Surgical Option . Each option has no guarantees

[reillybars]

I was diagnosed with aggressive PC in Oct 2014. My urologist said his uncles used the seeds. My decision was to have the surgery in January 2005. I went to Dr Patel in Orlando Fl as he had performed over 7000 of these.

My experience was excellent , however 3 months later PSA was detected and began doubling every month. Radiation was the next step but I declined. A well respected Radio Oncologist told me I would be dead in 5 years. I started Lupron and it was effective. Did not like the side effects so I went on an all green diet and dropped 30 Lbs and felt great, however the cancer was still there as I had stopped getting my 3 months check ups. It went into my bladder and for the 1st time I now understood that I had cancer, because I had to pee every 25 minutes. It was scary. I resumed treatment with Lupron and told my oncologist in Clearwater Fl that I wanted to go with Lupron and Zytiga ( learned about this from heathunlocked). My PSA went from 77 in November 2017 to being undetectable . It has remained so as of my last test aug 2022.

If surgery is chosen then be sure to have them do a chemo regimen after. That was not done for me but I believe more oncologist are doing this.

I eat regular food but try and limit sugar intake to occasional deserts. Also drink alcohol in moderation . I exercise by walking daily and I am a positive thinker who loves engagement . Also believe in a higher power ( am a J.W. ).

Each person must decide what they are comfortable with, do the research , select the best practitioners , eat a balanced diet, and enjoy life with those who you love and love you back. In this world we must recognize calamity affects everyone ( the good, the bad, and the ugly)🤓

[Nusch]

Keep on fighting and enjoying and stay open for innovative treatments. Every year we get something new - looking forward to a bright future.

[Tall_Allen]

Chemo is not done after surgery fails, salvage radiation therapy is the standard of care. In cases like yours, with persistent PSA, it is supplemented with some hormone therapy for a limited time.

[Hidden in reply to Tall_Allen]

I know of one clinical trial in 2009 that offered adjunctive chemotherapy after primary treatment of a prostectomy. The study was cancelled when there were not enough subjects enrolled. BTW, I buy into the trial hypothesis.

GD

[London441]

Rising PSA after RP is generally a poor prognostic indicator, your surgeon having performed ‘over 7000’ of them notwithstanding. There are a number of possible reasons for this, but what is known is that the skill of the surgeon is not determined by the number he has done beyond 500 or so.

Also, many surgeons who do thousands of RP’s are able to because they do only part of the job themselves before handing it off to assistants. I’m not saying this happened to you, but it does happen, and it can obviously make a difference in the quality of the procedure.

You advise chemotherapy after RP because it ‘wasn’t done’ for you, even though any benefit from it in your case was speculative. Instead you refused what they wanted to do for you, which was an option with proven efficacy. Hopefully you learned something from that.

Are you still opposed to radiation? If so why?

Your healthy diet and positive outlook are great and important. The exercise even more so. You should add weight training to that, especially on ADT, but also because you’re older. Great luck to you!

[Don_1213]

I'm confused. You said "I was diagnosed with aggressive PC in Oct 2014. My urologist said his uncles used the seeds. My decision was to have the surgery in January 2005" - am I correct in that being January 2015?

Later you said: "Did not like the side effects so I went on an all green diet and dropped 30 Lbs and felt great, however the cancer was still there as I had stopped getting my 3 months check ups. It went into my bladder and for the 1st time I now understood that I had cancer" - what 3 month check ups did you stop? PSA reads? Why?

Finally you said: "My PSA went from 77 in November 2017 to being undetectable. It has remained so as of my last test aug 2022.

If surgery is chosen then be sure to have them do a chemo regimen after. That was not done for me but I believe more oncologist are doing this."

So - your PSA has been undetectable for 5 years (yea for you!) - what would the chemo regimen have done for you? Is there any reason you're not doing chemo now (is it only effective right after surgery?)

There are men who've been on Lupron for 20 years or more where their cancer didn't learn a way around it, and it's still effective for them. If you've been on it for 5 years it wouldn't surprise me to hear it's still working for you in another 5 years. It appears adding in Zytiga might also have a desirable result.