First time posting here. I had a radical prostatectomy on 1/28/22. It was partial nerve sparing. My Gleason score was 7 (4+3). I was very fit going into surgery and recovery has mostly been going well. The only issue I have is that I still have ED. My erections are at about 50% with no aids. I've been doing injections for the past couple of months. I don't love them, but they work and I get a full erection. I've been told that there is still potential for the nerves to heal and regain function. A little background, I was on testosterone replacement therapy before I started this journey and, of course, stopped as soon as I got my diagnosis in late 2021. My testosterone is back up to 340 and hasn't budged for the past few months. I'm ok with that as it is low, but still within the normal range.
My recent PSA test was .27. It has been slowly climbing for the past 9 months. The doctor has recommended me for ADT and radiation, probably a 6 month course. The reading I've done has shown that men who have a test level of less than 400 going into ADT have a tougher time recovering their natural testosterone production post ADT.
There are a host of physical complications from low testosterone levels that I'm concerned about. Everything from bone loss, impotence, and depression to heart disease and diabetes (both of which run in my family).
I'm questioning if whether the loss of my quality of life and the risk of future complications from other conditions that might result from treatment are worth it. Is there another approach that I'm not aware of that doesn't involve ADT? Also, I had a consultation with Dr. Mulhall at Sloan Kettering and he said that the treatment would basically make me impotent forever and that I would have to explore other more invasive options post radiation and ADT.
I'm being treated at Sloan Kettering, and generally I've received good care. But I'm frustrated with the attitude of kill the cancer at all costs and the rest of your life be damned.
If anyone has any insights I'd appreciate any input. Any alternative strategies, treatments, any questions I should ask the radiation oncologist. I'm all ears. Thanks in advance.