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Cancer: Prostate Message Board

  • Surgical removal vs. EBRT

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    Old 02-21-2021, 04:10 PM   #31
    GuyBMeredith
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    Re: Surgical removal vs. EBRT

    The note about the cancer not having died during radiation treatment is something that came to my attention just a couple of weeks ago. The urologist did not address this directly, but made a comment about my still having cancer that I thought was another of her questionable remarks. Now I understand the PSA nadir thing as the cancer dies off.
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    Diagnosed at age 73 Feb 2019 DRE indicates nodule PSA 2.8 Aug 2019 PSA 3.1 Urologist suggests biopsy in Oct Results of biopsy: 2 of 12 cores positive. Low volume T2b, intermediate risk, GS 3+4, PSA 3.10, prostate cancer, perineural invasion. Followed up with MRI to help decide between surgery and IMRT. MRI shows suspicious PIRADS 5 lesion measuring 2.cm in diameter, with associated left neurovascular bundle involvement. Started 6 month lupron series Feb 2020, 28 sessions of high dose IMRT Apr 15, 2020. Sexual functions okay except ejaculate has changed. Without libido it is an academic process that requires much focus. July 27 first measure of PSA and total testosterone. PSA: .13 ng/dl Total testosterone is less than 12 ng/dl.

     
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    Old 02-22-2021, 08:49 AM   #32
    Terry G
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    Re: Surgical removal vs. EBRT

    Guy, From what Iíve read nerve tissue is not sensitive to radiation while that same tissue is very fragile regarding the mechanical damage of surgery. Even as they attempt to preserve the neurovascular bundles at least some bruising occurs and thatís one of the reasons that sexual function can be very slow to return. My sexual function remained sound even during RT. I did have some burning during ejaculation for a couple of weeks but no trouble with desire or erection.

    Unfortunately there are a lot of things that Doctor's donít explain to us that we should know prior to making important treatment decisions. My urologist didnít mention that RP was as complicated as it is. I found out later from watching ******* videos that the animation ones were nothing like watching real prostate removal surgeries. He also didnít explain that two of my three sphincters would be removed during surgery and what the purpose of those were. I have a better understanding of why urinary leakage, in continuance, and climacturia are so common. The long term effects of any aggressive PCa treatments can be life changing. Forumís like this one provide an opportunity to better understand our options and select the treatment best for our situation.
    __________________
    Rising PSA:
    11/13 1.95; 9/15 3.28; 10/16 5.94
    TRUS 1/17
    Bx: Three of twelve cores adenocarcinoma Gleason 6 (3+3) all on left side, no pni.
    DOB 7/21/47; good health; age 69 @ Dx
    Treated 6/17 SBRT @ Cleveland Clinic by Dr. Tendulkar
    Reduced ejaculate only side effect; everything works
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    PSAís post.SBRT 1.1, 1.1, .9, 1.8, 2.7, 1.0, 0.3, 0.6, 0.8

     
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    Old 02-23-2021, 11:07 AM   #33
    GuyBMeredith
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    Re: Surgical removal vs. EBRT

    Terry G, from what I understand, premature aging of the vessels from radiation is the issue, potentially (but not guaranteed) leading to loss of blood flow 3 to 5 years down the line. But at age 75 I found the option of at least continued function more attractive than wondering whether surgical damage would resolve before I entered senility.

    I sense that at 75 I am feeling a decline in testosterone driven libido. This is interesting as I dealt well with lack of testosterone driven libido during ADT. I guess I must have had some years of practice.
    __________________
    Diagnosed at age 73 Feb 2019 DRE indicates nodule PSA 2.8 Aug 2019 PSA 3.1 Urologist suggests biopsy in Oct Results of biopsy: 2 of 12 cores positive. Low volume T2b, intermediate risk, GS 3+4, PSA 3.10, prostate cancer, perineural invasion. Followed up with MRI to help decide between surgery and IMRT. MRI shows suspicious PIRADS 5 lesion measuring 2.cm in diameter, with associated left neurovascular bundle involvement. Started 6 month lupron series Feb 2020, 28 sessions of high dose IMRT Apr 15, 2020. Sexual functions okay except ejaculate has changed. Without libido it is an academic process that requires much focus. July 27 first measure of PSA and total testosterone. PSA: .13 ng/dl Total testosterone is less than 12 ng/dl.

     
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    Old 02-23-2021, 02:54 PM   #34
    Terry G
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    Re: Surgical removal vs. EBRT

    Guy, I have no first hand experience with ADT and to my knowledge I have no idea what my testosterone level is. Age 74 is just around the coroner and the Toby Keith song with lyrics “I’m not as good as I once was but I’m as good once as I ever was” rings true. As a teenage I believe I could **** over a Volkswagen without getting it wet. I know I couldn’t do that now either. The important stuff of sleeping through the nite and not worrying about where the next toilet is all still fine. I routinely take group exercise classes at the local YMCA and hold my own with guys our sons age. After more than 50 years with the same women the sex is still exciting so I feel blessed.

    I’ll try to research a little to see what I can find out about any studies suggesting a greater decline in either urinary or sexual function for guys choosing RT vs. those that have had no treatment. My guess is the data maybe difficult to sort out since just normal aging takes a toll. Terry
    __________________
    Rising PSA:
    11/13 1.95; 9/15 3.28; 10/16 5.94
    TRUS 1/17
    Bx: Three of twelve cores adenocarcinoma Gleason 6 (3+3) all on left side, no pni.
    DOB 7/21/47; good health; age 69 @ Dx
    Treated 6/17 SBRT @ Cleveland Clinic by Dr. Tendulkar
    Reduced ejaculate only side effect; everything works
    To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.

    PSAís post.SBRT 1.1, 1.1, .9, 1.8, 2.7, 1.0, 0.3, 0.6, 0.8

     
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