(This email was just between me and a friend.)


Ok... how do you know so much about Prostate cancer options?


Is it just because of your grandfather?


There are lots of options. There are lots of people who recommend 'their' option.


Removing the testicles is an 'interesting' option. I've wondered if that would be a 'good' idea given that's where testosterone comes from... I think.


The prostatectomy is the one 'solution' that lets doctors get a first hand view of what's inside. They remove the prostate, the seminal vesicles and the pubic lymph nodes.


The prostate and seminal vesicles are 2/3's of the reproductive system. The pubic lymph nodes are the highway the cancer would use to spread throughout the body. The doctor removes the nodes to see if there is cancer present. If there is, then that's a good indication there are cancer cells spread throughout the body.


When they remove the prostate they look for good margins. A good margin means the area surrounding the tissue is cancer free and increases the prospects that the cancer was contained within the prostate.


I don't know why they call the surgery radical... other than it sure is a radical idea... or a radical thing to do.


There are various types of radiation... proton, neutron, photon, radioactive seeding and then, cryo-therapy which freezes the cancer.


Unlike surgery there isn't a way to SEE the final results. So, the concern there is whether the entire cancer was killed or not. Radiation treatments are administered each weekday for several weeks, with weekends off. Radiation can cause one to feel tired after treatments.


Radioactive seeding involves the insertion of radioactive seeds into the prostate. The seeds are the size of rice. 40+ seeds may be implanted. The number depends on the size of the prostate. For an 'overly' enlarged prostate seeding may not be an option.


All of the procedures have the risk of incontinence and impotence. Those are big words. I have to double check them once in a while. Incontinence is not being able to stop urinating... there are varying degrees of incontinence. Impotence is what Viagra is for. Again, there are varying degrees.


There is a nerve sparing technique being used to help avoid incontinence and impotence.


The reason these are problems is because of the location of the prostate and the nerves that affect these functions. The prostate butts up against the bladder. Urine exists the bladder through the urethra. The urethra goes through the prostate like it was a doughnut.


To remove the prostate you have to disconnect the urethra from the bladder, remove the prostate and then reattach the urethra. Well, that point where it reattaches is where the incontinence problem originates.


The nerves surrounding the prostate are involved with impotence. To get to the prostate you have to deal with the nerves.


I just heard of a new surgery called robotic prostatectomy. The surgeon uses robotics hands to control the surgical tools during the surgery. The hype I've read so far indicates it uses a smaller incision (less than the typical 6-8 inches), recovery is faster, and incontinence and impotence happens less.


The downside. I think the closest hospital is in Orlando.


Regular surgery would take 2-4 hours. Recuperation would take 3-5 days in the hospital and then 3-4 weeks, possibly 6 weeks.


After reading about testosterone's affect on prostate cancer I think that may be something worth considering. I don't know at what point a doctor would suggest that, though. But, that's in the back of my mind.


I had a shot of Lupron this week. Lupron has some interesting side affects. It is supposed to chemically cut down testosterone production and thereby decrease the chance of the cancer growing and spreading. One side affect is kinda like menopause... MOOD SWINGS!!! That hit me a little on the first day I had the shot. But, I've been better since.


So, as far as praying I would pray for guidance in the best decision to make and for peace of mind and no mood swings. That would help the most, I believe. But, then again, the Holy Spirit knows the things that we need to pray for and intercedes for us with groanings which cannot be uttered.


The Lupron shot is good for 4 months. That lasts through Sept, Oct, Nov and Dec. That means I could possibly compete in the FCHR and maybe the Hooch. But then, we're getting into the holiday season.


My goal is to make it through the FCHR. I really would like to row the Hooch. I've never done that before. So, we'll see.


I'm getting a second opinion from another surgeon next week as well as a radiation oncologist.


I'm hoping to find some information on this robotic surgery. It's done using the da Vinci system. http://www.intuitivesurgical.com/ So, my goal now is to try and find more information by a hospital and a surgeon who is good at doing that type of surgery.


Thanks again for the prayers. I feel them working... a lot.