Final countdown to RP on 3/26th and I’m anxious

I'm nearly 2 months out now: not a second of ED, not a drop of incontinence, undetectable PSA and my margins did leave some "cancer" behind - and it was intentional since grade 3 is not really considered cancer these days.

I worked myself into a frenzy beforehand. I joined support groups, talked to social workers and therapists and I do understand how crazy scary the thought of the future is.

The only thing you can do now is what is in your control - lots of pelvic floor work, lots of core work beforehand and leave the rest to your doctor. I'm saying this as a hypocrite because others told me similar things and I still freaked out. Hindsight is a wonderful thing.

Just know that the only guaranteed outcome is loss of your prostate and your ejaculate, everything else is not guaranteed by any stretch of the imagination.

We have discussed your case a lot in this forum. It’s good to see you have come to a conclusion and decided to have surgery. I had surgery at 62 and as I have mentioned before, I was back at work four days later. When you have your own business, there’s no money coming in if you’re taking time off . The surgery isn’t difficult to get over at that age. It’s just the catheter that will bother you the most after a couple of days. The day after surgery the drive home was just the worst. Make sure you have pillows and blankets in the car so you can get comfortable.

It is sort of convenient though, not to have to go to the bathroom to pee, Everyone loves emptying a bag of pee!!!

No, but really it’s probably gonna be an easy recovery for you. Yes, and hopefully no margin issues!

@jeffmarc @survivor5280
Thank you for your focus: Another curve ball thrown at me today. I went to UMiami health today which I had on the books for a last opinion. They are strongly recommending that I don’t have surgery since there appears to be no space between the tumor and my rectum. This was a huge red flag for them. I reached out to my NYU surgeon to ask him if he sees this as well. Nothing back yet. The NYU surgeon was straight forward that my left neuro vascular bundle has to be excised and he has to go wide near the apical apex. Basically ED more likely and incontinece too.. and now possible rectum damage. I’m freaking. All this for maybe 60% chance I’m good after surgery. I’m rethinking two things now . Taking ADT for 3-4 months to shrink the tumor to make surgery more viable ( I know that no data on better long term outcomes) or go the radiation route. Man, I can’t catch a break with this. Distressing.

Even if they do radiation, they probably are going to want to have you on ADT for a few months to reduce the tumors. Even if you we’re getting an MRI driven SBRT they could also damage the rectum if it’s right up against a part of the prostate they have to remove. Have you spoken to a radiation oncologist about this?

I don’t remember what you did about oncologists, wouldn’t a GU oncologist or a center of excellence seem to make sense now?

@jeffmarc the rectum issue never came up at NYU Langone ( I met with Dr Zelefsky who might be tops in the field) The R/O at Mayo Jax Dr May didn’t mention or The Cleveland clinic team in FL. Only the UMiami Health surgeon said something. I just had a call with Cleveland Clinic and they said they didn’t see it as an issue but they also restated that taking ADT for 4 months will shrink the tumor. My wife says take ADT and delay surgery. I feel if the NYU surgeon Dr Taneja can get me good margins I should stick with surgery 3/26th.

I'm so sorry to hear about the added bad news, that's awful for you. Better to find it out late than not at all, give your other docs a chance to evaluate it. Do they feel there is a likelihood of bowel incontinence as well, given the proximity to your rectum?

I hope they can put you on something for a while so you can get this figured out!

Best of luck TM : )))) !!!! I will be sending you healing vibes Wednesday < 3 Wishing you super successful surgery and uber fast and complete recovery 🙂

@survivor5280 i haven’t spoken with my NYU surgeon yet. I’m going to ask him all that before I proceed. Thanks for your support.. you guys must think I’m crazy by now.. I am crazy with this PC but spirits are high! 🙏👍🤞

Taking ADT will essentially stop your cancer from growing. It will also allow it to shrink. If you’re going to have surgery next to the rectum think of the drawbacks if something goes wrong.

I think your wife has the right idea. This is a long journey not a 50 yard dash.

And finasteride will cause your prostate to shrink as well, perhaps those two things - if they are able to be taken together - will get it away from the danger zone.