Well folks, after diagnosis of advanced cancer in 2000, no removal of prostate, radiation and Zoladex, 2006 recurrence and chemotherapy, continued Lupron only until 2016, added Casodex for two years, then Erleada for two years, then Zytiga for two years and now with MRI revealed and biopsy confirmed recurrence of local cancer only, WE ARE GOING TO YANK THAT SUCKER OUT AND STOMP IT FLAT. DaVinci scheduled for 1/14/22. Never thought this would happen and really don’t know exactly what it means long term, but I feel good about it. Has anyone else ever had this done after so long or any concerns?
Removal after Twenty Years: Well folks... - Advanced Prostate...
Removal after Twenty Years
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Pmann
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This is the first time I have heard of RP after all of those treatments. Good luck.
Thanks much
The cancer seems to be castration resistant after all these treatments. I would request a PSMA PET/CT before surgery to be sure there are not distant metastases.
There are some options to treat recurrent cancer in the prostate which do not imply surgery. Brachytherapy and SBRT could be possible treatments. Perhaps you should consult with a radiation oncologist and a medical oncologist.
Also HIFU & Chiro are options and both can be repeated.
Has there been any type of biopsy recently? I'd be curious what kind of histopathology exists that it would result in that unusual procedure.
Pmann in reply to
There has been a biopsy and I will ask that question, thanks.
Zytiga+ADT will shrink any distant metastases and render them invisible. Even so, if there were few of them (<4), there is a survival benefit to radiation treatment of the prostate (and presumably with RP). Most men would opt for SBRT because of the lower side effect profile.
prostatecancer.news/2018/09...
Thanks for your feedback TA, much appreciated.
Good luck to you Sir, I wish I would have had my prostate out back in 2011 instead of going on the ADT track with its various side effects.
in reply to ARIES29
Hey Aries29 ! I am happy that I didn’t have mine out when I see so many men do an RP the still needing every other treatment.
I am just glad to be aggressive for a change even though more SEs come with it.
in reply to Pmann
Tap dance it into submission! APC deserves no less! 🤞🏼🕺
It’s not always so easy to understand options. As having a RP in my case theoretically solved the issue then a PSMA scan showed distant métastases so the ADT started as well. It sometimes just seems to be the luck or the unlucky of the draw, to which option you chooses. My choice was removal of the gland as IMO radiotherapy prior to surgery potentially makes later removal more difficult. But it appears as your 10 years of survival may well outlast my own prospects. What a difficult disease this is. Perhaps Voltaire summed it up by “Doctors are men who prescribe medicines of which they know little, to cure diseases of which they know less, in human beings of whom they know nothing”
We were informed that removal may cause “seeding” of minute cancer cells to other areas. I guess you have considered possible consequences i.e. incontinence? Removal was never an option we considered as many men had told him of their incontinence and erectile disfunction. We’ve changed our lifestyle a great deal and hope for a bit longer here in Australia. Good outcomes to you. He is G9, 5 years post diagnosis. 39 EBRT, Zoladex 96 weeks.
I don't have any data to back it up, but was discussed with my Surgeon and did read at the time that the idea of "seeding" has been debunked, or is very low (<1%)...
Do you have any data or studies to collaborate the information you were given? I'm curious, not debating.
Thanks
Cannot recall who informed us, after several appointments with various medicos. We got so overwhelmed with the subtle push for our money (surgery in private hospitals and overtesting) and eventually chose a man who offered us hope without empty promises. He consulted where I volunteered, at a local hospital with a fine Cancer Centre. The only out of pockets were for PSMA PET scan and MRI. Every other treatment was no cost. The Urologist our GP referred us to seemed to be only interested in how much we could afford to spend on surgery. We are happy with our decision and of course weighed up all the pros and cons. It was an awful time for us both but after 5 years of healthy diet and exercise he is as good as he could be. I am grateful!
Dr Jeff Nix at University of Alabama Kirklin Clinic. He is my third urologist.
Ah - debunked. But then they follow-up with "or is very low" to cover their butts. What does that even mean? Either it is debunked or it is not.. Yes, No, Maybe - the life of a prostate cancer patient in one sentence...
in reply to dagreer
I'm a big fan of coolone, but I'm pretty sure Dr. Kwon said something about it in his last video with Moyad. Something about coming across a patient that had prostate cancer in his belly button where the robotic port goes in and his mentioning his reservations about it. There is a paper on it that doesn't really give a conclusion in the synopsis. Maybe somebody has the full paper. pubmed.ncbi.nlm.nih.gov/318.... He expressed reservations about me getting a biopsy of a recurrence, I think for that reason, if I remember.
Is true... What is and what might be, isn't really a possibility at all, but just possibly may be a could be!
Debunked because if you look for the data, the association with a <1% chance is considered basically zero! But then, when you take my situation with PCa presentation in the Peritoneal, one of the only references I could find was a case study of a male in Japan who once diagnosed didn't survive very well because when the Peritoneal spread of PCa was found it was pretty well developed. The interesting thing is some notes about the RP procedure needing to follow methodology to prevent possible seeding as they could find no other reasonable idea as to the spread. So you take study data, and then look at a real situation and try to make a reasonable conclusion. Fact is, there's no way to know because they're not going to do a study to say RP is unsafe. Another thing I came across some time ago was the process being used whereas blood was passed through a chelation filter to try and catch loose cancer cells possibly circulating during surgery. Think it was in France... Now why would they do that if there was no concern about letting loose cancer cells that could possibly become a problem later. But then you need to consider how loose cells really can't attach and do that type of thing for the most part as blood vessel and other cell function is required to keep the cell alive... I know I'm bouncing around, just spitting out thoughts as they come.
So yeah, pretty much debunked, with the door slightly ajar for a maybe, because you never know! Lmao! 
For robot surgery they put the prostate in a bag before pulling it out of the hole to stop the spread - and other reasons like to keep it all in once place and together. But pulling the instruments in and out of the hole can contaminate as well. I do not think they have done any really good studies to understand the contamination levels and injection points.
What’s IMO?
IMO get used to the abbreviations.....
Good Luck, Good Health and Good Humor.
j-o-h-n Sunday 11/14/2021 12:46 PM DST
Im a bit confused....blame it on lupron etc...1. If you failed other treatments what was causing that?
2. At dx were u ogliometastatic?
3. The hystology of your original dx is very important an u should know...i was and am ductal w mets... with pin...not touching my prstate ..
And lastly it would take large balls to do that if dx was aggrrsive pc......and after 20 yrs you have anything that resembles balls......walk tall......just my 2 cents
I like the balls joke. Oh so tiny now. 😳
Theres the making of a blues tune...they sing of broken hearts..and a car that wont start...but apc and adt took my balls ..tore my life apart....lil harmonica playin...
in reply to Boywonder56
😂😂👏👏👏
1/14/22......Don't forget to bring a bottle of champagne to christen the mother ship farewell... Good Bye Mother Pucker.....
Good Luck, Good Health and Good Humor.
j-o-h-n Sunday 11/14/2021 12:59 PM DST
Pmann,
Was your first treatment EBRT? 16 years ago, my initial treatment was external beam RT and now i have a BCR (localized)…I am on ADT (firmagon)…MSKcc is recommending Salvage HD brachytherapy…Was that an option for you?
Bill
Such an unusual case; you are going where (almost) no one else has gone before...Out of interest, what did your recent PSA tests reveal?
Best wishes with the removal of your beloved (?) prostate
Hi Pmann
First off, well done with holding out for 20 years 👍
You seem to have a good run with Zytiga. Erleada and Casodex 👍
All the best
Haniff
Thanks much
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