Hi,

I'm 49. Gleason 3+3.

Last December my PSA doubled from around 2 to 4.15, had a Multiparametric MRI, it showed a lesion and the fusion biopsy confirmed a localized tumor with seemingly nothing affected outside the prostate itself. Three positive cores out of 18. One within the lesion; two more in the same lobe outside the lesion. The other lobe is clean.

In these three months, two more blood tests showed the PSA went down to 2 again (January) and up to 3 again (February).
My T is high naturally, in the 900-1000 ng/dL range. I've always assumed it is because of my vigorous workouts and healthy habits.

My father had prostate cancer too, his prostate was removed and he has not had any recurrence to date. I don't know what Gleason he had. And I won't know till after surgery, because I've decided not to worry him and my mother until everything is taken care of.

Because, yes, after thinking it through and doing my research I've decided to undergo surgery and it is scheduled for next week.

My surgeon says he believes my nerves can be spared, and he is confident I will be dry in 3 months and optimistic about my erections.

However, I'm having second thoughts. I wonder if my naturally high T will increase my risk of recurrence even if everything is removed now. I also doubt that the outcome in terms of functionality will be as positive as my surgeon implies.

So, I'm not sure if it's stupid or overreacting to undergo surgery now.

I do know that if I don't undergo surgery, I will be thinking about it 24/7. And I'm afraid that if I don't do it now, even under AS, (a) my cancer will progress suddenly beyond treatment or (b) it will progress slowly but beyond a nerve-sparing stage or (c) other health issues will arise down the road, so when (if) I really need to undergo surgery, I won't be as prepared either physically or economically to face the procedure.

I don't know. I had made up my mind, but a week prior to surgery, I question my decision.