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Prostate cancer diagnosis 2 weeks ago scheduled for surgery

CCD223355 profile image
16 Replies

Hello All,

I am new here as of now! I was diagnosed with Prostate cancer. I am 56 yrs old and in excellent physical condition otherwise Gleason score 3+4 = 7

2 weeks ago

PSA of 7.7

MRI shows growth on right lower side of Prostate approximately 1.5 cm and 40 - 50 % of rt side contains cancer

Strongly leaning to nerve sparing prostatectomy surgery to completely remove Prostate with concerns about the side effects

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CCD223355
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16 Replies
Tall_Allen profile image
Tall_Allen

With your intermediate risk prostate cancer, you can choose from several therapies: surgery, SBRT, or either kind of brachytherapy. You would have to talk to experts in each of these. You have plenty of time to set up meetings and talk to specialists if you haven't already. After you do, here are some questions to ask yourself:

pcnrv.blogspot.com/2017/12/...

David1958 profile image
David1958

Yours is almost a carbon copy of my diagnosis almost 8 years ago. I was 52, PSA 5, Gleason (3+4)=7. Maybe as Tall Allen says, you have time to consult all of these other specialists, maybe you do not. I know I was not feeling that lucky when I was diagnosed. I, too, opted for surgery. Yes, it took 3 months to learn how to pee again in a controlled fashion. I have had ED so far, but things are changing. How much only time will tell. I do not regret having taken the route I took. My PSA has been undetectable all of these 8 years since surgery. That is a wonderful thing. My cancer was contained within the margins of surgery, but there were microscopic extensions in the margin. If I had waited much more time than it took to get my surgery scheduled (two months), I am not sure I would have had the same outcome.

Jp2sea profile image
Jp2sea in reply to David1958

Yes, I'd like to echo this point. In fact, you don't know if you have a lot of time. Biopsy and other pre surgery data are limited, but certainly are informative. While your Gleason is important so is the amount and distribution of cancer in your biopsy cores. While prostate cancer is generally slow growing, it is important to get an idea of stage. It turns out that my cancer extended out of my prostate and my RP wasnt completely successful. I had to do salvage radiation and hormone treatment. I do wonder sometimes if I should have waited for another opinion and possibly another surgeon, but with the amount of cancer, I was afraid of delaying surgery.

CCD223355 profile image
CCD223355 in reply to David1958

Thank you David. I have been researching a great deal and keep coming to the same conclusion that for myself surgery seems the best way to go.

dadzone43 profile image
dadzone43

Why the rush? I would counsel that you take a deep breath, let the entirely-normal panic wash through and then read one of the many good books on prostate cancer treatment. You may see things differently. Yeah it is scary; yeah decidions made out of fear are sometimes not the best decisions. Inform yourself first. You are the only expert on you. Keep in touch

CCD223355 profile image
CCD223355 in reply to dadzone43

Thank you

You may want to research HIFU. Sounds like you urologist is, as is very typical, a surgeon so he is going to usher you into surgery. Slow down, call a timeout to consider your options. Prostatectomy is the most invasive option with unfortunate risks for quality of life impacts.

MelbourneDavid profile image
MelbourneDavid in reply to

Do you have knowledge of a randomized controlled trial of HIFU for Gleason 7 or higher prostate cancer? All the trials I have seen have had very unimpressive results. I think HIFU is one of the least reliable treatments.

in reply to MelbourneDavid

Trial of one. Me. No quality of life issues or complications. Time will tell I guess.

407ca profile image
407ca

CCD..,...

We're I in your shoes the first thing I would do is cancel the surgery. Why? Because if you were only diagnosed 2weeks ago and have already scheduled surgery that tells me that you have not educated yourself about other options.

Don't get me wrong here, maybe surgery is the best choice for you, but then again maybe not.

Your choice will affect you for your entire life. There are no redo options to first line therapy.

Have you consulted with experts in other therapies? If no then why not? Why the rush?

You have time to learn. Use that time to your advantage. Educating yourself will conquer your fear.

Don't mean to sound harsh but time and again I see men rushing into therapy only to later regret being hasty.

If you do see doctors like surgeons, radiologists etc. Bring a list of questions about the procedure, expected outcomes ( they will all give glowing reports on outcomes and brush off side effects, which are many). Be skeptical and get second opinions, but most importantly EDUCATE YOURSELF.

All the best.

CCD223355 profile image
CCD223355 in reply to 407ca

Thank you

cpcohen profile image
cpcohen

My thoughts are close to 407ca's.

Cancel or postpone the surgery, and do some studying.

"Nerve-sparing" surgery means the surgeon _tries_ to save the nerves. But in most cases, the patient ends up with long-term ED.

So talk to a radiation oncologist before making a decision.

You might be a candidate for "active surveillance". Check it out.

. charles

MelbourneDavid profile image
MelbourneDavid in reply to cpcohen

On his figures,CCD223355's cancer is far too large for active surveillance.

HonuHonu profile image
HonuHonu in reply to cpcohen

Active surveillance is not indicated here but don’t rush to surgery. Do your homework first.

aceace12 profile image
aceace12

I would never have surgery just 2 weeks after this diagnosis.. unless he said I was going to die ... please educate yourself .. also sounds like doctor needs to educate himself on the advance’s of prostate treatments

Handdrummer777 profile image
Handdrummer777

Hi CCD -- Are you sure you want the surgery? I looked at the choices with my oncologist and urologist and went with radiation, and began the ADT for 3 months prior to syart of treatments. Radiation itself most often causes ED to develop down the line, with late-onset vascular damage. But of course, ADT delivers a nifty package of libido-and-ED effects on its own. With surgery you will confront immediate ED -- from which recovery may happen, or it may not happen, at least to the degree you hope it will. Also the incontinence issue may persist for a lot longer than anticipated.

It was not a big ordeal for me to go through 43 radiation treatments. I guess I feel lucky in that regard. There is more of a risk of bowel problems from radiation. So each side has its risks and side effects. You may end up needing some radiation and even ADT anyway following surgery.

Just be aware that it's critically important to engage in a regimen of penile rehabilitation immediately following surgery or radiation.

This would most likely be the Viagra/Cialis daily low-dose as a beginning. Continuing penile stimulation cannot be overstated in importance, because that helps stave off the atrophy and venous damage that can develop if it lays there flaccid for long periods.

I support your decision regardless of which route you decide. Don't mean to scare you about ED recovery after surgery, just trying to give you a heads-up on that.

Best of luck and keep sharing your experiences!

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