My dad was 52 when he was diagnosed with prostate cancer, with a PSA of 72, Gleason 4+3, 12/12 biopsy cores were +ve for prostate cancer. Stage 3 with seminal vesicle involvement. Bone scan was negative for PC.



Surgery was not the conventional recommendation for his case, hence I would like to share our story in deciding his treatment choice.



He started on hormone therapy as soon as we found out he had prostate cancer, to buy us some time to think and also to shrink the tumor volume in preparation for any other types of future treatment.
An endorectal MRI was done as a baseline. Treatment decision was put on hold pending his response to hormone therapy(ADT)



He responded very positively to the hormone therapy, within 3 months his PSA fell to 0.5. A second endorectal MRI was taken, in comparison the prostate gland has shrunk considerably, infected lymp nodes have shrunk by half it's original size, and seminal vesicle is stable.



With such positive result, we decided to go with the da Vinci surgery.



"All Brain Crunching"

1. He is young, so we decided we should debulk majority of the tumor, so that secondary treatment only has to deal with any cancer cells that are systemic.
My dad was physically healthy to recover from the surgery.



2. Having radiation done usually rule out the possibility of having surgery in the future. This is because tissue that have been radiated is not as visible for surgery and doesn't heal as well as fresh tissue. We wanted to keep the radiation card for later just in case we might need it.



3. We felt very confident and comfortable with the ability of our surgeon Dr. Christopher Chang, Chief Urologist Singapore General Hospital. He has done many laprascopic prostatectomy with the da Vinci machine. With his agreement that this was the favorable choice, we felt confident.



Following surgery, my dad was on continuous ADT for the next 2 years. The hormone therapy was the more important treatment for him. This made sure we address any systemic disease.



After two years he is off ADT. It is recommended to be on ADT for a max of 2 years at a time to avoid permanent muscular atrophy. During this time it is important to have his PSA and testosterone level checked every 3 months intervals.

lynn