Thank you for this. But, why can't patient's get a full and objective and competent report on options and side effects from a single source. The business of having to shop around for different doctors from different disciplines is unprofessional and irritating.
I so agree. I have heard so many and read and took notes so I’m meeting with a radiologist to go over the radiation side of things then will talk to the surgeon whom I will have to do the surgery. I’ve gotten to the point my brain is in overload and have to take a break from all of this.
@Vincent50 Yes. I went through this and it is taxing. I met with first my primary doctor, my urologist, my oncologist, the surgery team, and radiation team. I needed to educated myself prior to sitting down with each of them. Most touched about everything I read and researched but there were one or two things that each didn't and they were caught off guard when I brought them up. Also keep in mind, all theses specialists will speak with you through the knowledge of knowing your health coverage. In short I choose radiation therapy 30 rounds. The results are mixed, still trying to determine if it was successful.
@@BigZWD Thank you for sharing your story. I decided to go through radiation therapy. Either way surgery or radiation they are supposed to do the same thing but prayerfully I hope so. Side effects ain't going to be pretty but I am already trying to get ahead of the game, changing my diet, increasing my workouts by adding walking, and most of all keeping positive in thoughts. I REFUSE to have my joy taken away.
WOW! Since being diagnosed with Unfavourable PC, i have watched SO many bloody video's from here in England )NHS) to across the pond, i was confused more than educated, but This video, spelled it out (For me anyway) exactly how i wanted it, basic, to the point and spot on. Thank you sir, for your time. I wish i had the money and time to pop over to NY and undertake your treatment, but i have settled on my course of treatment here in the UK.
Best overall information on all things prostate for a newbie I've found. I've watched a few videos but this one brought it all together in a clear, easy-to-understand way. Thank you very much sir
The whole thing seems to be in a status of flux. I am in this category myself and you really have to look around. You can take the Radiation and stick it. This is old stuff. It should be banned. Fortunately, there are new methods coming on board.
I am doing the research for my boyfreind who was disgnosed with prostate cancer 2 years ago. He is finally (I hope) ready to deal with it. I don't have a penis myself but I have observed that the relationship between a man and his dick is a very deep one so I can understand his fears of losing his erection at 57. That's what has been holding him up for these two years. This video is wonderful and educational and you can best believe we will be watching it together ASAP! I'll carry him to the doctor on my back if necessary but It's going to happen come hell or high water. Thank you so much for this video. You have no idea how much it helped me. And now it will help my boyfriend whom I love very much.
Stating it’s an expendable organ after a man is finished procreating is a horrible perspective on quality of life. I would never visit this Dr for any reason. This man’s flippant attitude shows why you must take health care into your hands and be vigilant in assessing what physicians tell you. You’re really just a number to them.
Yes. When I was diagnosed this month and told what my options were, I said to my doctor "I guess that is the end of any future sex" to which my doctor replied, "Well if that is still important to you."
How refreshing to hear an explanation about a difficult subject free from the confusing technical and medical jargon so beloved by the majority of doctors. Good work, Dr. Hasan!
Yes, great presentation. I do think that more could be shown about Robotic Surgery. I believe many of the side-effects like dysfunction erection are lessoned. Still very good presentation that avoids the technical jargon.
This is excellent information, best I've seen in many ways to compare the different treatment modalities. Looks like proton therapy may be the best choice on the side effect profile.
Proton is generally done with 45 sessions MRIdian SBRT is only 5 sessions. The MIRAGE study showed that MRI guidance reduces side effects with CT guidance (like proton) by around 50% th-cam.com/video/ZpK3JhVUNDk/w-d-xo.html
I agree about how good this presentation was and it sounds like proton therapy may be the best choice (for me), however he is a proton therapy guy, despite coming across as unbiased. More importantly with all,of the radiation choices, if ADT or hormone therapy is required than that can DRASTICALLY change the comparisons
Be careful. A friend in his 70s went with a prostatectomy and is borderline suicidal now--he pees himself, can't have sex anymore and hasn't left the house in a year. His partner left him. Is this really any kind of quality of life? I'm 60 and I've chosen to do nothing about my prostate cancer that was diagnosed when I was 55--not even a biopsy as I don't want to know my Gleason score--and five years later I'm still here and having some of the best sex of my life AND don't wet myself.
I'm sure that my boyfriend would be of the same mind but for the fact that he has full custody of his 3 teenage children. I'll be with him no matter what.
I recently got a second opinion on my biopsy and I don't understand it maybe you or someone else can help me. Here's how it reads."It involves approximately a 90% of the sample. The grade 4 is 4 mm. Gleason score 3 + 4 = 7". I don't understand grade four is for mm? I am trying to find the volume of the ...4! It seems to me that they're giving me the measurement! I don't know how big the core was. Please anyone I need help I went to a couple prostate hotlines and nobody already and they couldn't even figure it out.
Thank you for explainng the various tretaments with thier pros and cons. My GP has done an exmination and one side of prostate is swollen and felt lumpy/ hard. I am currently waiting for my PSA test result and subequent MRI scan next week to determine the exact diagnosis. This video gives me good information beforehand and as a result I would be able to understand the proposed treatments options much better.
I have Lowe risk prostrate cancer but I also have non bacterial prostititis I’m talking to a proton therapist and a surgeon the proton people are worried about the prostititis
Thank you Dr. Hasan. This video was very informative and is definitely helping me in making my decision on what treatment to seek. Though I'm not sure proton therapy is available up here in Canada . I'm definitely leaning toward radiation therapy with my Gleason score of 4+3=7. Thanks for your time well spent.
I had the same Gleason score with an aggressive type cancer and have been through radiation plus Brachytherapy. All my treatments were done at the Dattoli cancer center in Florida. He has the latest technology in exterior beam radiation with a focused beam that wont burn other organs just the cancer. 37 years experience and helped pioneer Brachytherapy. Please research Dr. Michael Dattoli
Instructive so to speak. Anxious still! From firsthand experience, what would you advise one who's had an open surgery and he's having problem walking properly vis Erectile dysfunction. As in Re-radiation, would you recommend keyhole surgery as a corrective?
I hear you, this has been such a frustrating process. Seems half the doctors are selling what they do while condemning others and half don’t know what happened in the last decade with new technology or statistics. Really sad we don’t have knowledgeable advocates helping us.
I’m surprised he did not mention that another advantage of surgery is that reoccurrence (if it should occur) is relatively easy to detect and track. Things are a bit more complicated in that regard when we are talking radiation (w or w/o ADT).
Yes true. I'm referencing spotting BCR early via rise in PSA following RP. Things are a bit more complicated in that regard when we are talking radiation (w or w/o ADT).
I had intended to share my experience with this problem but I don't think it would help anyone currently trying to choose a treatment for this problem. I can only say I sympathise, having never been ill before it was like a punch in the face to be told I had a life threatening illness. Even now it seems that diagnosis and type of treatment are largely a lottery. Now, 10 years later I am still here though no longer able to function sexually. I still apologise to my wife as obviously it has affected both of us, but although I tried various remedies I eventually had enough of embarrassment, humiliation and failure. And following co id, I keep as far away from the medical profession as possible.
Wow so this is what I have to look forward to. I am still on the fence of getting surgery or radiation. Both are horrible but I have to hold onto my faith and cash in living over functioning again sexually. At 68 of age I’m single and really not seeing anyone right now so tackling the treatments and side effects I have decided to give my other interests full attention and embrace each day God let me see.
@@joemaxwell1044 Hi Joe. I too am 68 and after I responded four months ago and lots of research I decided what would be best for me is radiation and hormone therapy (ADT). I prayed hard and I surely didn’t want to interrupt my life so this was my decision. The only side effect that’s a pain in the a** is HOT 🥵 FLASHES. They come and go when I least expect it especially at night when I awake to go to the bathroom here it comes and to ease the sweating I usually turn on the fan. I still work, exercise, and tailoring my diet cause weight gain is an issue as the testosterone level goes down (ADT) does this. The other side effect is the radiation enlarges the prostate so urinating can be a problem so after a three weeks of starting the treatment my Dr prescribed Tamsulosin which I take once a day which helps me empty my bladder 👍🏽. I feel great overall and have 7 remaining treatments left out of 44. Stay in prayer and I’ll keep you in mine as you research which treatment will be best for you. Good Luck.
My husband was just diagnosed yesterday. I wholeheartedly endorse his decision to have the prostatectomy. He’s 66 and I’m six years younger. It seems to both of us the most effective way of dealing with this disease with minimal recurrence. I want him in my life as long as possible. I don’t care about the rest
My experience is that “if you hire a plumber (surgeon) you get plumbing (surgery). If you hire an electrician (radiologist) you get electrical work (radiation). The two may not agree with the most effective approach, as was my case. I chose surgery by a urologist. He said “radiation is like trying to drive a nail with a brick”. Absolutely true story.
You are correct really, There is a huge "fight" going on between Urology and Radiology, Who is better and why and since the Urologists are usually the ones to diagnose PC there opinion and argument is the first said so most men just do what they say. My Urologist looked me in the eye and outright lied to me saying Radical Prostatectomy was my only choice. All of his co-working pears said total BS. I have many choices.
I was told nothing could be done for me since prostate cancer was now in my lymph nodes. I was never told anything about this Gleason score thing. If they cannot do anything they cannot say how and when I will die. My palliative nurse will at least make sure I have pain pills. Now just 15 mg of oxycodone every 4 hours.
I am sorry to hear this and I don't believe you are told correctly, But I certainly don't know your situation. Ask for another doctor and another opinion. I do know the Mayo Clinic mostly in AZ has a 2 step process, 1st infusion finds and binds itself to cancer 2nd infusion is radioactive and only becomes activated when it finds and binds to the 1st molecule that has attached to a cancer cell killing the cancer. It is having great success from what my doctor at Mayo told me.
I'm sorry to see how helpless and hopeless you feel, especially when you write that you don't know the answers to the questions, that, of course, have been bothering you and are bothering you. I think you should really talk about it all, about how you feel, either once more with your doctor or certainly with another doctor or more doctors if your doctor doesn't help you with support and with a detailed explanation of everything you want to know.
Thank you for this. But, why can't patient's get a full and objective and competent report on options and side effects from a single source. The business of having to shop around for different doctors from different disciplines is unprofessional and irritating.
I so agree. I have heard so many and read and took notes so I’m meeting with a radiologist to go over the radiation side of things then will talk to the surgeon whom I will have to do the surgery. I’ve gotten to the point my brain is in overload and have to take a break from all of this.
I'll second that. You have to take control of the entire process.isten respectfully but don't be pushed into anything
@Vincent50 Yes. I went through this and it is taxing. I met with first my primary doctor, my urologist, my oncologist, the surgery team, and radiation team. I needed to educated myself prior to sitting down with each of them. Most touched about everything I read and researched but there were one or two things that each didn't and they were caught off guard when I brought them up. Also keep in mind, all theses specialists will speak with you through the knowledge of knowing your health coverage. In short I choose radiation therapy 30 rounds. The results are mixed, still trying to determine if it was successful.
@@BigZWD Thank you for sharing your story. I decided to go through radiation therapy. Either way surgery or radiation they are supposed to do the same thing but prayerfully I hope so. Side effects ain't going to be pretty but I am already trying to get ahead of the game, changing my diet, increasing my workouts by adding walking, and most of all keeping positive in thoughts. I REFUSE to have my joy taken away.
@Vincent50 Good all those steps will help, especially if you are taking hormones injections or pills. GOD Speed!
WOW! Since being diagnosed with Unfavourable PC, i have watched SO many bloody video's from here in England )NHS) to across the pond, i was confused more than educated, but This video, spelled it out (For me anyway) exactly how i wanted it, basic, to the point and spot on.
Thank you sir, for your time. I wish i had the money and time to pop over to NY and undertake your treatment, but i have settled on my course of treatment here in the UK.
What did you choose?
Probably the best unbiased info on PC treatment on TH-cam. Thank you ZERO Prostate Cancer and Dr Hasan.
Best overall information on all things prostate for a newbie I've found. I've watched a few videos but this one brought it all together in a clear, easy-to-understand way. Thank you very much sir
I have crawled the internet for months searching for information. This is the best video I have found on TH-cam!!!!
The whole thing seems to be in a status of flux. I am in this category myself and you really have to look around.
You can take the Radiation and stick it. This is old stuff. It should be banned. Fortunately, there are new methods coming on board.
I just watched this for the second time. If the doc ever needs a change of career - he makes a wonderful presenter.
I am doing the research for my boyfreind who was disgnosed with prostate cancer 2 years ago. He is finally (I hope) ready to deal with it. I don't have a penis myself but I have observed that the relationship between a man and his dick is a very deep one so I can understand his fears of losing his erection at 57. That's what has been holding him up for these two years.
This video is wonderful and educational and you can best believe we will be watching it together ASAP! I'll carry him to the doctor on my back if necessary but It's going to happen come hell or high water.
Thank you so much for this video. You have no idea how much it helped me. And now it will help my boyfriend whom I love very much.
Hey Kat my husband (50) just got diagnosed and we're weighing options now. Did your boyfriend ever make a decision?
Stating it’s an expendable organ after a man is finished procreating is a horrible perspective on quality of life. I would never visit this Dr for any reason. This man’s flippant attitude shows why you must take health care into your hands and be vigilant in assessing what physicians tell you. You’re really just a number to them.
Yes. When I was diagnosed this month and told what my options were, I said to my doctor "I guess that is the end of any future sex" to which my doctor replied, "Well if that is still important to you."
How refreshing to hear an explanation about a difficult subject free from the confusing technical and medical jargon so beloved by the majority of doctors. Good work, Dr. Hasan!
Yes, great presentation. I do think that more could be shown about Robotic Surgery. I believe many of the side-effects like dysfunction erection are lessoned. Still very good presentation that avoids the technical jargon.
This is the best overview I have found on the the internet. Wonderful. Thank you.
Thank you so much for this thoroughly helpful synopsis. You are an exceptional Human~~
This is excellent information, best I've seen in many ways to compare the different treatment modalities. Looks like proton therapy may be the best choice on the side effect profile.
Proton is generally done with 45 sessions MRIdian SBRT is only 5 sessions. The MIRAGE study showed that MRI guidance reduces side effects with CT guidance (like proton) by around 50%
th-cam.com/video/ZpK3JhVUNDk/w-d-xo.html
I agree about how good this presentation was and it sounds like proton therapy may be the best choice (for me), however he is a proton therapy guy, despite coming across as unbiased. More importantly with all,of the radiation choices, if ADT or hormone therapy is required than that can DRASTICALLY change the comparisons
Why not mention SPACE OAR hydrogel that is more readily available now to protect the rectum from radiation?
A wonderful lecture. Deals with pros and cons.
Be careful. A friend in his 70s went with a prostatectomy and is borderline suicidal now--he pees himself, can't have sex anymore and hasn't left the house in a year. His partner left him. Is this really any kind of quality of life? I'm 60 and I've chosen to do nothing about my prostate cancer that was diagnosed when I was 55--not even a biopsy as I don't want to know my Gleason score--and five years later I'm still here and having some of the best sex of my life AND don't wet myself.
Yes but what was your psa score and did it increase dramatically?
you are one hell of a strong man
Ignorance is bliss, I guess.
I'm sure that my boyfriend would be of the same mind but for the fact that he has full custody of his 3 teenage children. I'll be with him no matter what.
Excellent, thank you.
I recently got a second opinion on my biopsy and I don't understand it maybe you or someone else can help me. Here's how it reads."It involves approximately a 90% of the sample. The grade 4 is 4 mm. Gleason score 3 + 4 = 7". I don't understand grade four is for mm? I am trying to find the volume of the ...4! It seems to me that they're giving me the measurement! I don't know how big the core was. Please anyone I need help I went to a couple prostate hotlines and nobody already and they couldn't even figure it out.
Thank you yours has been the best most comprehensive talk on TH-cam. I am very grateful. John Deehan London
Thank you for explainng the various tretaments with thier pros and cons. My GP has done an exmination and one side of prostate is swollen and felt lumpy/ hard. I am currently waiting for my PSA test result and subequent MRI scan next week to determine the exact diagnosis. This video gives me good information beforehand and as a result I would be able to understand the proposed treatments options much better.
Would SpaceOAR hydrogel lessen the collateral damage and remove that "con" from the SBRT column?
That is the same thing I just thought of and posted it before I saw your comment. It is more readily available now to help protect the rectum.
Excellent presentation!
Very informative, I thank you and I have a lot to think about..
First class. Excellent and extremely clear. Well done Doc.
Excellent talk, detailed and to the point, thank you so much.
Thank you for your advise.
Very helpful thank you
I have Lowe risk prostrate cancer but I also have non bacterial prostititis I’m talking to a proton therapist and a surgeon the proton people are worried about the prostititis
~ If you remove the prostate, those problems are gone. It does take time to recover bladder control.
Thank you Dr. Hasan for your clear and concise teaching! So helpful
Thank you so much Dr. Hasan, it was the best video I have seen on the subjects.
Excellent explanation! Thank you!
Thank you Dr. Hasan. This video was very informative and is definitely helping me in making my decision on what treatment to seek. Though I'm not sure proton therapy is available up here in Canada . I'm definitely leaning toward radiation therapy with my Gleason score of 4+3=7. Thanks for your time well spent.
I had the same Gleason score with an aggressive type cancer and have been through radiation plus Brachytherapy. All my treatments were done at the Dattoli cancer center in Florida. He has the latest technology in exterior beam radiation with a focused beam that wont burn other organs just the cancer. 37 years experience and helped pioneer Brachytherapy. Please research Dr. Michael Dattoli
May I ask how things are going? My husband was just diagnosed with the same Gleason score. He's 50.
Instructive so to speak.
Anxious still!
From firsthand experience, what would you advise one who's had an open surgery and he's having problem walking properly vis Erectile dysfunction. As in Re-radiation, would you recommend keyhole surgery as a corrective?
very informative and useful thing thank you Hasan Saab🙏
Thank you for this most informative PSA!
Best facility for Proton SBRT?
Great info and very informative.
For someone who has been on TRT for the past 2 years, I see ADT as a complete horror show
Sorry to hear that. It is the one thing my doctor said don't let anyone do. Just guessing you are not alone.
@@JNJSD Would like to find a doctor like that. They all seem to be on board with ADT
I hear you, this has been such a frustrating process. Seems half the doctors are selling what they do while condemning others and half don’t know what happened in the last decade with new technology or statistics. Really sad we don’t have knowledgeable advocates helping us.
@@skinfiddlerWhat the hell is ADT
@@catfish24 Androgen Deprivation Therapy: chemical castration
Is it possible to use brachytherapy with spaceore gel injected to protect the rectum?
I used space oar with brachytherapy. Worked well.
Exactly I can not believe he never mentioned it. I live in a backwards town with a local urologist that mentioned it to me
09:00
I’m surprised he did not mention that another advantage of surgery is that reoccurrence (if it should occur) is relatively easy to detect and track. Things are a bit more complicated in that regard when we are talking radiation (w or w/o ADT).
Not true. PSMA PET is equally effective. Repeat radiation with MRIdian is possible with low risk.
Yes true. I'm referencing spotting BCR early via rise in PSA following RP. Things are a bit more complicated in that regard when we are talking radiation (w or w/o ADT).
Also the fact that after radiation surgery becomes much more difficult if there is a recurrence.
I had intended to share my experience with this problem but I don't think it would help anyone currently trying to choose a treatment for this problem. I can only say I sympathise, having never been ill before it was like a punch in the face to be told I had a life threatening illness. Even now it seems that diagnosis and type of treatment are largely a lottery. Now, 10 years later I am still here though no longer able to function sexually. I still apologise to my wife as obviously it has affected both of us, but although I tried various remedies I eventually had enough of embarrassment, humiliation and failure. And following co id, I keep as far away from the medical profession as possible.
Wow so this is what I have to look forward to. I am still on the fence of getting surgery or radiation. Both are horrible but I have to hold onto my faith and cash in living over functioning again sexually. At 68 of age I’m single and really not seeing anyone right now so tackling the treatments and side effects I have decided to give my other interests full attention and embrace each day God let me see.
@@Vincent50 I am 68 single just diagnosed and feel the same way. Not sure which way to go surgery or radiation. Definitely a life changer. Who knew?
@@joemaxwell1044 Hi Joe. I too am 68 and after I responded four months ago and lots of research I decided what would be best for me is radiation and hormone therapy (ADT). I prayed hard and I surely didn’t want to interrupt my life so this was my decision. The only side effect that’s a pain in the a** is HOT 🥵 FLASHES. They come and go when I least expect it especially at night when I awake to go to the bathroom here it comes and to ease the sweating I usually turn on the fan. I still work, exercise, and tailoring my diet cause weight gain is an issue as the testosterone level goes down (ADT) does this. The other side effect is the radiation enlarges the prostate so urinating can be a problem so after a three weeks of starting the treatment my Dr prescribed Tamsulosin which I take once a day which helps me empty my bladder 👍🏽. I feel great overall and have 7 remaining treatments left out of 44. Stay in prayer and I’ll keep you in mine as you research which treatment will be best for you. Good Luck.
My husband was just diagnosed yesterday. I wholeheartedly endorse his decision to have the prostatectomy. He’s 66 and I’m six years younger. It seems to both of us the most effective way of dealing with this disease with minimal recurrence. I want him in my life as long as possible. I don’t care about the rest
Hi, My father 74 age 3+4=7,grade 2,psa 8,8,biopsy 4 of 12 positiv all left and left centar 1 and 2 (6%-10%) 3 and 4 (11%-20%)
Surgery or radiation
Over 70 prostate surgery is even less appropriate.
th-cam.com/video/ZpK3JhVUNDk/w-d-xo.html
@mperloe what if he is 62
Surgery or radiation?
Tell me what happen with your father now.please
He go to radiation and its good choise. He finish in may no side effect,very easy and no problem. Now he feel very good
My experience is that “if you hire a plumber (surgeon) you get plumbing (surgery). If you hire an electrician (radiologist) you get electrical work (radiation). The two may not agree with the most effective approach, as was my case. I chose surgery by a urologist. He said “radiation is like trying to drive a nail with a brick”. Absolutely true story.
A Flintstone way of thinking. There are different ways to accomplish a goal.
There is no data to show that any age man does better with surgery than with MRI-Linac.
You are correct really, There is a huge "fight" going on between Urology and Radiology, Who is better and why and since the Urologists are usually the ones to diagnose PC there opinion and argument is the first said so most men just do what they say. My Urologist looked me in the eye and outright lied to me saying Radical Prostatectomy was my only choice. All of his co-working pears said total BS. I have many choices.
I know two PC survivors. Both had surgery and are doing well. Recovery takes about 9 to 12 months .
The recovery time from surgery that you mention (9 to 12 months), is quite a bit longer than what he mentions in this video. Any thoughts ??
I was told nothing could be done for me since prostate cancer was now in my lymph nodes. I was never told anything about this Gleason score thing.
If they cannot do anything they cannot say how and when I will die.
My palliative nurse will at least make sure I have pain pills. Now just 15 mg of oxycodone every 4 hours.
I am sorry to hear this and I don't believe you are told correctly, But I certainly don't know your situation. Ask for another doctor and another opinion. I do know the Mayo Clinic mostly in AZ has a 2 step process, 1st infusion finds and binds itself to cancer 2nd infusion is radioactive and only becomes activated when it finds and binds to the 1st molecule that has attached to a cancer cell killing the cancer. It is having great success from what my doctor at Mayo told me.
My prayers to you. Wish I could do more.
Oh my God. I’m praying for you.
I'm sorry to see how helpless and hopeless you feel, especially when you write that you don't know the answers to the questions, that, of course, have been bothering you and are bothering you. I think you should really talk about it all, about how you feel, either once more with your doctor or certainly with another doctor or more doctors if your doctor doesn't help you with support and with a detailed explanation of everything you want to know.
I'm so sorry. I'm praying for you 🙏