If the first nerve-sparing surgery was performed in 1992, it is the 15th anniversary, not the 25th. Incidentally, do we have data-driven research on nerve sparing vs non-sparing concerning biochemical failure and other therapeutic markers?

You said: men over mid sixties, the recovery of erection is unlikely, even if the nerve sparing was successful. If the man had the ability to get the erection prior to the operation, and the nerve sparing succeeded, why not? WW Metts wwmetts@q.com

In your answer to the 72-year old you said radical prostatectomy is not usually recommended for patients more than 70 years old. Can you say why?

I would like to share my experience in the use of alternative therapy for my treatment of prostrate cancer. I was diagnosed with T1 and a Gleason of 6. I am 69 years old and I believe that I will die of something else before I die of prostrate cancer. I have chosen "quality of life over quantity of life" and with the aid of an alternative medicine urologist have been using vitamin and herbal supplements to prevent the progession of the cancer. My PSA was 4.8 prior to my starting the vitamin/herbal regimen, and after four months of supplementation is presently 2.93. In addition to the supplementation I take, I strongly believe that my mindset not to listen to the doomsayers advising immediate surgery, but rather to go forward in the most positive of mental outlooks, has contributed greatly to my cancer not progressing. Perhaps this is even more evidence of how the mind can control the body.

I had prostate surgery six weeks ago, at age 68. How soon can I expect to see some control of the bladder function (nothing apparent yet)? No sign of erectile function either. Otherwise, physical stamina is improving daily and I feel good.

I'm age 64, T1C, Gleason 6 and 7. I, too, went the route of alternative means with Lycopene, Vitamin D, and others. Managed to drop PSA 10.6 to 6.0 in three months and thought I was on my way to keeping this cancer under control. Unfortunaly, the biopsies did not reflect the declining PSA scores. My urologist did not mention the "penis shrinkage" factor in the surgery discussions. Nor were any references given to me...red flag. THus, after much study, I underwent non-invasive proton beam therapy at Loma Linda Univ with 150 other men over a 9 week period. With over 12,000 procedures behind them, the LLUMC treatments show excellent results, but little is ever mentioned of proton beam therapy via the Johns Hopkins documentation, even though MD Anderson, Univ. of Florida, Boston General, etc. offer this non-surgical technique. Urinary and erectile dysfunctions are not an issue with this approach. I just married again and both functions are performing at peak. Why this proton beam approach is so little known amazes me. Pioneered at Harvard, it has been around in the prostate procedures for nearly 13 years and remains a quiet wonder in this prostate cancer world. Study hard, make your choice, and be happy with whatever approach you select. But this is not a vasectomy...there is no going back, once cut.

Wondering why so little is known about Proton Bean therapy? How about HIFU, High Intensity Focused Ultrasound, that has been used for years in Europe? You have not heard much about this highly successful, non-invasive, non-radiation procedure because it is just now in clinical trials in the US. Only at the most recent national meeting for Urologists did the subject of HIFU even come up. To receive this treatment US patients have been traveling to Canada and the Carribean, but you will not hear about this treatment from your Urologist since it is not approved yet in the US. One starts to understand why the US is behind 21 other countries in survival rate.

When it comes to possibly getting your "manhood" sliced and diced it truly pays to look into Global prostate procedures including HIFU, Proton Beam, and other approaches. Japan and Europe have been marching at a much faster pace than the States. The HIFU apparatus originated in the States, but is not approved here (yet)...Heidelburg (Germany) and other places set the pace here. Study, ask, interview previous patients, look around, search the internet, read R. Marckini's book :"You can beat Prostate Cancer" and take personal charge of your life. Your doctor is a consultant, not a god!

My urologist, who is on the faculty at a well-known teaching hospital, had recommended lycopene, vitamin D, and selenium as adjuncts in preventing prostate cancer or slowing its progression. And indeed the literature reports drops in PSA titre with regular use of one or more of these supplements. But I've never been able to get an answer, either from urologists or by reading the literature, as to what's happening. Does taking these supplements actually suppress prostate cancer growth or does it merely lower PSA titre, perhaps by blocking PSA production, destroying or binding PSA, or interfering with the test chemistry? If so, then taking these widely-used supplements could actually be masking prostate cancer or its growth, a disturbing possibility. Does anyone know of any clinical or laboratory data that addresses this or is there good medical opinion on the subject?

Warning to those who rely on high-tech non-surgical procedures, specifically Proton Beam, HIFU and ESPECIALLY alternative: I am a physician who took care of and watched my uncle die from metastatic prostate CA involving ONLY his bones. He suffered in the hospital for one full year before going home to a Hospice situation. His pain was intolerable as virtually every bone was riddled with the cancer and fractures were everywhere, as if he survived a failed parachute jump! The point is that prostate cancer is notoriously SLOW to progress, but once out of its capsule the progression CAN be relentless and merciless. IF AT ALL POSSIBLE, CONSIDERING AGE, GLEASON SCORE AND STAGE AT DIAGNOSIS, BE VERY THOUGHTFUL BEFORE YOU DECIDE TO EXCLUDE TOTAL PROSTATECTOMY AS THE RIGHT CHOICE!

JonK, Here is a recent research article (very impressive, I might add) on the subject you queried: J Natl Cancer Inst. 2007 Aug 1;99(15):1200-9.

I have read about certain foods and their conduciveness to prostate cancer development, specifically that the omega 6 oils are dangerous. Are soy products good or bad in regard to cancer development? Do you corroborate this information? Do you endorse any sources of information re cancer and nutrition?