, both have equal back up plans if cure is not there and in both situations you have world class doctors who will be performing the procedure. With surgery you have the knowledge of your pathology and the gratification of a quicker drop to PSA nadir. With brachy you have a considerably less invasive treatment and a better chance of avoiding onerous side effects.

When I got to your state of knowledge the decision became pretty easy for me. My sex life was (and is) vitally important to me and I was eager to maintain that. The pathology knowledge was only minimally important to me. However, that's the way I'm wired and your priorities and mine may be different.

In any case, you have done your homework. Now take a deep breath, consider what's really important to you and make a decision that's based on your now-considerable knowledge rather than emotion.

Best wishes whatever you choose.

Jim


Seriously though PMan. You have had some very good constructive comments made here, like the one from Jim above and not forgetting the great posts from Tall Allen and Purgatory either. These are the type of responses that I was hoping for in my own recent thread. I have certainly gained a lot of help and information from them myself to help with my final decision. I truly hope the same apply's to you.

Good luck my friend.
Posted 12/9/2014 9:23 AM (GMT -5)
Lol at Numbers on my tombstone.

I have a question. Does anyone know approx what % of men choose Brachy? Are there numbers published?

It seems, and I know this is anecdotal, like Brachy is in the minority, vs Surgery and other forms of radiation.

Just curious
Posted 12/9/2014 9:47 AM (GMT -5)

Pratoman said...

I have a question. Does anyone know approx what % of men choose Brachy? Are there numbers published?

Yes.  I did a quick Search of HW, and found this thread which answers your question.  It is, I believe a couple years old, but it has several years of helpful trending data.

https://www.healingwell.com/community/default.aspx?f=35&m=2020929


Posted 12/9/2014 10:07 AM (GMT -5)
Thanks Jack.
Posted 12/9/2014 10:30 AM (GMT -5)
Lots of food for thought.

Again, my big fear was always the 30% chance that the G-score would be upgraded.

But, you know, if your MRI results in good news, I would think that 30% number would be substantially lower. I wonder if there is any data on that (ie: a G6, good MRI, still has surgery, find chances that the G-score is worse than expected). Maybe you can ask that question when you discuss your MRI results.

I guess the PSA anxiety in the radiation setting is something you'll have to deal with. Regardless, let's face the fact: you will have PSA anxiety whatever tx. you choose (ie: waiting for those darn results!)

Mel
Posted 12/9/2014 10:33 AM (GMT -5)
interesting chart in that thread, but you have to remember it is almost 4 years old now. Things have moved on a lot since 2011.
Posted 12/9/2014 11:27 AM (GMT -5)
Compiler, very good question, I will have it on my list. I have no doubt the chance of upgrade comes down from the 30-40% after a good MRI. The question is how much.

And yeah, the PSA anxiety is something that will be with me for the rest of my days on this planet. Hey, its been with me for the last 4 years anyway, so WTH.

Caspar, good point.
Posted 12/9/2014 11:42 AM (GMT -5)
One thing that "haunted" me, for lack of a better word.

When the urologist at Emory called me back for my results, I had about an hour wait there in the lobby area before I saw him. During that time, I saw many waiting and coming and going who had obviously recently had surgery.

Seeing those guys carrying around those urine containers and knowing they had the cathater in was a bad marketing decicison by the uro, for me anyway. One guy sat over in a wheel chair moaning the whole time as well.

I'm sure the thought of radiation beaming through 16 small pins stuck through the skin under my testicals freaks some out as well. I guess that's what makes us all different.

I'm a week out from my HDR and all I can really tell is it stings a little when I pee, and it feels like it's maybe 10-20% slower stream. Not 'weak', but sort of feels like it takes just a little longer to empty my bladder.
Posted 12/9/2014 12:40 PM (GMT -5)
Dewayne, your insight is appreciated. Glad things are going easy for you, please keep us posted, I will be interested for sure. I asked about HDR I think (I may have posted this but now don't remember), the RO responded that he prefers LDR for me based on my pathology and more the longer history of LDR (he considers me young with a lot of years ahead of me, which is probably why I love the guy so much LOL )

You are a tough dude, handling things very well.
Posted 12/9/2014 1:15 PM (GMT -5)
Given that pretty much everyone is diagnosed by their urologist and urologists are surgeons and generally recommend surgery, it makes a ton of sense that surgery would be the most common. If ROs provided the diagnosis the numbers might be different.

My conversation with my uro went something like this:

Uro: Since your cancer is considered high risk, I recommend that you have robotic surgery.

Me: Got it. So if I wasn't considered high risk, what you recommend?

Uro: I would still recommend surgery.

Me: Oh, when don't you recommend surgery?

Uro: Unless you have a positive bone scan, I always recommend surgery.
Posted 12/9/2014 1:44 PM (GMT -5)
Haha. Very telling MichaelT.

My Uro doesn't do RP, he does Cryo. But his hospital, at which he is Chief of Urology, has a huge investment in Cyberknife and advertises it incessantly.
When he called me to give me the results of the biopsy, his first words were "it came back cancerous 3 cores, G6, G6 and unfortunately G8. His SECOND sentence was "if you'd like, I can set you up with an appointment to meet Dr Haas, who does our Cyberknife .

My response was, well, I need to explore all options. I finally did set up an appointment with him to discuss my options, two weeks later, after I had already seen 2 surgeons. And I've since seen his Chief of RO, who was definitely selling Cyberknife, even though he discussed Brachy, which he said he hardly does anymore because he doesn't like it.

The upshot of this, is that I am likely not going to use him as my urologist anymore.
Posted 12/9/2014 1:52 PM (GMT -5)
Michael-T -- LOL!!

In the defense of doctors, it is unreasonable to expect that a person who has devoted his career to one therapy, would wholeheartedly endorse another therapy. He would be a hypocrite if he did. It's also unreasonable to expect that a doctor who has all he can do to treat patients and attend the occasional specialty conference to keep up with what's new in his field, would have the time, or take the time to investigate the latest developments in other treatment specialties. That's why we can't rely on, say, an RO who does SBRT to know the latest findings about, say, LDR Brachy, or vice versa. Even in Pratoman's recent posts I have seen a few a few details of misinformation that I haven't bothered to correct because I don't want to get splattered when his brain explodes. Fortunately, there is no rush for him to make a decision, and there will be plenty of time for a brain explosion later.

- Allen
Posted 12/9/2014 1:53 PM (GMT -5)
To the man with a hammer, everything looks like a nail. I wouldn't say it's universally true, but I guess that's human nature. Not to get OT, but ditto with our industry...
Posted 12/9/2014 6:14 PM (GMT -5)
Michael_T ha ha re: the surgeon.
Posted 12/9/2014 6:55 PM (GMT -5)
Ok Allen, lay the misinformation on me. This is gonna be a hard decision and I need all the datapoint a I can get. And im no different from others in this situation. I tend to see what I want to se
Posted 12/9/2014 7:01 PM (GMT -5)
No way! I'm hiding behind my splatter guard. Nothing that can't wait. I think you're doing a great job so far; much better, in fact, than most patients do, and much better than I did at a similar point after my own Dx. Bask in the glory!
Posted 12/9/2014 7:18 PM (GMT -5)
Glory I could do without, but ok.
Warning you though, once I have my final two consults with the RO and SUrgeon, I'm finaliIng my decision faster than you can blink.so it may irrevocably decided with misinformation.

I'm already not liking the possibility of a protracted slow PSA fall.
Posted 12/9/2014 8:04 PM (GMT -5)
I stand duly warned. I suppose the rigid time constraint you've set for yourself is because this is all adding to your anxiety? I hear so many men tell me (in fact even at my meeting last night) - "I wish I had taken more time to make a more informed decision" So it's decisional anxiety weighed against anticipatory regret - a rock and a hard place!

The PSA usually falls quickly at first, and then more slowly settles to nadir. But there may be bounces along the way. It's never been a problem for me, but then I practice, you know, Mindfulness. Have I mentioned that before? ;-)

- Allen
Posted 12/9/2014 8:14 PM (GMT -5)
Ok, ok, yes Allen, yo have mentioned mindfulness before. And I guess I need some help with it, (ya think?)

Can you point me in the right direction? A book, a podcast series, something?
Serious request (just hope I find the time, reading this forum has become a full time job. ;-)
Posted 12/9/2014 8:28 PM (GMT -5)
You can google Jon Kabat-Zinn and get a bunch of CDs or downloads, but I would recommend taking classes. I found that classes create a good atmosphere for practice, and may help prevent sleepiness (it is very relaxing). Just google mindfulness and your local area - there are classes almost everywhere these days.

- Allen
Posted 12/9/2014 8:40 PM (GMT -5)
Thanks Allen
✚ New Topic ✚ Reply
1234