My husband was diagnosed with PC Dec. 2006.Our MD sugested surgery or seeds.We decided on surgery,however,open radical prostatectomy or Davinci ? Went for a second opinion to another urologist.He said no surgery, and suggested Tripple therapy; hormone, seeds, and external radiation. Went to third opinion.MD said surgery is a gold standart ,seeds can work as well. PSA IS 10.4, Gleson score 7 ,Stage T2. We are in process of scheduling a surgery, and very scared if we made a right choice.
Thanks
Vassi

My husband was diagnosed with PC Dec. 2006.Our MD sugested surgery or seeds.We decided on surgery,however,open radical prostatectomy or Davinci ? Went for a second opinion to another urologist.He said no surgery, and suggested Tripple therapy; hormone, seeds, and external radiation. Went to third opinion.MD said surgery is a gold standart ,seeds can work as well. PSA IS 10.4, Gleson score 7 ,Stage T2. We are in process of scheduling a surgery, and very scared if we made a right choice.
Thanks
Vassi

Most important aspect is to CHOICE THE BEST DOCTOR AVAILABLE, regardless of the treatment method you ultimately use, as this will have a large influence on results and long term prognosis.
Main thing is that you feel the doctor you have is top notch.

Your FULL DIAGNOSIS is an important consideration, for example with G7 there is a difference between 3+4 and 4+3, and also how many samples were positive. Stage T2 could be T2a or T2c.
Sorry that my comments are therefore not specific to your case.

I always suggest reading the book on PC by Dr Lee Nelson which is very comprehensive and covers diagnosis, selecting your doctor, lifestyle changes etc. Lee Nelson considered his own PC to be intermediate risk and used radiation and hormone treatment himself some years ago.

Post again if you can't get your hands on a copy.

John

Considerations include the health of the patient. Some cannot choose surgery due to health reasons. My doctor states he does not do seeds because he feels cryotherapy is as good or better and because he feels that a number of docs doing seeds do it because they also own an interest in the company producing the seeds. At $80-100 per seed, with 40-80 used, that is a lot of money.
My reason for opting for surgery is because you cannot have surgery after radiation or seeds, but can have radiation after surgery if there is recurrence. With a Gleason of seven, I would want to move aggressively toward making a treatment decision, particularly if it is a 4/3 rather than a 3/4reading. There is a relatively high incidence of elevating Gleason on post op evaluation of a surgically removed prostate.
There are numerous options for treatment, but the National Comprehensive Cancer Network came out with new guidelines for treatment in January, 2007. Google National Comprehensive Cancer Network, 1/03/07 for the article.
Good luck.

My husband had the surgery in March of 2005 we heard thru support meetings some horror stories about the seeds plus a family memeber had lots of problems with them. Every case is different and I know that. Check thru hospitals in your area about support groups for prostate cancer and try to attend a meeting before or after they are really a good palce to get info you will need. Good luck to you both and try to stay calm and you will get thru this like alot of us before. Take care and stay safe geifer

I am a newbie, as you may have seen, but have read a lot and am a healthcare professional. I am aware of nine physicians who have had PC. All of them chose surgery, if that is an indication of any significance.
The newly issued guidelines for surgical treatment of PC indicate it is the gold standard for early PC. They also indicate that robotic (Da Vinci) and open surgery are basically equivalent. High volume surgeons in high volume centers have better results. Reading these standards led me to switch, and I am now scheduled for robotic surgery. If the two are equivalent, then the longer surgical time is counterbalanced by less bleeding, better visualization of the surgical area, less surgical trauma, more rapid recuperation, and less time with a catheter. Though short term convenience should probably not trump longer term results, if results are the same, then robotic surgery is the correct decision for me.

Dear Vassi: I have had a similar experience with the different opinions. Private practice MD's may have a different interest than an equally experienced MD at a teaching hospital. I keep this in the back of my mind. My research on PC has led me to believe that surgery is a great way to go, especially if no estrogen therapy or External beam radiation is needed. I would look for the most experienced MD for the treatment being done. The "Walsh technique" of nerve sparing surgery seems to be the gold standard so I looked for an MD who was trained at John's Hopkins. John's Hopkins and Sloan Kettering Institure in New York have been leaders in the Laproscopy surgery, so I looked for an MD who had a residency or fellowship at one of those institutes. Laproscopy seems to be very state of the art and well researched and used by the MDs, not sure if robotics is the same but I think the robotics may be a newer form and maybe the MDs are still training on it. Something to think about. I found that each Doctor was open in giving me the standard options but not so open when it came to me asking what they suggest. The best thing I did was walk out of the first consultation to seek three more. One interesting fact I learned is that if I go to a teaching hospital such as Stanford, the chief surgeon will start my case but a resident will do most of the surgery unless there is a problem and then the chief surgeon comes back in. This is a good point if one finds a very experienced and well known MD who is not associated with a teaching hospital, ie: that MD will do the entire surgery which could be a big plus. Good luck to your husband and you.
Sincerely, Leonard