I last wrote back in July post-biopsy. My vital stats then:
-4K PSA: 18%
-MRI: possible 1cm lesion left Apex
-Targeted Biopsy: 34% positive cores. Grade 3+4. Stage T1c.
-Prolaris score 2.7 (favorable intermediate)
Since it was caught early and lower grade, gave myself 'til end of 2020 to decide on a course of action. The most worrisome aspect of the testing was from the MRI, which noted the lesion "abuts capsule". That felt like a ticking clock.
Consulted with MSK surgeons and radiologist, as well as Dr. Tewari at Mt. Sinai. I settled on Dr. Eastham at MSK because, well because of a gut feeling, as well as quality of the re-hab program with Dr. Mulhall. I think Eastham, Tewari, and Coleman are all way up there in experience and number of procedures, so it comes down to going with your own instincts and rationalizations.
It's definitely a mix of feelings, as this procedure looms closer. I feel perfectly fine and am well aware of the potential side effects I am submitting to. Why would anyone do that? Well for me, I want all those cancer cells out of my body and this seems the most direct way to do it, plus it leaves open salvage treatment options.
With multiple small foci and the 1cm lesion where it is, I'm not a great candidate for focal therapy, and the docs I spoke with universally recommended surgery given my stats.
I respect everyone's personal decision process and wish all the best in their journey.
In return, good wishes accepted.