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I agree with some of the other comments in regards to consider your salvage options if cancer comes back. It also depends on the surgeon.

After doing my research, I am leaning towards NeuroSafe surgery. So far, I have only found one person on the US who does it (Mt. Sinai). Long story short, they do a biopsy during surgery to determine how much to take out while trying to stay away from the nerves. I believe this is better than intraoperative cavernous nerve stimulation (by stimulating the nerves that control erections, the surgeon can confirm their location and preserve them, a procedure known as a nerve-sparing radical prostatectomy), as with that process they might be sparing the nerves but aren't quite sure about getting all of the cancer.

NeuroSAFE stands for Neurovascular Structure Adjacent Frozen Section Examination. It is a technique that was first described by the Martini Klinik in Germany in 2014 that involves analysing the margins (edges) of a prostate immediately after it has been removed from a patient and whilst the surgery is still on-going to see whether cancer cells have reached the cut edge of the specimen. The prostate is delivered immediately to a pathologist in the room next door where it is frozen using a cryostat, cut into thin slices, stained with special dyes and examined under the microscope.

This analysis is done whilst the operation is still ongoing (the urethra has to be joined to the bladder after prostate removal), so it has to be done rapidly – typically within 20 minutes of the prostate being removed from the body. The team processing the tissue needs to work together quickly and efficiently to get the report to the surgeon within this time frame

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Replies to "I agree with some of the other comments in regards to consider your salvage options if..."

This sounds like a real interesting technique. One of my wife’s best friends husband is a pathologist who worked in a hospital analyzing tissue. One of the things he did was analyze the tissue as the surgery was going on to make sure that the margins were clean. He did this with many different types of surgeries, and this was pretty standard.

It makes me wonder why prostate cancer surgeries don’t always get this treatment.

He was good to have around when I Was diagnosed with prostate cancer 15 years ago. He had me bring him the slides, and he reviewed them to tell me if they confirmed what they had diagnosed. He did agree with what they had told me.