I spent 9 years on active surveillance. During that time I studied and evaluated all treatment options, had referrals to specialists, put together a treatment plan, and finally executed accords to that plan. All of that built confidence in successful results. But even with all that due diligence, recurrence is always a possibility.
How I do it? —> I never dwell on failure. When I had successful knee surgery in 1995, I didn’t dwell on failure (even though it did in 2018). When I had a microdiscectomy in 2012, I didn’t dwell on failure; so far it has not. When I had a cholecystectomy in 2023, I didn’t dwell on failure; so far it has not.
Statistically, I’m more likely to die of cardiovascular disease than I am of prostate cancer. (They say that a heart healthy diet is a prostate healthy diet.) My thinking is that my PSA tests are the best ways to determine if there is recurrence and, unless I see a bad PSA trend, I have no reason to seriously consider recurrence; it isn’t even on my mind at all.
Dry ejaculate is an absolute certainly for anyone getting surgery, and a high likelihood for anyone getting external radiation; due to the location of the seminal vesicles, hitting them with radiation is almost unavoidable. In the grand scheme of things though, that’s a minor after-effect that comes with successful treatment.