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Angela Jenkins left a comment for mike gessner Jul 29

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mike gessner replied to the discussion New Diagnosis of Gleason 7 Jun 10

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mike gessner replied to the discussion New Diagnosis of Gleason 7 Jun 9

What brings you to the New Prostate Cancer InfoLink social network?: a question about which treatment to pursue

About Me:: Am a 67 year old teacher. I have GE reflux and am on antidepressant medication. After my PSA went from 6.3 to 10 in six months, I had biopsy: Gleason 4+3. Abdominal CT and bone scan were negative. My urologist recommends surgery; the radiation oncologist recommends EBRT. Both say that there's no evidence of one treatment being better than the other. Would appreciate help with making a decision.

At 12:00am on July 29th, 2008, Angela Jenkins said…: Mike - haven't heard from you in a while. Have you had treatment yet? Stay in touch and let us know how you are.

At 10:43pm on July 3rd, 2008, Angela Jenkins said…: Mike - how are you? Have you decided on treatment yet? Have you found the groups and discussions to be helpful? Keep us updated on your story.

At 2:54pm on June 10th, 2008, Samuel A. (Sam) Cox said…: By now you may have decided, but for what it is worth, if your chances of beng cured are good...have surgery and call a Good one. Don't be afraid to travel...to Miami? either!

In my case, the chances of a cure were not good, so I went with seeding (P-103) and 3D conformal....a good start to my present mangement program which could stave off serious problems until I live a normal life span anyway.

Best Wishes...Sam Cox

At 9:14pm on June 9th, 2008, Mike said…: Good ... Then at least you are talking to a couple of guys who are giving you straighforward advice. Dr. Keisch is absolutely correct about Fox Chase's reputation as a radiation oncology center. And Tony C.'s comment about you benefitting from a "committed mind" is a good one. If you don't "feel" that commitment to a specific therapy, you may not do as well as you ought to because of the doubts in your own mind. :O)

At 8:32pm on June 9th, 2008, Tony Crispino said…: Mike,
I had a run at your numbers and also had to make a call. I am doing well and would recommend that you keep studying. Whatever you decide will be better coped with with a committed mind. Until you find your mode of treatment, don't let that ping pong ball effect you undoubtedly feel get you down. Both methods have led to cure. Stay close and let us know what you decide.
Tony

At 8:17pm on June 9th, 2008, Martin Keisch, MD said…: I think both Mike and PaulC have valid comments. You have a high probability of being cured with all the standard modalities. There are pluses and minuses for all of them, mostly revolving around their side effect profiles. They are all operator dependent, although EBRT is probably the least, it too requires a good facility and MD. I would suggest finding a doctor who can openly discuss the good and bad things of their modality.
A fair consult takes about an hour of discussion. If the doctor does not do all forms of radiation, he may not give you a balanced discussion. If you are in southern NJ and Philly is not far, the Fox Chase cancer center has an excellent reputation for treatment of CaP with radiation (both seeds and IGRT)

Hope this helps

At 5:29pm on June 9th, 2008, Mike said…: (About) 97.23% of the radiation oncologists I have known always recommend RT and (about) 95.37% of the surgeons recommend surgery. Surprised! Don't be! There IS an argument that EBRT might be a better first line choice for you. There is probably just as good an argument that surgery would be a better first line choice because you can always have follow-up radiation after surgery if it still seems like a good idea. I know this doesn't help you much. It's just what I have learned over the last 20 years!

At 3:56pm on June 9th, 2008, PaulC said…: Hi Mike - welcome aboard. How long has it been since your diagnosis?

I echo what Mike says below (and, of course, heed the caveats and advice from Dr. Krongrad): If there are no other factors to consider, your chances of benefit from any of the Big Three — surgery, EBRT, and seeds — are roughly equal. More important than the treatment modality is the practitioner. The initial urologist who happened to diagnose you is unlikely to also be a top-notch surgeon.

Regarding mental health: When I was grappling with the diagnosis and the competing benefits and drawbacks of various treatment options, I found that I really needed to talk things through with someone; my depression and anger were too large for me to deal with unassisted. Given that you were already prone to depression before your diagnosis, I hope you'll consider getting yourself some counseling.

Please feel free to e-mail me about anything. (The e-mail icon is in the top left of each page on this website.)

At 3:51pm on June 9th, 2008, Angela Jenkins said…: Great. Let us know if you need anything.

At 3:49pm on June 9th, 2008, Kathy Meade said…: Since you are from New jersey, you may want to contact the mentor's program in the Prostate Cancer Coalition of New Jersey. You can get information about their program at http://www.pcc-nj.org/pcmentors_spry.php