When I was first diagnosed, I was really scared about how long I would live. I thought a lot about how my father had prostate cancer for many years and after Lupon failed he died.

My first decision to have surgery was based on that. But things have changed so much in the years since I was diagnosed in 2010. We’ve got so many different drugs that can keep us going for years, With only some annoying side effects. I’ve had four reoccurrences and each time there was something to do next. I Still have something to do next actually three different things I can try one after another.

In the next few years, there should be some really good development in prostate cancer treatment. Don’t worry so Much about the future, You’re probably gonna live many years and medicine is keeping up, to make you live longer.

You are totally correct - the nightmare never goes away but it dies become less and less scary over time.
I too, opted for surgery (grudgingly!) because my pessimistic nature ‘knew’ it would come back ….and 5 yrs later it did.
Literally just finished 25 tx radiation at Sloan and have 2 more months on ADT. It was NOT the end of the world! You just say, “OK, let’s do this!” And you do it.
I also met many men going for Cyberknife therapy and if you are a candidate, its 15 yr success rate is on a par with
Surgery. Another newer modality is high intensity brachytherapy - (seeds for like an hour or so) followed by 5 cyberknife treatments.
The big question is what to do if it returns and that subject will get you many, many different opinions and answers….best of luck!

On a positive note, I do personally know 2 guys who had NS RARP, one 14 years ago and the other about 8 years ago. Both are continent, sexually active, and neither has had the PCa come back. So there are good stories out there, but as you said I suspect most of those guys just move on and put it behind them. I had NS RARP in late June 2024 so it's too early to tell for me. But before surgery my surgeon at Mayo Phoenix said that for my specific case 3+4=7, T2a, 11 of 19 cores containing cancer, I had a 90% chance of being continent at 1 year and 70% of sexual recovery. Frankly, those were better odds than I expected, and at 5 months I am 100% continent and am able to have intercourse with my wife (albeit much less good than before but slowly improving). After surgery at the 3 month visit the Mayo urologist said based on my clean margins, no extension, no gland involvement, I had about a 95% chance of being cancer free at 5 years. The following Sloan Memorial data base gives me a 91% chance of being cancer free at 5 years and 82% chance at 10 years. So I think there are positive stories out there, but as you said I think they don't tend to frequent this blog. Here's the link to the Sloan Memorial database:
https://www.mskcc.org/nomograms/prostate/post_op
BTW, this is just the data I happen to be familiar with. I'm not suggesting that RARP is the "best" treatment or that's it's what you should do. I have no idea what's the best treatment for you. Rather, I just wanted to share some positive data with you to respond to your post. As an aside, I don't know but I believe the quality of care (ie. going to a cancer center of excellence if possible) is more important to one's outcome rather the specific treatment selected. I'm not a medical professional but that's my 2 bit opinion.

Hi Survivor! Good points. I vividly remember the thoughts, fears, emotions of every stripe. All of that is valid and very real.

I wrote something very similar to yours prior to my surgery in Sept ‘23. That’s when my Mayoclinic friend, Michael, sent me the encouragement I so needed to hear at that time. I want to share that same sentiment with you.

It seems you have done the research/reading/consultation that you needed to do and have made the decision that’s right for you. We can’t predict the future (I sure didn’t see PCa in my future) but, I believe, we can influence that future. With Michael’s encouragement, I turned my thoughts to positive thinking about my outcomes. I read “Life After Prostatectomy” by Vanita Gaglani about regaining continence and followed it diligently.

My surgery went well. The catheter was inconvenient (at times uncomfortable) but very short-term. Thankfully, it wasn’t a big deal for me. I’m glad I didn’t focus on it pre-surgery. My continence returned very quickly. Thankfully, my ED was short-lived (although I was prepared to surrender this part of my life in exchange for removing the invader and getting to spend more time with my 4 (soon to be 5) grandkids.

In short, good things/results can happen. Try to focus on them and encourage them to happen. It’s much more fun than focusing on negative outcomes that may never happen…and I believe it can only help.

Best of luck to you, brother. I hope and pray that your results are all positive. I look forward to reading of your good results in a couple of months.