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Just diagnosed

Prostate Cancer | Last Active: 1 day ago | Replies (23)

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@stevemaggart

Having had a RARP at Mayo in June, I can tell you in all honesty that for a 3+3=6 Gleason score, I would NOT consider surgery regardless of the Decipher score! The surgery is not that big a deal, but the incontinence, impotence, and nerve damage that causes me continuing pain/numbness are a very big deal. Granted that you might not experience any or all of these but most patients do, and in my case they are mostly permanent. Get more opinions. You will find active surveillance or other less invasive procedures will manage you situation well. I was a Gleason 9 and stage pT3a but had a reoccurance at 3 months with < 3 month doubling times so now I'm getting ADT, AR, and radiation. Obviously, my cancer had already matastisized, so even in my case I got no benefit from surgery and all the consequences. I'm not saying RARP doesn't have its place, but I don't think your case is one of them. Talk to more doctors and not just urologists. Good luck.

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Replies to "Having had a RARP at Mayo in June, I can tell you in all honesty that..."

Just a few observations about your post. Most men don't have long term ED and incontinence following RP. Most men recover continence fairly quickly if they are young. The potential ED is dependent on the extent of disease locally, age of the patient and whether any ED existed pre op.
It sounds like you have an aggressive tumor with a G9 and rapid doubling time. I, also, had a G9 and rapid doubling time (< 1 month!). I had an RP with post op recurrence with limited metastatic disease. I have persistent stress incontinence and ED (could be due to the ADT as well). I am still glad I had the RP because it got rid of the significant majority of my cancer. More than 2 years after my triple therapy/MDT/pelvic radiation my PSA has remained undetectable and my T is back.
Radiation to the prostate has significant side effects as well. Just most of them are delayed a year or two. I had regained continence a year after my RP but became partially incontinent following my pelvic radiation.