Impending surgury

9johnl

Ok this is the story. Diagnosed in Jan. after annual physical showed psa 28.1. 58 years old first psa, not sure why I just never asked and DR never requested. Biopsy first of Feb 5/14 cores all 3+3=6 all bottom left side. % of cores, 100,98,95,90,35. Psma pet end of feb. No metastases, DR wants to do sergery and remove asap, set on schedule.for 4/11 at a center of excellence in mineapolis.Had second opinion at Mayo Rochester. DR said he would advise AS, and do another psa in July. No need to hurry with Gleason 6, you have slow moving cancer. I have decided to go forward with sergury as I just want it out and not take any chances. I know long post, first time I've typed it out, but its getting real now less than a week out. Thanks for listening.

Rob.Ski

Those are high volumes in your core samples and PSA is quite elevated. Johns Hopkins recommended me to stop AS with 2 high volumes (100, 70) of 3+3, PSA was 4.6. IIf you do decide on AS, I'd get a third opinion.

Marlon

At 58, you have a lot of life left to live. I'd suggest doing as much research as you can to understand the many side effects of surgery and radiation, and to have better informed questions for your docs.

9johnl

Thanks it was like two completely different conversations. MN. Urology said the volumes are high as is psa, and we need to operate. The Mayo said he doesn't take a lot of stock in volumes more Gleason score and with yours being 6 I would prescribe AS.

jc5549

I recently included this link on another conversation thread. The Memorial Sloan Kettering (MSK) data on men with prostate cancer is something I have found very useful for survival numbers after my radical prostatectomy.

They also give numbers for biopsy findings and what you should expect for survival if you choose a radical or radiation. You have a high PSA and high biopsy volumes, it does suggest significant disease and at your age it would be understandable to go for treatment rather than AS. I encourage you to plug your numbers in, it will give you very sobering numbers about five, 10, and 15 year survival as well as percentages of what your pathology findings would be after surgery.

jc

https://www.mskcc.org/nomograms/prostate

Wheel

You have done your research and answered your questions that have made you comfortable going forward. At this point with surgery in less than a week look forward not back and don’t second guess at this point. It is a good decision for you and good luck.

LuckyKYGuy

Good luck! It’s really not that bad. As you’ve probably read here the catheter for a week is the worst part. I had very minimal if any pain.

Giving yourself time to heal is the most important thing. This is a major surgery and it does sort of zap you for a few days.

By you wanting it out now instead of active surveillance that tells me you’ll be fine mentally with some erectile dysfunction and incontinence (if you have either or both at all)

Clevelandguy

Hi,

Sounds like you did your homework and have made your choice, good for you. As others have stated the worst part is the catheter after surgery, but tolerable. Just make sure your surgeon is very experienced and has done hundred to several hundred recently. Three plus three is a candidate for AS as long as the cancer is not close to escaping the Prostate capsule. Good luck…..

Dave 3+4

Old Salt

That PSA (28) is very high, even for five Gleason 3+3 lesions. Could be one enormous lesion?

Whatever, you have made your decision; best of luck and note that there are a lot of (recent) informative threads on the aftercare.

9johnl

Thanks for the responses much appreciated. The fact its all on the lower left side he'll do nerve spearing for the right but can't on the left side. I've read about guys who have done AS with Gleason 6 and shouldn't have. I just don't think I want to take that chance. Its a lot if unknowns. Again thanks for the input!

KittySlayer

The choices are hard but the choice is yours. I did Active Survelience for a couple years. Hiked the Appalachian Trail last year and came home knowing I was ready for surgery and looking forward to many future adventures. The laparoscopic/robot surgery is amazing and I had my appendix removed that way 25 years ago. They call a Robotic Assisted Radical Prostatectomy “major” surgery but I was up walking the same afternoon and well on my way to recovery within a week. As noted the catheter is an annoyance but I was pain free without any drugs post surgery. Get a good surgeon with experience. My wife had worked as a circulating nurse in surgery with my surgeon and knew he was good. 11 weeks post surgery and I am thrilled with my current situation and looking forward to continued improvement. The relief knowing my prostrate was removed with no cancer in the margins is immeasurable. Enjoy the many future stress free (hopefully cancer free) years of your life.

Khaffey

Good Luck with your surgery. My PSA was 5.3. MRI showed two lesions. Biopsy showed one was 4+3=7, and the other was 3+3=6. At that point my surgeon said AS was not an option. Had robotic surgery. Pathology showed 4+4=8. This told me that you can't always count on the biopsy results. I am now 9 weeks out, the first few days were a little tough, but each day saw improvement. At this point I have practically no incontinence, ED still an issue. The hardest part for me was coming to a decision for treatment. Once that was decided, it was like a burden was lifted. I gained much knowledge and support from this discussion board. Nothing like hearing it from guys who have been there before us.

Marlon

What Khaffey said: " . . .  This told me that you can't always count on the biopsy results."

Until they get in there, they dont actually know with certainty what they'll find. The biopsy is a guess. My situation turned out to be more aggressive than they thought so surgery was the right choice for me. ED is definitely an issue at 9 months, but frankly all that messing around down there has dampened my interest.

9johnl

Thanks fellas, that was my exact fear and after close considerations the reason I chose surgery. I'm now one week post surgery and feeling a lot better, a little everyday. Days 2 and 3 were the worst and the Cath is certainly annoying but that'll be out next Friday along with staples so expecting to make a big turn then. I know there will be other things go deal with and ill habe to be prepared for them as.it goes. Keep up the good fight and again thanks for the responses all of them helped me make a better informed decision.

LuckyKYGuy

I’m coming up on six months post op on Tuesday….be patient with yourself and give yourself time to heal once the catheter is out. Things do slowly improve (for some things improve faster than others and maybe you’ll be one of those lucky ones!) Either way, welcome to the club that no one wants to be in….but we are all here for! :)