Newbie. First post but I’m sure there will be mor

Hi,

Its really up to you with inputs from your Oncologist &Urologist. The most two common methods are Robotic surgery or some form of radiation therapy. Both types can have excellent to bad results so don’t let someone tell you one is better than the other. Incontinence and ED can also happen with both surgery and radiation. Surgery usually results in an overnight hospital stay, released the next, radiation is usually done outpatient over several days. I know it seems daunting but study the treatment methods and choose one that best suits your best chance for remission and least side effects. I had surgery in 2014 and wear a light pad everyday because I drip a drop or two when I strain while lifting. ED was initially a problem but I recovered to a useable “tool” in about a year and a half with slow but steady progress. You can also choose active surveillance (AS) if you want to just monitor for a while. Bone scan and MRI are good tools to look for cancer that might have escaped. I have include a link for you to study the various types.

Dave 3+4

Hi,

If you mean focal ablation I don’t know much about it or men who have had the procedure, that in itself would make me weary. If it was me I would go with well established procedures with known history of failures/successes. I would imagine the hospital networks that do focal would talk it up but I would still be weary.

Dave 3+4

Hi,

Let me start by saying at age 69, I am cancer-free. Thank you, Jesus.

I was your age, 59, then diagnosed 3+3 in two of twelve cores. Did active surveillance for 3 years. Then went to 3+ 4 in one core. 3+3 in two. My urologist suggested the gold standard, which is surgery. I went with the surgery.

I now have had major side effects. One is light incontinence. Not bad if you stay away from caffeine and alcohol. The second is serious, 100% ED. As in, it does not work. Third is shrinkage. All of which can lead to depression.

I am probably the worst story out there on side effects but every day, I thank God for my life.

If I had it to do over again, I would have slowed down and spent more time talking with an oncologist.

The bottom line is don't rush your decision. Talk to a surgeon and an oncologist. And you will talk with other people who came out of surgery, just fine,

I pray that either decision you make works for you.

I was 47 with a PSA of 14.00 Ng/M L when I was diagnosed. When I had my biopsy my Gleason was 3 + 4 = 7.

At age 20 I had a full cardiac arrest and had not been under general anesthesia since that cardiac arrest.

I was referred to the Cleveland Clinic Cancer Center. The “Gold Standard” was a robot-assisted radical prostatectomy. The surgeons on my team would be some of the best in the country with a lot of experience with sparing nerve tissue. But I looked at my other options as well.

It had not metastasized so chemo of course was not an option.

External Beam Radiation was an option, but the issue of them “microwaving” my bladder and bowels, was not something I wanted (I am physically disabled and I already have issues there, and I did not want to lose everything).

Another option I was offered was Low Dose Prostate Brachytherapy, where they would insert numerous radioactive seeds in my prostate to slowly kill it off.

There is also “high dose” Brachytherapy, where a single seed is inserted temporarily into the prostate via the urethra and held in place for about 30 minutes. Then they pull out the seed.

I went with the “Low Dose” Brachytherapy implants and was under less than 90 minutes (left pre-op and returned to post-op in 90 minutes…short time compared to about 8 hours of the robot-assisted radical prostatectomy). It was done on 10-January-2017.

In about 3 months my PSA was back to “normal” forage 48 and now it is 0.64 Ng/ml and dropping. I now see my Urologist once a year, a week before the appointment I go to the hospital for a PSA test, so I know it will be on the Epic MyChart EMR by the time I see the doctor the next week.

So once it is down to 0.00 Ng/ml I will be “cancer-free free” and after five years at that level I would officially be considered “cured”.

The doctors were concerned about the long time under anesthesia and this was deemed the “second best” without any issues of my heart causing problems. So the seeds have done their job for me, had minor issues (nothing as severe as the doctors advised me…no swelling, only bruising was a line on my scrotum where the frame that held the “cube” with the guide for the needles to insert the seeds hit me, but not in the surgical area of my peritoneum). I had one needle Nick my urethra during the procedure so a bit of a “burn on urination” for about a week. But no other issues.

I did not even need one of the Tylenol with Codeine they gave me for post-surgical pain.