halbert said...
I went the surgery route as well. ………… My surgeon told me that given my age and general health and lack of issues that I had a 90% chance of making tri-fecta within 3 months. This proved to be true.
In the end, as others have said, it's a gut question. What feels right for you? When you relax and let it all soak in, you'll know what is best....and who is the best team leader for you.
lapilot said...
I too looked deeply on my options, but I decided to have nerve sparing robotic surgery. It has been over 21 months since my surgery. I have had zero negative consequences of my surgery, no ED, no incontinence and sex is as great as ever (just dry.)
The main reason I decide with surgery was I wanted it out, and I wanted a true biopsy of the prostate, which can only happen once it is removed. Secondly, if my surgery does fail, I can then go to SRT.
Pratoman said...
5. I had access to one of the best robotic surgeons in the world in my "own backyard"
6. Speaking to a number of friends and family who had the surgery with good outcomes gave me the confidence to move forward.
I am happy with my decision, so far undetectable PSA after 6 months, fully continent after 5 weeks, except for an occasional,stress leak. And erectile function, with now every other day Cialis, is as good as ever, maybe better.
As others have said, whatever decision you make will be the right one for you, and any treatment will likely give you great odds at a cure.
I am always amazed to read these kinds of results, and there are definitely some of them out there. Good to know that it can happen. My experience is just the opposite. Maybe a lot of these variables are due to the difference in surgery for G6/nerve sparing plus a little luck thrown in, compared to surgery for G9? 18 months out, I am still not fully continent though for the most part it is no longer(most days) a big problem. Some days I don't even wear a shield and most of those days I totally get away with it. But I still don't consider myself fully continent, as I must always be on guard and ready to clamp down immediately. And several times a day I will get these little spasms that try hard to force some out. 9 times out of 10, I can clamp down and stop any escape, or at worst a small drop or 2 will escape, but experience shows I best be finding a urinal because those contractions are likely to repeat until I empty. However, while not perfect, it could be 100 times worse and was for several miserable months. Right now I deal with the question: is the current situation worth doing something about
(surgery), or do I just live with it?
Sex is a thing of the pre-surgery past. I had some problems pre-surgery, although Ciais 5 mg daily had given me a rather spectacular renewal during that few months before surgery, complete with morning wood even after a big pleasurable night before. It was wonderful. But I was told going in that I would have ED since he would have to cut wide, but I could just inject. Well, yes, I can inject but only ever got mediocre barely usable results as long as I remained standing, with a whole lot of ache for hours, and orgasms are never worth having and sometimes even unpleasant. Pumps(with or without injections) produce rock hard results even laying down(at least with 2 rings), if the unpleasant/uncomfortable rings can be kept in place during action, but having to go through all of that for an orgasm that is always disappointing hardly seems worth it at all. So, I've just put all of that aside and am now waiting to see how much shrinkage I will end up with.
digger1948 said...
I had consistently rising PSA which I know wasn't over a 7 when I agreed to the biopsy. The biopsy resulted in 7 out of 12 positive cores with a Gleason 0f 7. Never really spoke with a RO which in retrospect was probably ignorant. After biopsy report decided to get opinion from a urologist at Cleveland Clinic. Just felt better in their hands. I knew of some of the RT side effects and in my mind surgery was more cut and dried (no pun intended) and seemed to have less side effects. Unfortunately, in my case, the pathology from the surgery revealed an aggressive cancer raising the Gleason to a 9. There was SVI, etc. at the post op visit we received the bad news. So now, approx 3.5 months later I have just begun on 8/3/15 radiation therapy which will go on for 39 treatments and I will have to deal with the side effects I had hoped to avoid by choosing surgery. I also had a 6 month Lupron shot in July. I had a PSA of 0.07 on 6/23/15. I had the Lupron injection 6/24/2015. The day radiation started, a PSA was drawn prior to the first treatment. It came back non detectable. Radiation Oncologist was really pleased but said I still had to go through with the treatments which I guess I knew. Was it the Lupron that brought the PSA down? Would ADT have been enough? Should I have never had surgery and done radiation in the first place? If I had chosen that route, how would the extent of the cancer be known? I just have to be resigned that the course chosen will ultimately lead to positive outcomes. Has this course of events happened to anyone else? Has anyone else had a higher Gleason post-op?
I was G9(5+4) going in. I actually had a slight downgrade, to 9(4+5), but with a positive margin and SVI. And I have certainly wondered many times if I would have been at least as well off with RT which would have possibly covered all areas, and maybe with fewer immediate SEs. But you know, if it had been contained, as my surgeon hoped, at least I would feel pretty certain of a cure. That was the main selling point for me, though I never was completely sure which path I should take. I think if I could have foreseen the SEs and SVI and positive margins, I would have just taken my chances with RT. Then again, no way to know all of that except with a surgical path report.