Second opinion paid off

[Hondo555]

I received my biopsy results mid October and was a 3+4=7. I decided to go to MD Anderson. For a second opinion and happy I did. They said it was actually a 4+3= 7. Removal using robotics was the only option given and is scheduled for 2/19. Really glad I got someone else to look at this. Not looking forward to the 6 months afterwards.

[Jimhoy]

Why is that the only option?!!! I hope not because thats all your Dr offers / does!!! Just curious if you took advice in previous posts and came up flat!!!

Jc

[Hondo555 in reply to Jimhoy]

I was aware of all options and we discussed all of them. He said there was no guarantee any other options would kill all the cancer due to how wide spread it was.

[Jimhoy in reply to Hondo555]

I’m sure more knowledgable others will chime in. Still doesn’t make sense to me but I’m as dumb as a stump lately anyway!!!

Best of luck!!

Jc

[cpcohen in reply to Hondo555]

". . .He said there was no guarantee any other options would kill all the cancer due to how wide spread it was. . . ."

Well, that's true -- the other options don't have a guarantee.

But if he implied that surgery _was_ guaranteed to kill all the cancer, even though it was widespread:

. . . he was implying something that is not true.

No surgeon is that good, and no cancer is that well-behaved. You might want to look at the "Pre-Radical Prostatectomy" nomogram here:

mskcc.org/nomograms/prostate

and put in your own numbers. It will give you an estimate of the "Progression-Free Probability" for surgery, given what your biopsy showed. That's what (in layman's language) you'd call "the chance that the surgery got all the cancer".

I don't know what it will be, but I'll bet it's not 100%. Please run the numbers, and report back -- I'm interested.

Thanks --

. Charles

[Tall_Allen]

If that was the only option you were given, you may want to get more opinions. MD Anderson is a great institution, and Deborah Kuban and Steven Frank are great ROs who I hope you have talked to separately from your urologist. They don't offer SBRT or HDR brachytherapy as monotherapies for intermediate risk patients. Steven Frank can certainly offer you brachy boost therapy using LDR brachytherapy and external beam radiation.

As you can see from the following list of outcomes for various therapies for "unfavorable intermediate risk" PC, surgery doesn't measure up to some of the others:

pcnrv.blogspot.com/2018/10/...

The side effects also vary depending on your choice.

You are to be congratulated for taking the first step in seeking second opinions at all. Most patients don't even get that far. I encourage you to keep going.

[Hidden]

Good luck in finding the right healing path..

[EdinBmore]

To echo Tall_Allen, get another opinion re options; RO and medical oncologist may provide you some other choices.

Good luck to you.

EdinBaltimore

[dadzone43]

The "good" in those next six months will be in knowing there is no cancerous gland in your body. And you will get thru those six months and be dry again.

[OldRadioGuy]

I'm two weeks out from my prostatectomy. The first couple of days were pretty miserable but now I'm comfortable and can easily wait out the 6 months.

The good news is that the biopsy showed the cancer contained to the prostate so I will able to go about my life from here.

[Dogdays1]

Sorry but maybe I’m missing something. You are a 7+3 GS7. Your doctor (surgeon/URO) at MD Anderson said that your cancer is so wide spread that only surgery will kill all the cancer. Doesn’t make sense to me. Is he saying that it has escaped the capsule? If so, how far does he plan on cutting to get all this wide spread cancer? You really need to get the opinion of an RO. Even if just for their opinion alone.

I may be right there with Jimhoy and dumb as a stump also. If so disregard what I asked.

[PKLA]

Hondo,

I'm 8 months post-surgical removal of my prostate. I, too, had similar numbers, and robotic, nerve sparing removal, along with several lymph nodes. I also got a second opinion from a John Hopkins trained urologist in Dallas who confirmed the diagnosis and treatment I had done at UT Southwestern in Dallas, Dr. Claus Roehrborn, Chief of Urology at UTSW. Prostate cancer is his specialty. Following MRI, and targeted biopsy, 9 of 12 samples tested positive for cancer. Dr. Roehrborn, said that following the biopsy, that while not aggressive, there was a lot of cancer, and while confined to the capsule, one particular mass was getting close to the edge of the capsule and nerves. His recommendation was robotic surgical removal. Following surgery and removal of several lymph nodes, that diagnosis was confirmed. My cancer had not spread. At the time of my surgery, Dr. Roehrborn said that he had performed over 2400 such surgeries. and I felt quite comfortable and confident in him and my decision. My prognosis is excellent. I am not completely continent yet, using usually a pad a day, but progress continues to improve. Keep doing kegels! Erectile function seems to be returning, slowly. For me, I'll take all that, with the knowledge that I consider myself 99% cured. Time will tell, but I feel good about my decision. Good luck.