What do we here know about Prostate Cancer treaments and outcomes?

I’m sorry to hear that.It is really hard when a parent gets sick.
My grandfather had prostate cancer.He chose to do nothing and lived to 99 years old.He died of heart failure.

I do not have any first hand or second hand experience with prostate cancer.
Here is a good informative wecast about Brachytherapy for Prostate Cancer
from a world class Cancer organization MD Anderson.

Prayers to him for what he is going through.

Like any cancer, it is an individual case by case thing. Try not to read into mortality rates relative to it. The main thing with cancers is to remediate as much stress as possible to allow any therapy to do as much as possible.

Prostate cancer is typically a very slow moving cancer. Therapies are usually very effecive from what I understand. I know 3 men who have been diagnosed with prostate cancer. 2 had surgery and are fine, 1 had the Brachytherapy. All turned out fine, all clear of cancer now years later, although the brachytherapy one is only 2 years out actually.

I know one person who was diagnosed with likely prostate cancer, but never did any invasive testing because he was already in his 80’s. He died in his early 90’s from old age.

I would always get a second opinion.

Best wishes to your entire family, Cruiser. I worked with a guy that had prostate cancer and after the treatments he continued to work right up to retirement. He recently remarried and moved to be closer to the new wife’s family. I wouldn’t have known it ever happened if he hadn’t told me.

I’m a prostrate cancer survivor. Had had annual PSA tests from 50 to 60 and were OK. Just before 60th birthday my PSA went way up. Had two prostrate biopsies done, six months apart and both showed one of the 12 samples having atypical cell structure. I would have been eligible for several therapies including brachytherapy, but I was soon to have kidney transplant so best choice for me was removal due to post transplant anti-rejection meds can give some cancers open door to spread. Surgery was robotically, and basically a none event. Four small, half inch incisions, and one about one inch. Restricted routine for a couple weeks, back to my regular activities in about a month. Good luck to your Dad and you.

As far as cancers go, it is one of the slower growing ones. It is very treatable when caught early and for some depending on age, they don’t even opt for some of the real aggresive treatments (the patients of course). Brachytherapy can be very effective. You do want to be at an institution that does lots of it. Best of luck to you all!

From I what I hear, it depends on what kind of a doctor you see first. Say you see a surgeon, they’ll want a prostatectomy done. Say you see a radiation onc ologist, they’ll recommend radiation. Say you see an oncologist, they might say wait first or do hormonal tx. I read studies about this bias, it’s disturbing. If your father doesn’t want a second opinion, you can’t force him, you know? I’ll pm you my info in case he wants to call me.

I completely agree with @Simone_De_Beauvoir. This is true about everything pretty much, doctors generally think/work within their own specialty.

I’m not a doctor and I can’t talk about it in as much detail as the fine jellyfish above. But my father had prostate cancer before he passed (of unrelated problems). He had surgery to remove the malignant tissue. As a result of the surgery, he was incontinent for the last two years of his life and had to wear a diaper. It lowered the quality of his life.

And I disagree with @Simone_De_Beauvoir and @JLeslie. Cancers are almost always discussed at cancer center tumor boards where all the specialists get together to discuss a comprehensive treatment plan.

I concur with @Rarebear . It is a team of Dr. that work together. Tumor boards discuss the cases and are made up of surgeon, oncologist, radiation specialist, etc.
Then each of them discuss and participate as needed.

But it does not sound like there is any board conveining. Although, possibly his is very straight forward for what treatment is best.

Maybe cancer is handled better than other illness, which is nice to think that, gives me some comfort. Other doctors do tend to recommend what they are used to doing, especially surgeons seem to like to cut. I had a situation recently that three doctors gave me three different opinions on what to do, all the same specialty. in the end, you have to decide what to do. When I was younger I never knew so much depended on the patient deciding.

I’ll also add that there is no problem with getting a second opinion. Usually, in cases like this, we encourage it.

@Rarebear And as I always tell you, you work in a hospital that is very unlike the many Brooklyn hospitals we have here, okay? You have nutritionists for god’s sake. I’ve been to tumor boards, each department has their own and they consist of a doctor, his partner, a nurse and a tech. They talk about vacations in the Galapagos and they make me sick.

I asked a urologist today about brachytherapy and he said that it’s where they implant radiation beads directly to the prostate tumor (as opposed to doing external beam radiation). It’s something that’s done in a specialty center.

@Simone_De_Beauvoir I know several physicians who work in New York and they have fully functioning tumor boards. My hospital is like most others in that way. And they’re registered dietitians, not nutritionists.

I use to work on a unit in the hospital that did brachytherapy. We had a lot of special procedures we had to follow while the patient had the implant beads in place. We didn’t take care of patients with it very often, but basically, the patients would be in a private room and there would be limitations on any going into the room. I’d be happy to answer any questions I can from the nurses standpoint.

@Rarebear Tell me the names of the hospitals.

@Simone_De_Beauvoir That will take some research on my part, which I don’t have time for right now as I’m working on finishing a couple of projects before I leave for a conference in a couple of days. I know this because I was the director of a national medical organization for a few years and at a meeting the issue of tumor boards came up in conversation.

And furthermore, I’ve decided I didn’t like the way you ordered me to tell you the names of the hospitals. So I’m not going to bother. You want something from me, you ask politely.

@Rarebear I feel the same about second opinions as does my mom, but apparently my dad has a comfort zone with the oncologist who is/has successfully treated quite a few of his golfing buddies where he lives. My dad has always made informed decisions and a testament to his longevity and successes in life. Thanks for your input!

@Rarebear Hi, this is the internet. You have no idea what ordering you around sounds like when I do it. Just because I didn’t attach a pretty please a hundred times doesn’t mean I was being disrespectful. I don’t need you to tell me the names of the hospitals.

@Cruiser Being comfortable with someone is very important.

@Rarebear My dad HAD to be very comfortable and convincing to get my mom to back down from insisting on a second opinion!

@Cruiser One of the biggest things when it comes to cancer is to have trust in your Dr’s. The trust in the Oncologist is of primary importance.
Glad he is also making informed decisions.

@blueiiznh I just got off the phone with him and we talked at length over his decision and he is pretty convinced this is the best thing to do as it will have the least impact on his everyday life which being able to continue to play golf played a big role in this approach he chose. Apparently it is called the Calypso IGRT Image Guided Radiotherapy which plants markers that allows the radiation to be targeted more accurately to the prostate with less spill over to the other organs. He is very positive about this approach and that gives me comfort that he is doing what he feels is best for him.

@Cruiser thanks for the update. It sounds like he is certainly going at it well informed and in the positive spirit and approach. He is also lucky to have you backing him up with care and to simply talk about it.
I pray and hope it goes well.

@cruiser Sounds like he has researched it a little. I think it sounds reasonable, not that I am a doctor. Also, since it is slow growing, if the cancer persists he can probably still do something more radical like surgery in the future. Once you do surgery it is done, and if he winds up with any bad side effects from the surgery, he would probably have a lot of regret since he is so inclined to try the radiation.

I hope everything goes well.

I had prostate cancer surgery 10 years ago. There are some prostate cancers that are very aggressive. My urologist recommended surgery, which is what I would expect from that specialty. There is not so much of a rush to decide on treatment that you can’t make an informed decision. This is major surgery. Please strongly encourage your dad to get at least a second opinion and third if possible. If you have access to a major cancer center then I would start there. Also look at www.pcri.org (PC research institute) for unbiased information. In addition there are many yahoo prostate groups to view. I can’t strongly enough recommend to look at all treatment options. Take the time to make an informed decision.