I know most men eventually get pca. It lingers or it doesn’t. We got attacked. Psa was 3 for years. Didn’t have it checked often. Last year in the 7s. Urology said normal for 76yo. Prostate not enlarged when palpated. Went to urology for slow stream. Had that for 20 years. Started flomax but it continued flow minimal. Rechecked psa was in hi 8s. Decided to do biopsy. Gleason 8. We thought open surgery. Urologist thought he could tolerate because otherwise very healthy. Met with a couple of docs and other said radiation with Lupron and Casodex. Doing that. Scans indicated not spread. But cancer is sneaky and likes to travel when given the chance. Freeloader.
I was hospice nurse many moons ago. Didn’t have many pca pts If you had to pick a cancer prostate was the way to go.
So good natured husband now cranky and changed his name to Kaitlin. That’s a joke. I’m thinking we should be optimistic. Easier said then done.
Lupron 30mg 1st dose a month ago. Is causing anxiety and forget fullness. He’s overwhelmed. A lot to keep track of.
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I am of the view that the decision to do surgery or not depends on whether the cancer has spread or not. If the patient already has metastatic cancer, then what possible use can surgery be, except to line the pockets of the surgeon ??
Clarification : Cancer has spread from the prostate to other parts of the body, not restricted to lymph nodes surrounding the prostate.
I had a combination of Lupron + radiation in 2003-2004. Now, with no other treatment, my last PSA was 0.09. There were side effects but not bad and different but not worse than most surgery patients. So I'm very happy with the outcome.
Best of luck to you and your husband. I hope the radiation oncologist successfully zapped all of the cancer.
Thanks for your reply. I ain’t who I used to be. And it’s hard to settle into this. As my husband always said. There are toooo many choices just hope we’re making the right one!!!
Had both bone and soft tissue mets and had prostatectomy any how. Right decision for me. Surgeon found real mess and continued. No clear margins, veins and nerves out of prostate area all gleason 9/10, no nerve sparing possible. PSA went up 10 pts from surgery to 6 week checkup. Lupron/chemo/Xtandi. Invalid after 4 mo. on 160mg dose. Cut dose 4 times, recovered a life. Still on xtandi, megace, gabapentin. New normal sucks at times, but I don't mind that my 3 1/2 yr old grand son beats me in dolly races across the yard and out runs me on walks around the neighborhood.
I was here for my youngest daughters wedding and will be here for my third grand daughter to be born. Also moving to the retirement home my wife and I bought in North Idaho Feb, 2 years ago. Life goes on as long as you are willing to fight for it.
Yes. only one bone met showing at time and other scans showed clear. Dead wrong. Scan 2 1/2 mo. later at start of Chemo showed new lymph nodes and pelvic, iliac, sacrum bones. Didn't show spider web of nerves and veins through out abdomen, even in unrelated tissue samples pulled during surgery. No target for radiation.
Nurse, I have an in-law who was on active surveillance for PCa for maybe 10 years with annual or bi-annual biopsies. During most of that period he had urinary issues due to an enlarged prostate and was on Flomax. About three years ago (at the same age as your husband) he got completely blocked and had to have a full-time catheter installed. His urologist (who is one of the most experienced urological surgeon is the region) suggested RALP vs a TURP procedure, the argument being that the RP would solve the urinary blockage and the cancer with one procedure. Three years later, his surgery has been a 100% success; i.e., no incontinence, no urinary issues, and NO MORE needle biopsies. He could not be more satisfied with his decision. As the saying goes, "You mileage may vary", but it is one real world example of a successful outcome in a man about the same age as you husband.
As for robotic vs open surgery, The standard line is with either is that it relies most strongly with the skill of the surgeon. The most mentioned positive for robotic, is the shorter recovery time. Duke did a survey some years back comparing the two and found at something like a year post-surgery, those having robotic RP were actually LESS satisfied. It seems the actual outcomes were near identical, but the expectations of the RALP patients was significantly higher. Here is a link to a pretty good TIME special issue that describes the development of the RALP. It might help you make a decision, if surgery becomes an option you pursue.
Hang tough with the ADT. The loss of T is a real challenge, but there are men here who have been doing it for years on end and have been able to successfully deal with its side effects.
Good Luck & Be Well - cujoe
BTW. Funny you should mention "Kaitlin", When I started ADT, I joked to my MO that I should: 1. Buy some nice lace nightgowns , 2. get myself a training bra, 3. Change my name to Josephine, 4. Start hanging out on the Wild Side with Caitlyn J. He looked like he wanted to laugh, but obvious felt it necessary in his professional role as a doctor to not do so.
I wish my husband's urologist has suggested the other surgery two years before his TURP! It was after almost two years of "enlarged prostate", awful symptoms, catheterizing, and no PSA testing... that my husband's urologist did a TURP and found cancer in the routine biopsy.
pakb, IMO, that he was not having his PSA tested borders on malpractice. I feel the same about urologists not testing for both free PSA and testosterone along with PSA. I guess we gotta keep those medical expenses down, the heck with any possible benefits to the patient.
The irony is that earlier detection would result in earlier treatment and MUCH lower lifetime medical costs for the largest majority of men. Sort of like the old auto parts retailer's TV ad about regular oil/filter changes: "You can pay me now, or you can pay me later"; i.e., pay me MUCH more later when, as a result of not doing periodic oil changes, you have to rebuild the engine. Be Well - cujoe
The slight spelling error above may well be a true Freudian slip. Hopefully the new urologist is top notch and he gets the great care he deserves - with or without any biopsy "needles". Be Well - cujoe
I'm still a lightweight here, just occasionally stoking the fire of the APC steam engine. Doesn't matter which car you are riding in, just that you are on the train. Good luck to you and your husband & Be/Stay Well - cujoe
"But cancer is sneaky and likes to travel when given the chance." If you do a cell-search with cured patients, most of them have detectable cancer cells. This is no problem because prostate cancer grows slowly and it takes a long time until you can see metastases. And these will not kill you right away.
The study Nalakrats may have refered to is the ProtecT study. It shows no difference between radiation and surgery, maybe a tiny advantage for radiation:
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