Testosterone Replacement Therapy after RALP

@jeffmark Unfortunately, I live in Spain, so they won't ship the test out of the US. Too bad, I think a genetic test would help me make a more informed decision. Thank you anyway!

I probably got my letters crossed up. Robotic-Assisted Laparoscopic Prostatectomy (RALP) . I have had many say I was crazy for doing the surgery. Mayo clinic phoenix in 2019 did not take Medicare. They now take Medicare but not advantage plans. I went with a Banner network private practice surgeon that operates out of senior community. He was one of the few doing ultrasound treatment. I had to convince him to do removal. He seemed a good choice. I have since had Mayo review all his work. I felt I was also a good candidate. 6'2" 200# with a muscular build. No other issues. No ED issues. I have said on this site that my only regret would have been having the surgery at Mayo. I would most likely not change the decision. Pick a center of excellence. Not many Dr. are going to tell you they dont have confidence. You like me probably have a little time to make sure with a second opinion or third. I did not. I also decided not to cloud my mind. I wanted it gone. Never thinking that I could be one of the 15%.

actually I still got it wrong. Nerve-sparing during robot-assisted laparoscopic prostatectomy (RARP)

I really appreciate your input, @tuckerp. I'm still getting used to the lettering thing... and just about to get into the surgery room! It's crazy. I may hold up and delay the surgery for a couple months or so. It's embarrassing, it has been even paid for already, but I'm not certain. I think I'm lacking very paramount information, such as a genetic test, and more importantly 100 percent trust in my surgeon.

I have two guys at the gym that I work out with. Both have had the same surgery as us. Neither has ever had a problem. They dont think anything about it. Both men are in there late 70's. Of course thats what they tell the guys at the gym. Who knows.

Hello, my sense is that if you are not 100% absolutely certain about surgery DON’T DO IT. Surgery is a life altering, irreparable step with many side effects no matter what a surgeon tells you.
You are young, under AS, and only a Gleason 3+3. NO WAY is complete removal recommended these days. If you do anything, focal treatment is more desirable; many less side effects and your low grade cancer - if they even call 3+3 that anymore - will be gone.
The mindset of “take it out and then my anxiety will be gone” is misplaced. You will continue PSA testing for life and trust me - and many others - your anxiety will flourish with each .01 move either way!
You are in a position most of us would envy. Don’t rush into anything! Your location - Spain- is your biggest obstacle since the medical system there, as well as treatments available, are much different than in the US and Canada. Be well,
Phil

Thank you, @heavyphil, and all of you guys. You are being really helpful.

Today, I've delayed the surgery for the time being. They will pay me back. I'm worried that this delay might worsen things if I eventually end up taking the surgery route, but I think I need to compile all the relevant information to make the most informed decision, such as a genomic test. I would also like to know my father's Gleason at the time of the procedure when he underwent open surgery in 2007. I believe those are key pieces of data I should know before I make the most solid decision. It may end up being the same decision, but at least, if something goes wrong, I will know I did my homework.

I would also like to gather as many of my surgeon's stats and reputation indicators as possible, given that his skill is so important in the outcome. I think @tuckerp suggested that Mayo helped him gather information about the surgeon who operated on him (only after surgery)? I would love to know that about the surgeon of my choice. I've tried, believe me, but it's no easy task. At least, here in Spain. @tuckerp, do you know if Mayo provides such information from surgeons abroad?

Also, @heavyphil, the doctor who was going to operate on me said he was prone to discard focal therapy, given the fact that two cores out of the lesion came back positive, which suggests a multifocal tumor.

Thank you, guys. I hope I didn't f*** it up by canceling next week's surgery.

No. I am such a babe in the woods compared to the guys on this site. I would not be much help. I answered your comments because we are very similar except for your age. I wanted you to know there are risks. My second opinion at Mayo revealed that the Mayo surgeon would not have done my surgery although he could not find any issues. Good Luck.

Well, your doctor is doing what he knows best - not what’s best for you.
Look up TulsaPro, which is usually used in focal therapy; a poster just this morning had his ENTIRE gland ablated - no surgery, no pain, nada!!
Catheter for 2 weeks but that’s to be expected. If you have some $$ see if you can pay privately for a consult - or fly to another EU country that does focal/non-removal procedures. It’s well worth it!

Thank you, @heavyphil. As for the focal therapy, being a complete ignorant about the matter, I must say it seems to me somehow counter-intuitive, because it is a fact that I had positive cores outside the lesion, so there might as well be several more spread throughout the lobe/s, so how would they know where to apply it and eradicate cancer for good? I don't know, I have to do some research about it. For starters, I bookmarked the pdf from TulsaPro.

Thank you!