Very helpful. Certainly the same path I took with my cholangicarcinoma as it is relatively rare to begin with. You need to do everything you can to find out info and advocate on your behalf with such a diagnosis--at least I felt I did.

I am getting a second surgical opinion on the nerve sparing pursuit. My urologist, who does do surgery, just not Davinci, said based on the location of my malignant cores (these are on the outer most interior location) that one side could likely be salvaged while the other may not. For the same reason you stated (quality of life), and while it may be true, it behooves me to verify this with a second surgeon at a center for excellence (research hospital Indiana University) .

Why did I go straight to surgery? You didn't ask but I'll tell you. Because when you are diagnosed with such a rare cancer and you are told up front it is stage 4 and incurable, and then you beat it, you learn to recognize miracles and not play the odds. I would much rather have the cancer out of me while localized to prostate than having it metastasize. Could radiation do that--certainly possible. But then there goes my shot at surgery if it comes back. Additionally, he was almost certain I would have zero incontinence issues. As such, when you weigh the pros and cons of all the procedures, consider your own perspectives and history, life goals, and combine with science it becomes easier.

Your comment on tackling any ED issues down the road is well understood on my end as well. Of the possible rehabilitation processes and treatments, I am perfectly happy to entertain all and 'deploy' as necessary.