Gleason 7 (3+4), 6/12 cores positive, PSA 6.68, PSMA negative, Decipher 0.56.

The local surgeons and ROs stopped short of recommending RARP vs. RT. My primary care provider recommended that I seek a second (third? fifth?) opinion at MD Anderson. They had a cancellation opening that coincided with spring break so I was able to get down there pretty quickly.

Why RARP and not RT? Both local ROs recommended against SBRT/CyberKnife because it might worsen existing urinary issues (frequency, weak stream). My local urologist performed a cystoscopy and didn't find anything notable, but started me on oxybutynin to help with mild bladder irritation. The ROs at MD Anderson went even further than the local ROs and dismissed RT altogether as a viable option for me. The surgeon I saw at MD Anderson (John Ward) is also an expert in focal therapies. The entire MD Anderson team recommended RARP as a "no brainer" for my particular case.

Why am I not going back to Houston for treatment? Mainly logistics - Columbus is a 3-hour drive and my sister will be able to go with me instead of me having to drag my 85-year-old dad to Houston. I was also able to schedule the surgery 10 days earlier than at MD Anderson so that I can use my two-week summer work break for a 'free' (i.e., not wasting PTO) recovery period. It was an extremely difficult decision, because MD Anderson is a (the?) top cancer center and I was very impressed with Dr. Ward, but Ronney Abaza is also a world-class surgeon. Dr. Abaza and Dr. Ward both expressed confidence in removing the cancer and a return to continence within six weeks.

I'm single and not sexually active so my priorities are cure and continence. I can't do much about the former but since my diagnosis, I've cut out sugar and caffeine and switched to a Mediterranean-ish diet, along with continuing to run and work out. So far, I've lost about 10 lbs. I'm also two weeks into pelvic floor PT with a specialist. Hope that all helps.