Prostate cancer: Anyone had surgery at 3+3?

Like you I was 4-3 but 73 years old and elected the 5 proton treatments at Mayo with 8 months of no Testosterone. My age had a lot to do with what decisions people must make for themselves. Like the study you quoted the 15 year survival was almost identical for each choice. 73+15= 88. My sister works in a great nursing home and says you don't want to go there so I am fine with whatever happens. My 3 month and 9-month PSA were both undetectable so my long-term prognosis is positive based on those numbers.

I subsribed to many medical sites including WEB MD. If you do not get the free web site you can always sign up free. Mayo Clinic also has excellent information as well as other medical providers. I found a recent article from WEB MD giving some good explanations on many subjects being asked on MCC. I have posted that article below. You will see "read more" this is where you get the digest of the subject and you will need to be on WEB MD to get it. It is free and articles are posted by medical doctors.

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Spotlight on Prostate Cancer

New and Better Ways to Treat Prostate Cancer
Vaccines, robot-assisted prostate removal, better hormone therapy -- prostate cancer care is becoming less invasive, highly targeted and, most importantly, more effective.

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Warning Signs You Need to Know
It's the second-most common cancer in men. Here are the most common symptoms, and things that may put you at risk.
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How to Have Better Sex After Prostate Cancer
Bedroom troubles after prostate cancer are often temporary or treatable. Ask your doctor about penile rehab and these other therapies.
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Active Surveillance a Leap of Faith
Should men with low-grade prostate cancer skip treatment and opt for active surveillance? And as they get older, is surveillance even worth it? Here are questions thousands of aging men must consider.
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8 Things That May Slow Down Prostate Cancer
Studies suggest certain foods and healthy practices can curb the growth of tumors in the prostate. See what might be worth trying.
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Does Medical Marijuana or CBD Help?
Medical marijuana is touted for a lot of things, but the research is mixed as to whether it can help treat prostate cancer.
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Castration-Resistant Prostate Cancer: Symptoms and Treatments
Chemical and surgical castration deprive the cancer of testosterone, which it needs to keep growing. But what do you do when this strategy doesn't work? Here are your options.
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One thing if considering surgery is the doctor can be less aggressive when removing prostate in regards to nerve bundles. I was diagnosed in OCT. 5.2 PSA, DRE felt something, MRI Pirads 5, Biopsy 5 cores left side all 4+4, Pet Scan showed no seminole or node spread. I am having surgery next week where my surgeon will be aggressive on left side not sparing the nerve or area where margin may be compromised. ED don't care about, not as important as life expectancy for me and my wife. I want the Dr. to be aggressive. If done early in your case the Dr if skilled, I believe can have great success. Can you do testing on Biopsy samples to see how aggressive or what type of cancer it is?

Post surgery; the pathologist will do a complete analysis of the entire prostate and will provide an accurate Gleason score. In my case a Gleason 3+4 was upgraded to a Gleason 4+3 which put me at a higher risk. Although my post RP PSA was < .008 my PSA began to slowly rise which 4 years later led to Salvage Radiation along with 2 injections of Zoladex. 18 months later my PSA continues to be < .008 although my Testosterone level is virtually zero and my radiation oncologist suggested that at my age of 81 that it may never come back. In the meantime I keep exercising as much as possible. Everyone's journey will be different but the post surgery pathology report will provide you with more accurate information then you had going in to surgery.

Thanks

My biopsy showed two cores out of 14 at 3+4=7. After numerous consultations I decided on removal. I had no side effects at all(Religiously doing Kegels and having 100% confidence in my urologist/surgeon). My pathology came back at 4+5=9 and was close to the capsule. My first PSA came back at < 0.01, but my decipher indicated a higher risk of recurrence. So far so good. My advice: make sure you feel comfortable with your biopsy score; mine came back higher. Also, if removal is the way you’re leaning, IMO the earlier the better. Best wishes.

Here is my background which may help in the decision process: I was diagnosed at age 61 with Gleason 6 (3+3) with genetic testing showing it as slow growth with 2 cores less than 15% on biopsy, PSA at 4.6 At age 67 after 6 years of active surveillance (checks every 6 months with one or more of the following: PSA, MRI, DRE, MRI/Ultrasound guided biopsy, etc. on a periodic basis), still at Gleason 6 but with rising PSA to over 10.5 and biopsy with 4 cores less than 15%, I had my prostate removed using never sparing single port robotic surgery. Pathology showed I was at Gleason 7 (3+4) so the timing for removal was on target.

Unfortunately severe incontinence and ED resulted (main reason I originally opted for active surveillance as long as safe) which was a surprise since I was in excellent shape and a great surgery candidate. The surprise was how severe each was since it is expected nearly 100% for some period of time. After 10 months of pelvic floor, mybetriq bladder medication, physical therapy, etc. I opted for an Artificial Urinary Sphincter (AUS - Boston Scientific) surgery to resolve 4 - 6 maximum pads per day for leakage. Now I'm down to 0 max pads and just one very light pad per day for a few drips, so a big success. Since I was beyond 3 max pads per day, the less intrusive Sling surgery option wasn't feasible.

On now to tackle the severe ED issue. Medications have no impact, vacuum device used for penile rehab is not really feasible/desirable so I opted for a stem cell injection a few weeks ago and am waiting to see if there is any impact by the 3 month mark. If not I may then try Trimex injections. Hopefully one of those will work since the last resort would be a penile implant, which I rather not have to do.

Any advice on the ED issue would be appreciated. If I can help in the decision process for active surveillance, prostate surgery or incontinence with AUS, please contact me.

Your case sounds severe.If you had to do over again would you have surgery earlier? Or maybe radiation?

Hi, Robo45vt -
Like you, I had a Gleason of 3+3. My PSA bounced around from a normal range to 9 or 10. I was 61 and in good health. In addition, my prostate was pretty enlarged to the point of causing difficulty urinating. When my biopsy first came back, my immediate reaction was surgery - I wanted it out! I made an appointment with Mayo and had a teleconference interview with my doctor. After talking with him, I was more open to other options. I went to Mayo Jacksonville and had bloodwork, urine test, and an MRI. After talking with the second doctor, who was more concerned with my enlarged prostate and the resulting larger bladder (since I could not empty it), we scheduled a HoLep procedure to remove some prostate material in order to make urinating easier. Basically about 1/2 of my prostate was hollowed out. I can go now like I was teens (lol) and the biopsy from the prostate material came back benign. Now, at almost 63, I am on active surveillance and living life. I’ll go back for my next check in June or July.
All this is say - every man’s journey is different.
Have you read Dr Patrick Walsh’s book Guide to Surviving Prostate Cancer?

Mcbieber1 sounds like you are one of us that had surgery and are having a tough recovery from Constance. I am glad to hear you have better control on it now. I hear of men as yourself and realize just how Blessed I am. I use light pad still 9 months after surgery but hope to be free of pads in the next few months. Mostly dry myself except for after peeing seams to take forever to stop dripping.
ED I found Trimix is really great for me. I am having better sex now than I did before surgery, even for several years earlier I just didn’t realize how much I was struggling with Ed. I encouraged you to look on this form “ Trimix good or bad idea” there are several men including myself that have shared experiences on it. I hope you have great success with the stem cell injections and won’t need any further treatment.