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Hi all, My name is Bryan. I am 39 years old, I am married with a 16 year old son. I work as a firefighter/paramedic. My father had prostate cancer a few years ago in his mid 50's and after that I started watching my PSA and glad that I did as I was diagnosed in February. I have elected to have the surgery as the doctors are giving me a great prognosis and as the surgery date approaches my mental state gets a little worse. The side affects of the surgery become more and more real everyday the surgery draws closer and I'm scared of how they will affect my life. My wife says your not your dad and you are young, but I look at it as science is science, right, so when she acts as if nothing is going to change in the bedroom I'm not sure how to respond, I get the same if not less attention in that area than normal, I feel like I'm on a timed clock and the hourglass is running out so I want to be in overdrive. I also worry about how the incontinence is going to affect my job, am I even going to be able to do my job with out pissing down my leg every time I lift a patient or fight a fire because of the physical stress I'm going to place on my body. I just need people to talk too that understand and that have the worries that I have about my future.

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  • Sorry I forgot to post my info, at last check my PSA was 3.64 and has been climbing about 0.5 per year. I had 5 core samples taken and 1 sample showed about 20 % involvement with another sample just having abnormal cells. My Gleason Score was 6 (3+3). The Oncologist told me he was confident I could watch it for at least 10 years and it wouldn't kill me but I really don't want to wait more than 6 months I'm waiting to have surgery. The waiting 6 months has put me in the mindset I described though.

  • I am sorry you have to go through this. I had surgery. The side effects will improve over time.

  • Thanks, I'm sure they will, I think I'm just seeing things from a worst case scenario too try and protect my self. I told myself the entire time I was being tested that it was cancer so it wouldn't be as hard of blow when I got the results and if it wasn't I could just be relieved as opposed to broken.

  • It depends on the location of the tumor as to the success of the nerve sparing technique. The accuracy of the biopsy has a lot to do with outcome also. A urologist told me that he until he got in there he really couldn't say with certainty what my chances are. Based on your biopsy results there would be high confidence in success that's why I said the accuracy of that is important- you only had 5 samples taken.

    Some people have 2-3 times that many. There is a fairly new biopsy that is something like Battleship-if you ever played that game- they use full anesthesia for that because they take so many samples. If your biopsy is accurate you would have at least one nerve bundle spared and that's all you need. Good luck.

  • Thanks, I wondered about the amount also, he told me my prostate was pretty small and felt he had pretty good coverage due too that and that the digital exam revealed no physical tumor. The surgeon also said the prostate was pretty small even compared to a normal prostate

  • That's another point in your favor.

  • Bryan, sometimes smaller is better. Especially in this case.

  • When I had my biopsy, I figured I had cancer. The medical assistant said it has not been tested yet. I was just preparing myself with information, just in case.

  • Hi Bryan. You are totally welcome. And you are not alone here as a guy diagnosed in his thirties. Your concerns are appropriate which supports your doctors offer to help you with active survealence Considering a long future with major side effects can't be easy but you now have hundreds of brothers to help you down your path. If surgery is definitely your choice then I encourage you to sperm bank; if not for children, then for peace of mind. Also get a second opinion on your pathology, right now. The Malecare.org website can guide you in that.

  • My Urologist said he was going to have it sent for a second opinion just because of my age and I never heard back from that so I assumed it was the same. Being a firefighter and my family history I figured it was accurate results. I had concerns when my PSA continued to climb even though it did slowly and I think even with the side effects I want to get it nipped in the bud. I have to say the side affects do scare me more than the cancer does. I have talked with my wife but I'm still not sure she could grasp what's going on in my head, no matter how much I try to explain it to her. Thanks for the support from everyone, it's nice to be able to talk to other people and get their experiences.

  • 90% of prostate cancer treatment choice making is Knowing your diagnostics. Assume nothing. Ask for a copy of your second pathology report today and compare it to your first report

  • Kegel exercises will help with incontinence and impotence. Start the exercises after you have the catheter removed. you will probably have to wear a catheter for at least a week. I don't know about your Dad and what happened to him.

  • Don't make an assumption, you know the saying what that will make you. You should get the second opinion, not the doc. Our Malecare web page tells you how to get it (www.malecare.org). insurance usually covers the second opinion. You are involved in making a major life decision; you must get the best information and be 100% comfortable that you have al the possible information. Please take responsibility for your medical decisions, it will keep you alive longer and with a better quality of life. I know, I have 5 primary cancers, including metastatic prostate cancer and I consider myself healthy. I am here today because I have taken 100% responsibility for all my decisions. I urge you to do the same.

    Joel

  • Thank you I will start investigating

  • Fire medic, I can assure you, your urologist has a few tricks up his sleeve to help out in the bed room.

  • Bryan. It's your choice but I think you should take a breath and do some more research. Your urologist is right. With only a Gleason 6, you may never have any real problems. With a prostatectomy, you surely will. The side effects can be severe and long-lasting but it varies from man to man. You will probably -- not definitely but probably -- experience erection problems and incontinence. Also, I noticed they only took five samples. You may want to have another biopsy with more samples (12 minimum) taken to make sure it's confined to only 20%. If it is only 20% and it's only in one location, you might want to consider focal therapy (e.g, HIFU or focal cryotherapy) because you'll have a better chance at keeping your potency and less long-term side effects. At the very least, I would recommend a second and possibly a third opinion. You have some time so take advantage of to do more research.

    Best wishes and good luck.

    Jake

  • I just ran across the HIFU treatment, do you know about it?

  • Please read this post I did a week ago.

    TRUS-biopsy Inferior for Prostate Cancer Detection

    CHICAGO — Transrectal ultrasound-guided (TRUS) prostate biopsy poorly detects and rules out clinically significantprostate cancer, whereas multi-parametric magnetic resonance imaging (MP-MRI) can identify 27% of men who might safely avoid unnecessary biopsy, a study presented at the 2016 American Society of Clinical Oncology (ASCO) Annual Meeting showed.1

    "The current diagnosis pathway can result in various errors: clinically indolent cancers are identified by chance; clinically significant lesions are missed; important cancers are incorrectly classified as unimportant; and men undergo whole-gland treatment, which carries harm," said co-investigator and presenter Hashim Ahmed, PhD, an MRC clinician scientist at University College London Hospitals in the United Kingdom.

    Because MP-MRI as a triage test might allow men to avoid unnecessary TRUS-biopsy, since men with an elevated PSA do not have clinically significant prostate cancer, researchers evaluated the accuracy of MP-MRI followed by TRUS-biopsy vs template prostate mapping biopsy (TPM-biopsy) as an accurate reference test.

    renalandurologynews.com/pro...

  • Firemedic54_9 I read your post and the replies and pretty much agree with what was said. Your biggest problem with this, IMO, is your age. Although PC usually tends to be a slow developing cancer, at your younger age that simply means you have many years for it to grow. There is also research that shows getting PC at a younger age can mean a more aggressive type. As a 23 year PC survivor diagnosed at age 52 (now 75)and a long time facilitator in our Local PC Support Group, I recommend a more aggressive approach in dealing with PC for someone of a younger age. The nerve sparing surgical techniques have come a LONG way since my surgery in 1993 and in most cases, incontinence tends to be a minor, if any problem until you become older. I had NO incontinence from the radical PC surgery for 18 years! Unfortunately at that time, following 2 heart attacks, it became a real problem. BUT, I had an Artificial Urinary Sphincter installed by my Urologist (simple surgery) and it has completely eliminated the problem. I mention this to you just to let you know there are MANY options available for us PC guys! As far as sexual function goes, that seems to vary from patient to patient, but as one gentleman replied, there are numerous options available now days to handle ED, from pills, injections, vacuum pumps and penile implants. I have tried all except for the implant. It might be a good idea for you AND your wife to discuss this important issue with your urologist to put both your minds at ease. I am also an American Cancer Prostate Cancer Mentor and have had phone conversations with many men, some younger than 50 who have had your concerns concerning ED. They tend to lean toward not doing anything for that reason, and I tell them this simple fact..., "your erection won't do you a bit of good in the casket."

    Good Luck. I'm not an expert, but I'm happy to discuss anything you want to talk about.

  • My thoughts and prayers for you and your up coming surgery. To have the grenade removed from the fox hole was my goal. And to that I am grateful to have an undetectable PCA after 5 years. And I am able to control my urine flow. I lift weights at the gym. No leaking. Only issue is coffee drinking before a road trip. Need to stop often. I have ED issues. If the doctor is trying to save your nerve bundle, you have a chance. Do your Kegler exercises. They helped me.

  • Thanks, that is good too know that you can still lift and not have problems, I had heard where guys say they have some issues occasionally standing up and I know every guys experience is different so hearing this is encouraging, thanks.

  • Don't worry about the side effects. Individual side effects vary.

  • Bryan, don't worry. You have age in your favor. You will be able to recover from the surgery quickly. Is the doctor doing to use robotic surgery? That is what I had.

    What is the exact date of your surgery? Is it set already?

  • Yes it will be the nerve sparing surgery with the DaVinci robot, I have it scheduled for October 27th.

  • God bless. Keep us posted.

  • Firemedic:

    My prayers are with you. I am not as knowledgeable as some of the men who left replys. My advice is don't let your cancer rule you. Don't change how you act or your behavior. Stay the same person you were before the cancer was found.

    Dennis

  • Thanks, I sure hope to and have been trying to so far, I for the most part do really good just have days that I get to thinking and get stuck in my head.

  • I seen something about the HIFU treatment, does anybody know much about this. I looked on-line and per my urologist only trust like cancer treatment of America ect. for information but they pretty much only describe what it is. I would like to know numbers good and bad results but not finding much, is this because it's still new enough they don't have enough data yet? I know AS is an option but not really sure how long I would like to be doing that knowing that at my current point I have a good chance of cure with the surgery.

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