Hi Kevin. Thanks for the thoughtful response. That’s a lot of great information there. Looking at your history you’ve had quite a ride haven’t you?

I’m 3 months away from turning 69 YO. No co-morbidities. 30 BMI. I exercise 5-6 days a week. I don’t smoke, drink, or use recreational drugs. Avid cyclist.

I was first diagnosed in 2020 with Gleason grade 6. I opted for focal brachytherapy and all indications were that I was disease-free until March 2023 when my PSA started to rise. My urologist was also my radiologist so when he went on medical leave (and never came back) I couldn’t find anyone in the Chicago area familiar with brachytherapy I had to travel to St. Louis for consultation. A PET-PSMA scan and 3T MRI showed two lesions. One at the site of the failed brachytherapy and a second in the untreated area of the prostate. Also 2 pelvic lymph nodes. Treatment in st. Louis would’ve required my wife and I to move down there for at least two months so I sought treatment in Chicago.

I went to Northwestern Medicine in Chicago. They felt that I was a good candidate for salvage RP which as you likely know is seldom performed after radiation. I had surgery in January. They removed the prostate and every local lymph node they could reach. 3 mos post surgery I’m doing well. Pathology showed one lesion Gleason 9 (4 +5) and the second lesion Gleason 8. Post surgery PSA Nadir at 0.43. The surgeon was unable to safely remove one of the suspicious lymph nodes so the plan is to go after it with ADT and radiation to the pelvic lymph node basin. The current plan is 33 sessions over seven weeks. They’ve got baseline numbers on everything and will do regular bloodwork.

I’ve met with a personal trainer and have developed an upper body exercise routine, using my bowflex and a lower body workout routine using ankle weights and or the bowflex. I have both a recumbent trike and a cyclocross two wheeler and hope/plan to include cycling in my effort to maintain strength and muscle mass.