New DX

Hello and welcome smc64. Sorry you had the need to find us here, but it is the best place on the net for dealing with PC. It takes a while just to properly digest the ds, yours is barely a month old. Here, you can get any number opinions all the treatment methods. There are more than several younger men like yourself in their 40's, so you should find good company. With your PSA, just one core and a gleason 6, you definitely have plenty of time to find the best treatment for yourself. Not a doctor, but your preliminary stats would make it pretty likely that it is contained at this point. Now you need to research here, with other urologist from a surgical perspective and a good oncologist from a radiation point of view, and to be fair, some would advocate a period of "watchful waiting". Hope you can find the answers you are looking for, plenty of people here more than happy to help you where they can.

David in SC

What part of the country are you in?

Thanks Guys! Purg. I'm in MA

Welcome home smc64, the home where nobody really wants to be but where you are always welcome to sit and chat. I come close to fitting your criteria. 48 at dx. I looked at all the answers and chose roboticRP and here is why. Others will offer different opinions but at an early age we will live longer with this disease than those who are dx'd in their mid 60's. I spent alot of time looking and found that almost all the data is geared around a 65 year old being cursed with this. That data leaves little for us who will have this 15-20 years longer. After considering all options, the survival rates look better with the cancer removed and if by chance there is a recurrence, we have additional options to eradicate it. There are so many other sides to this disease. You will read about ED and other sexual side effects by looking around here. There is always the continence issue. Frankly all of it sucks but it beats the alternative. I was going to write a rant today about feeling like a broken man sexually. I may still write that but when I look where I am and where so many others are, I feel shame because I am lucky. All things considered, I am a blessed man and would have chosen surgery over the other options to have the best survival rate. I have 5 children (26,23,20,9,7) and a beautiful wife of 28 years who would be worth living for even with the other struggles. I wish you the best in your research and will pray for you.
Tim

Welcome to best place in the World to disucss PCa, I totally agree with vs1vs2! Being very young myself when diagnosed the stats of survival for us are looked at differently then most. I have ED but still hopeful and only 5 months out of surgery. The most important thing is to be strong dont keep your emotions inside, talk to people. I know for me the 1 priority was to be cancer free, then deal with the possible side effects.

Dear smc:

Sorry to have you here, but welcome.  Purgatory (David in SC) gave a nice, quick summary of your options and I agree.  You DEFINITELY want to get multiple opinions from at least an experienced robotic surgeon (300+ procedures) and an experienced radiation oncologist.  At your age and stats you have an excellent chance of cure and you may have the option of watchful waiting...however, if you choose that route, you need to be diligilent in terms of repeat testing.  And, frankly, while the cancer may never get more serious, chances are that it will and that you will have to undergo treatment at some point.

As another poster noted, most of the research has obviously been done on older men since that's when the cancer is most often manifested.  So...the statistics reflect that.  However, the research I did showed that the cure rates for the most common treatments are essestially the same.  But, if you choose surgery and the cancer returns, you can treat the cancer further with radiation.  If however, you choose radiation first, then salvage surgery is very risky...I certainly would not do it...and you would need to go to the other options available.

Having said that, I chose radiation (seeds).  I'm playing the odds that the cancer is cured and my SE's are non-existent so far and are likely to me less problematic than if I had chosen surgery.  But...that's for MY particular case...you need to consult with your docs and make a decision for your own situation.  If you are interested in my decision making process and progress to date with seeds, just go to "Tudpock's Brachytherapy Journey" on this forum.

Good luck and please let us know how things progress and what you decide.

Tudpock

Smc64,

I was diagnosed at 54 years in January and had my surgery in March.  I had 10 cores with 1% in one core.  Gleason 6.  T1C.  After surgery they found that my tumor was 10 % of both lobes and that my gleason was actually 7 ( 3+4).  Not much different but different just the same.

You have plenty of time to determine your course of action for sure.  It seems to me in my brief 9 month experience that clinical diagnosis more often have a lesser Gleason score and smaller tumor than is found if you choose surgery and subsequent pathology.

This site is a great forum to ask questions and learn from others.  You will realize very soon that this journey you are about to embark on is so very linked to the skill, experience and knowledge of those you choose to hire.  Seek and obtain the very best you can.

As you meet with Doctors and consider treatment options go ahead and schedule the procedures even if you have not decided.  This way when you do decide you can quickly cancel the other procedures.  I was explained that smart patients do this all the time.  This way you wont have to wait 6 months to get it done.

All the best,

Frank

Hi all,

I wanted to say thanks for all the responses!  There is certainly no easy answer, but agree with the consensus, take the time needed to make a well informed decision.  Again Thanks!