THERE WAS NO RESPONSE TO AN UPDATE REMINDER IN 2015 SO THERE IS NO UPDATE.

Hello everyone,

I'm 61 years old with no major medical problems. The results of my 12 core biopsy were: one core positive for Gleason 8 (2.2 mm 30% of total tissue amount), 1 core positive for Gleason 6 (2.5 mm and comprising 25% of total tissue amount),2 more cores of Gleason 6, measuring less than 1mm. High grade neoplasma were identified in multiple areas. "No perineural invasion is identified in any of these foci." I had a negative bone scan, PSA 0f 4.6, and I was staged at T1c (downgraded from T2a as a result of another rectal exam). What worries me the most is the Gleason 8.

I have read a few books on the subject, including those by Dr. Hennenfent and Dr Scardino, as well as medical journal articles from the Internet. Unfortunately, most of these articles and books concentrate on the large number of men who are in the gray area of Gleason 5-6 not 8. I was leaning towards high dose temporary seed implantation when I read a study of from the Mayo clinic of April 12, 2005, which showed a 15 year, 80% survival rate for advanced prostate cancer with RP. The article stated: "The problem with radiation therapy as the first line of treatment for T3c prostate cancer , according to the Mayo clinic researchers, is the cancer survival rate which is 79% at only 5 years , in contrast with RP, 79 % lived at least 15 years. Doctor Zincke also explains that when malignant prostate tumors are high grade-more aggressive - they are not especially responsive to radiation therapy alone."

Also, in his book, Dr. Scardino of Sloan Kettering, cites his record that "Even men with seminal vesicle invasion or lymph node metastases had only a 30% risk if dying of prostate cancer in the next 15 years (with surgery)."

I do not wish to subject myself to surgery and all its complications if I don't have to, but I can't find any references to studies of radiation treatments for advanced cancers that go to 15 years. If anyone can help me with this dilemma, I would be most grateful.

Thanks,
Carl

I apologize to all that have written me, for not returning emails sooner. I was forced to make a quick decision and decided on Laparoscopic Radical Prostatectomy at Sloan Kettering. As you may recall, my biopsy Gleason score was an 8. When I was examined by my doctor's assistant, she said she could not feel the tumor and downgraded my stage from T2a to T1c and said it was confined to the prostate. She explained that because it was discovered by PSA it did not get a chance to spread, even though it was an aggressive 8. They advised that I should receive treatment before the end of the month. I also saw a radiation oncologist (also at Sloan Kettering), who said that I was not a candidate for any type of seed implant because of the prostate infection that I had since my biopsy. He felt that my prostate was too sensitive for needles. He recommended 10 weeks of high dose IMRT radiation. I opted for surgery, which was performed on March 31.

The catheter was removed over two weeks ago, and I'm still experiencing heavy incontinence each time I get up from a sitting position and occasionally when walking. I never leak while sleeping and I'm now able to get out of bed to the toilet without leaking. This I do about 4 times a night.

The good news is that my tumor had not spread beyond the prostate, with negative margins, and both nerve bundles were spared. The nurse said to picture an orange and the tumor, which was downgraded in the post-op pathology report to a 7, had been caught in the white part of the peel. She said the operation couldn't have been timed better. The doctor said that I had peculiar lesions on my prostate, and felt it was related to the infection caused by the biopsy. I wonder if it was a poorly done biopsy or that my prostate was just super sensitive.

Carl

It has been 14 months since my Laparoscopic radical prostatectomy (LRP). I have had a PSA test every 6 months and the results were always insignificant.

I have decided against penile injections and now have erections hard enough for intercourse (with Viagra). My penis isn't as fully erect as previously, but is slightly curved. [It seems likely that Carl has a mild case of Peyronie's Syndrome, a common result of surgery which is rarely mentioned in discussions.] I'm hoping that this will improve.

Unfortunately, I still need pads, and my incontinence occurs out of nowhere. It is heavier on some days than others. I use very light and comfortable pads (Tena Serenity for men). For some reason, they are no longer sold at my local stores. I order them on Amazon.com.

It has been 27 months since my Laparoscopic radical prostatectomy (LRP). I have had a PSA test every 6 months and the results continue to be insignificant.

I now have erections hard enough for intercourse, but not as hard as before surgery. For this, I still need Viagra. My penis isn't as fully erect as previously, but is still slightly curved. It now seems like a permanent condition.

I still use one pad a day, and my slight incontinence also seems to be permanent.

It has been 41 months since my RALP operation.

I continue to have a PSA test every 6 months and the PSA remains "undetectable."

All the problems listed in my last update seem to be permanent.

It has been 56 months since my RALP Operation.

My condition remains the same as it was in my prior report.

I have had a blood test every six months , and it is always "undetectable." After my blood test next month, marking five years, I will be required to have a blood test every year, instead of every six months.

Outside of having my gallbladder removed last year, I remain in good health.

All the best, Carl

It has been 6 years since my RALP operation.

I have just received the results of my last PSA test, which was "undetectable."

All else remains the same.

No change to report

The only change is that I no longer use Viagra.

Carl's e-mail address is: thoreau54 AT yahoo.com (replace "AT" with "@")

NOTE: Carl has not updated his story for more than 15 months, so you may not receive any response from him.