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Jeff the bottom line is that whatever treatment (or even no treatment for that matter) you choose, do so after making an informed decision. In other words you need to become savy on all the treatment options appropriate to your cimcumstances. Try to have enough knowledge so as not to have to ask your Doctors, "what would you do in my position". Knowledge is power. It is your body, and you should be making the decisions. If only there was one perfect treatment for PCa, a long way off yet methinks. Cheers and Good Luck.
Thanks John for your comments and advice.. I'm obviously a rookie in this field and truly appreciate all the information, experiences and resources that this site provides... I think I've seen enough medical specialists and understand the basics, but with all the personal experiences from everyone around the world, I'm getting closer to a decision for me.. I hope all is well with you and thank you again.
Jeff, as usual Terry hits all the nails on the head. My two pence worth echoes what the others told you: go and see many experts and take your time to consider.
I was 61 at diagnosis with similar figures to you only a lower PSA. I chose the robot with a top man. But he encountered technical difficulties due to a previous TURP and left me with 10 ml of prostate which is still being investigated to see if it is mailignant.
A third opinion uro I have spoken with suggests my cancer was insignificant and possibly could have been left alone.
The point I'm making is check them all out and if you have had previous surgery such as a TURP and you decide for surgery, make sure your surgeon has ewxperience under THOSE circumstances.
I still believe (despite what happened to me) that if you decide on any treatment at your age and with your numbers, that at least with surgery (a) you know exactly what you had in there and (b)you still have other options.
Radiation can leave you with scar tissue and collateral damage that makes secondary surgery or HIFU impossible. I think surgery where possible at least gives you the chance of a second bite at the cherry (or walnut perhaps).
In my case, if my surgery has failed in the sense that I have any malignancy left, depending on its significance I will consider watchful waiting. If I choose more treatment I still have the choice of HIFU or radiation.
Ted: Thank you so much for your advice and to share your experience. I love how within 1 day of my inquiry, that I have received such concerned and intelligent responses from all over the world.. Your two pence advice is more than equal to our two cents, ( with the failing dollar) yours is more valuable than mine)
What I'm not hearing from my uros that I'm hearing around the world is to even consider active surv. or watchful waiting.. I agree with you re the short term info and backup options re surgery, but I'm obviously concerned with lifestyle side effects that I'm too young to accept for a while... I will continue my research and learning process and continue to appreciate this website and your helpful assistance.
Jeff W, Terry suggests on the thread "Salvage Treatment Better than Primary?" that it might be a good idea to miss out the primary stage and wait to see what happens, then, if it goes bad, to rely on the last line of defence which is hormonal therapy. He did this and it worked for him.
But I couldn't do that and the sense I get, is that seems difficult for you too. Although I think surgery is a better starting point, I understand your fears of the side effects at your age.
I am told that men of your age regain their function better after surgery than men like me over 60. My uro gave me the telephone number of one of his robotic patients who regained erections whilst still catheterized! (Ouch!)
But let us not kid ourselves. After surgery the chances are that you will be severely winged. Incontinence for me was no problem after 4 months although even now at 10 months out I always have to think about the possibility of a squirt. So you think about whether to wear your white pants when you're drinking too many beers at the neighbour's barbie! Mostly though that is all OK (and in my case I had already had a TURP which gave me a worse chance on the wee front). So incontinence I think is dealable with.
But the ED is different. To be frank if this is a major consideration for you then get to grips with that discussion with a number of uros and radiologists and your partner first. I have a great wife and we have a good sex life, but penetration is not part of it. I have tried all the pills and all I get is a headache. I'm not going to do the jabs or the Muse or implants - nature will have to take its course.
The more I read about this the more I see that for most guys it takes a long time to come back and it will not be the same as before. You have to know that and accept it.
But if cure is the paramount thing for you then go for the one you and your partner decide will give you the greatest chance of getting cured and also of avoiding the side effects you fear most at your age.
In your case you may be persuaded that radiation in whatever form will give you the cure you seek with fewer ED or incontinence problems. However, it might spare you ED side effects only to give you some other side effects in a different part of your body. It's a bit like you pays yer money and takes yer choice.
One thing I think anyone here will tell you though, is that when you and your partner make a choice, go with it, stay with it and no regrets. You will do well.
VERY well said Ted. I agree with every word. I will add that at some point during your decision making journey, someone will say something, or you will read somethng that will make it clear to you what your choice will be. We were a couple of months into the search when we met with the Dr. who would do seed implants. That was the treatment I was leaning towards. The Dr made the statement, some guys are comfortable with a procedure like seed implanrs where you may not know the exact outcome for awhile down the road. Others choose surgery so that they will know sooner what is going on. That is the basis that we chose Robotic suregery. For US, we wanted the prostate out and the pathology report as soon as possible to know where we stood. We are still comfortable with that decision and stand by it.
