Balance of recurrence risk vs function

[Vayshe]

I'm was a bit older than you when I was diagnosed with Gleason 3+4 restricted to one lesion. I took a very different path, electing for focal therapy in hopes of minimizing negative impacts on sexual function and urinary continence.

I had cryoabaltion of the lesion almost 2 years ago and I'm happy with the outcome. My sexual and urological function are unchanged. My procedure did not have to include any nerves due to my specific presentation.

I opted to accept high(er) recurrence risk along with likely minimal side effects. For me and my age, I wanted to kick the can down the road and if I have a recurrence, see what medicine has to offer years from now.

Taking your time, talking to lots of guys similar to you, and seeing if you have unusual options that might fit your situation and treatment goals are good uses of your time I think. In the support group I attend guys are pretty surprised at how optimistic doctors are about sexual outcomes vs their own results. Of course, guys in support groups are probably much less likely to have had optimal results. I'm guessing those guys don't feel the need for a support group.

Also, enlist your support system to help you sift through all the data and talk about it and how you're feeling. Unless you can find otherwise, remember most of the published data on sex is about *vaginal* penetration, not anal.

Breathe, read, talk, breathe some more, then decide. Very best of luck!

[cpl901]

how old where you when became diagnosis. After biopsy it says i have G 7 on left side but there was also a G 6 (non agressiv i guess) on the right side. I m not a good case for focal therapy as my prostate is small. But i try to understand how long i can wait how much time i have before doing what s good to save my life and it s quality

[Vayshe in reply to cpl901]

I was 50.5 years old when I was diagnosed and then had my procedure about a year later. In my specific case, the doctors weren't too worried about a fast progression, so I took my time to decide what treatment I wanted and who/where I was going to get it. My understanding is that most cases of prostate cancer are pretty slowly progressing, so taking significant time to decide on treatment usually isn't a problem.