These are the questions that
 I asked my doctor.

What is the size of my prostate in cc?

What is the Grade of the disease?

• Gleason Grade

What is the stage of the disease?

• T1, T2, T3, T4

What are my treatment choices and what are the negative and positives of each treatment?

What are the expected benefits of each treatment?

What are the risks and possible side effects of each treatment?

Tell me about the Treatment Prerequisite of Combination Hormonal Therapy (LHRH Agonist + Eulexin) for a minimum of 6 months, followed by a reevaluation?

What About Hormonal Therapy

• Double Hormonal Blockade

• Triple Hormonal Blockade

Tell Me About a New Radical Prostatectomy That I have Read About.

• Incision in lower abdomen.

• Incision between scrotum and anus.

• Microscopic cancer cells penetration?

• Same Day Surgery for Radical Prostatectomy.

• Reduced average time in the operating room approx 1.5 hours.

• Reduced estimated blood loss by 37%.

• Reduced patient and hospital charges 32% and 35%.

• Reduced the length of the hospital stay by 3-4 days.

• The neurovascular bundle does not take a straight pathway from its origin in the sacrum along the lateral surface of the prostate to the urethra. Its takes a variant curve.

• Do you have records that shows your 10 year cure rate using a PSA nadir of .2 ng/ml.

• What % of your patients become impotent?

• What % incontinent?

Tell Me About Radical anatomical prostatectomy.

• This refined, nerve-sparing approach to radical prostate surgery involves using long, thin surgical tools to dissect free and protect the nerves and valves responsible for normal erectile function and bladder control, respectively. During surgery, the dorsal vein complex is carefully cut from the prostate, thus freeing the urinary sphincter from the gland. The prostate is then removed -- without harming the nerve bundles on either side that control erection -- and the bladder is reattached to the urethra

What About External Beam Radiation Therapy (EBRT) with:

        x-rays
        Electron Beams
        cobalt-60 gamma rays
        Protons
        Neutrons

What About Brachytherapy. (Seed Implants)

• High dose rate. Followed with external beam radiation therapy using 3D treatment planning.

• Permanent seed with 3D treatment planning.

What about Simultaneous Radiotherapy (ProstRceison) I-125 Prostate Implant Followed by External Beam Radiation.

• Accelerator radiation?

• Temporary symptoms of frequent urination, decreased urinary stream and moderate burning upon urination. Short term mild rectal irritation leading to more frequent bowel movements and occasional mucoid discharge can be experienced.

• Growing tired in the afternoon during the radiation treatments.

• Since with conformal beam radiation, the urethra , bladder, and rectum receive the same amount of radiation as does the prostate cancer inside the capsule why doesn’t radiation damage occur to these organs?

• Blood tests for checking the levels of red blood cells, white blood cells, and platelets.

• Will a special diet be necessary?

• Will radiation therapy affect me emotionally?

• What will be the follow up PSA tests?

What about external-beam radiation therapy.

• Radiotherapy typically is used as a first-line treatment for localized prostate cancer in those who wouldn't easily tolerate open surgery. Radiation also is frequently used in prostatectomy patients who've had a localized cancer recurrence.

• Traditionally, about 10 percent of men who undergo radiation therapy for prostate cancer develop bladder and rectal complications. However, at the U-M Department of Radiation Oncology, such complication rates are distinctly lower -- despite the use of higher radiation doses -- thanks to the combined use of three-dimensional treatment planning and conformal therapy, which allows precise targeting of the cancer while sparing normal tissue.

What about 3D Conformed Radiation Therapy: Performed at the University of Michigan.

Do you know anything about a new technology called Intensity Modulated Radiation Therapy IMRI which varies the intensity of the radiation beam as it rotates around the patient. This allows highly conformal radiation doses to the prostate gland with excellent sparing of the bladder and rectum. Done at the Prostate Cancer Institute of New Jersey.

What hospitals in the country could you recommend for Radiation Therapy?

• Mary Bird Perkins.

• Radio Clinics of Georgia

• John Hopkins

Tell Me About Cryotherapy.

What About Watchful Waiting

What is my expected survival rate based on clinical stage, grade, and various treatment options.

What treatment do you recommend for me and why?

Does the technique where chemicals are injected into the patients blood interact with the magnetic field of the MRI machine to produce an image of the tumor work with Prostate Cancer?

Did you use state of the art ultrasound equipment with color doppler capability to locate the tumor when you took the biopsy samples?

Is a bone scan and CT scan to rule out the possibility of distant metastases needed?

How about Lymph node sampling?

What about androgen ablation therapy (blockade of male hormone production) to shrink the prostatic and cancer cells prior to treatment?