Recently diagnosed with prostate cancer: What questions to ask docs?

Solesky, sorry to hear you have been diagnosed with prostate cancer at 73. I was diagnosed about 2.5 years ago when I was 55 - Gleason 7 (4/3), healthy, no other comorbidities, physically active, positive attitude on life and wanted 30+ years of cancer free life. After extensive research, I went with a robotically assisted radical prostatectomy at Mayo Rochester. For myself, this was the only viable option, given my goals to live cancer free for 30+ additional years and to remove all known cancer. I also did not feel comfortable relying on imperfect imaging tools and the lack of margin definition associated with less invasive treatment plans. Surgery does not guarantee the cancer is all removed or will not come back, but in my eyes, it gave me the best chance to overcome the prostate cancer long term. So far, PSA undetectable and all bodily functions have returned. Based on my research and personal experience, I believe successful prostate cancer surgery is highly aligned with choosing to go with a center of excellence, picking the best possible surgeon at that center of excellence, being in good physical shape, having a positive attitude, and following all pre and post surgical exercises/PT/...

With that said, there is no one treatment plan that meets every man's situation - I always tell other men to listen to all advice, but bias lower those that are singularly focused on one treatment plan for everyone. You must be honest with yourself and pick the treatment that best aligns with your goals and then live with all positive and negative consequences. Second guessing yourself only creates stress and anxiety going forward.

Best of luck and I pray all goes well with your treatment of prostate cancer!!

Jim

I had my prostate removed six months ago and doing just fine no leaking problems but ED problems

I'm 70 and in otherwise good health when I was diagnosed 3/30/24. As already mentioned by others, my best piece of advice is to go to a recognized "cancer center of excellence" if that's an option available to you. Google it and you'll easily find one. I did (Mayo Phoenix, Dr. Paul Andrews) and I was very happy I did. I felt the advice and care was outstanding. Also, I'd recommend Dr. Patrick Walsh's Guide to Surviving Prostate Cancer Paperback – October 3, 2023. It's on Amazon and it's the best $20 I ever spent. It really helped educate me on some key points in my decision making. In the end my wife and I felt surgery was the best option for me and that's what I did in late June 2024 at Mayo Phoenix. So far the results have exceeded my expectations as the recovery has been remarkably low pain and quicker than I imagined. Also, only 4 days out from catheter removal and I'm essentially 100% continent. No idea on ED yet. As far as questions to ask, I was interested in the doctors feedback specifically regarding my case, which treatment they felt would provide me the longest survival rate and the percentages of likely occurrence of incontinence and ED for that treatment.

If you're into the science research on prostate cancer, I'd recommend watching the videos by Dr. Eugene Kwon at Mayo Clinic in Rochester. The videos are long, but, they're quite educational. I'm a little nerdy but I found these presentations extremely informative and helpful.

I too found the post-surgery pain to be considerably less than expected. In fact (IMO) the biopsy procedure was more distressing. I called it borderline barbaric ... but you survive.

I watched one of Dr Kwon's videos. It was informative, but it was also very-much aimed at other medical professionals, so there was a lot of technical shop talk. I was able to follow (just), but there's a lot of nuance that we laypeople might miss.

As I said ... I'm pretty nerdy.

What I got out of the video I watched was that he was celebrating the growing recognition of "oligometastatic" as a disease stage, with preferred treatment of ADT, ARSI, and curative doses of radiation to the primary location and each metastasis.

He was also frustrated that some practitioners were taking it too far and radiating 5+ metastases. In those cases (which aren't really "oligo"), he recommended a big dose of chemo up front as part of a "triplet therapy" instead.

Does that match your reading, assuming you saw the same video? Also, I should note that it's many months since I watched it, so I might be misremembering parts.

I don't know which video you may be referring to. He has a lot of videos and I haven't seen all of them. I was particularly interested in one of his videos discussing Lutetium-177 which is used for metastatic spread of prostate cancer. At my last PSMA PET in April, there was no indication of it spreading, but, Lutetium was discussed with my oncologist and I just wanted to learn more.

How to contact Dr. Eugene Kwon from Miaoyou Medical International Rochester Campus via video

I don't live in the United States. Do you have an online version of the paperback version of Dr. Patrick Walsh's Prostate Cancer Survival Guidelines that you recommended?