Dr. Urban, the Surgeon

Today, we went to talk with Dr. Urban.  We were there over an hour and he gave a lot of good information. 

Geoff went into the appointment thinking he was going to ask if he could go ahead and make the appointment for surgery.  I think this is a case of the more information you have, the harder it is to make a decision.  It takes a while to sort everything out.  Needless to say, we left without making an appointment for surgery.

Dr. Urban explained that there are three indicators of a high risk (for recurrence) patient.  One indicator is when there is an obvious tumor growing and the prostate is oddly shaped.  The second indicator is if there has been spreading of the cancer outside the prostate.  The third indicator is high Gleason scores.  Unfortunately, Geoff falls in the high risk category because of his Gleason scores.  For this reason, while surgery is not contraindicated, Dr. Urban feels that radiation may be the better choice because it covers a broader area.  With surgery, there are limitations to how much tissue they can remove.  Surprisingly, he said they would not remove any lymph nodes because they feel it is better to leave the lymphatic system "intact" so to speak.  They look around at the lymph nodes to see if there are any that look abnormal, but feel it is better not to remove them, especially if radiation is a possibility as a second treatment.

Dr. Urban pointed out that with Geoff's high Gleason scores, there is a one in three chance that the cancer WILL NOT recur.  With radiation, there is a 50-50 chance.  If he does the surgery and there is further treatment indicated, the odds do not change.

Dr. V (his urologist) and Dr. Urban talked this morning before Geoff's appointment.  Dr. V told Dr. Urban he thought Geoff was a good candidate for surgery (further confusing the issue:-)

So...no decision at this point...maybe tomorrow