Can’t decide course of treatment… help!

Old Salt

Regarding classical DaVinci robotic prostatectomies, one typically reads statements on patient forums like 'better find a surgeon who has done at least five hundred of them'.

Similarly, as Wheel already wrote, you need to find a surgeon who has significant experience doing single port prostatectomies. You don't want a newbie and don't be afraid to ask! Doctor Yuh might be able to guide you in finding such a specialist:

Single-Port Surgery Changes the Landscape in Prostate Cancer Treatment

Another (very new) development:

New Surgical Robot Demonstrates Success in Prostate Cancer Treatment - EMJ

mac2237

hello all,

I was diagnosed in 12/2023 and as luck would have it I had a heart attack(which I still question) and had 2 stents placed. I am 56 years old and in fairly good shape. I have a lot of energy and I don't have any symptoms. I've gone to different very reputable hospitals in California and now in Texas. I have had MRI, Pet scan, biopsies etc. at the beginning it was said I had some cores 4+3 another said 3+4 and the last biopsy confirmed 3+4. 3 Surgeons have wanted to do surgery immediately. 2 radiation oncologist as well as another surgeon said active surveillance. One went as far as saying not to worry about my prostate, that I should focus on anything related to my heart. Kinda of all over the place I think, Any Thoughts or similar situation?

Wheel

At your age as long as your Gleason is a favorable 7 (3+4), active surveillance is reasonable. My concern would be whether it was an unfavorable 7 (4+3). That being said you want active surveillance with your Urologist with regular PSA’s, Mri’s and even additional biopsies as necessary. Now Surgery is usually preferable in younger patients. I don’t believe your stents would be an issue for surgery, but would still need a sign off from your cardiologist.

mac2237

The most recent biopsy had 3+3 and 3+4 on a few cores. So I think I'm right at the bubble. PSA is 4.88. I just started watching videos on you tube PCRI has some very informative ones. Makes you question, research and become your own advocate. Thx for replying, how are you doing?

Wheel

Mac2237,

It does seem you are right about being on the bubble. This is an older thread not pertaining to your specific concerns. It might help if you opened a new thread which likely would draw more current responses. I myself 9 months post Surgery could not be happier.

Wheel

I don’t mean specific to your concerns as it is, but the longer an older thread becomes it becomes less readable to many to get to end and takes a long time re reading older comments.

mac2237

Not sure about what you're referring to, old thread?

Wheel

I don’t mean old thread in terms of date as recent questions by members or threads can rack up comments and when someone sees a new comment they may take it as pertaining to the original conversation and not realize it is actually totally new comment asking another similar question and also if some time has passed spend time re reading multiple comments to see the connection or skip it. It is generally more helpful if someone has a question to begin a new conversation from their name (thread) to attract attention specifically to your post.

Marlon

mac2237, you've hijacked don0218's old thread is what they mean. The forum follows individuals' threads rather than grouping by subject.

As far as your situation goes, yes it is confusing to get all these different opinions. I look at it as they are all making educated guesses. It's your cancer, and AS seems to me to be just postponing action until its worse.

Steve1961

doing the right thing you’re overthinking this the surgery is not that bad. Get it done. Get it over with get on with your life. Trust me on this find a top-notch surgeon make sure he’s done over 3000 of them. I can’t even see my scars anymore.

mac2237

thanks for your positive outlook.

Steve1961

https://csn.cancer.org/discussion/comment/1723048#Comment_1723048

you caught it early 80% chance of beating this at this early stage ..great odds ..get it done

mac2237

https://csn.cancer.org/discussion/comment/1722964#Comment_1722964

mac2237

hey all,

does anyone have an opinion or dealt with Doctors at Md Anderson in Houston?

TheMatt

https://csn.cancer.org/discussion/comment/1721437#Comment_1721437

I to am trying to decide my direction.

thanks for the insite.

Buff1977

I am with Steve on this one….I am guessing you will eventually have to do something so I would probably get the surgery done now…. why risk more disease that may spread outside the prostate. Just my take after being on this forum for the last 5 years ! Git er dun !

TheMatt

I am meeting with the surgical oncologist next week.

Just found out mid May 4+3 - still contained to the prostate ,according to the Pet scan. -I'm 68 and pretty healthy, cant run a marathon, but active.

So all of this is heavy. I'm reading a lot .

Thanks for the advice.

T