Connect
← Return to Newly diagnosed and looking for treatment advice.
Discussion
Newly diagnosed and looking for treatment advice.
Prostate Cancer | Last Active: Oct 11, 2025 | Replies (71)Comment receiving replies
I am 62 years old healthy and very sexually actuve. PSA jumps between 4.5 and 3.2. MRI in April showed PIRAD 5 Lession approx 2.2 cm in the inner transitional zone. 13 core biopsy confirmed one core, 70% of core 3+4 with 10% being 4. One other core in different area showed 3+3 in only 10% of core. Had second opinion at Moffit in Tampa which matched exactly. Had CT and PSMA PET with both showing all confined to prostate only where identified. I did several AI tests that evaluated my biopsy. Decipher was not one. I Can’t remember some of the names but one was to determine if I was a good candidate for AS. That came back with a 42 and 49 and below says your ok for AS. AS doesn’t excite me though so I think I want treatment. One test described the chances of Metastification over a 10 year period and the need for ADT. This came back showing that I only had a 7% chance of Mets after one modal treatment and no need for ADT. Last test was Prostox which said I had a 95% chance of urinary toxicity (Grade 2) after SBRT and only a 5% chance after IMRT. This eliminated SBRT for me. I started out wanting a RAPP and it out of my body, but then got scared about ED and incontenece by reading blogs, so I started looking elsewhere. I had meetings with several different Drs and different facilities about focal theories and most said I was not a great candidate due to the size of my lession. Met with both Mayo and Sceonnti about TULSA Pro and was exited I found what I was looking for, but Mayo Dr said it would be his second option behind RAPP and chances were good if I did TULSA it would reoccur sometime later. Well after 7 mos of reading, visiting 3 different centers including Mayo and Moffit, and talking with 9 different Onocology / Drs, I think I’ve decided on removal, and I’m trying to schedule it with Dr Ram at Mayo for later this year. It does scare the crap out of me, but I think that would be the best to move forward. I guess I’ll pray for the best regarding ED and incontenence but will just live with it if it occurs. I chose RAPP due to salvage opportunities if/when it reoccurs and because success is easy to measure since PSA should be zero or close to it. I also feel I’m young and healthy now and can overcome surgery better today then I could 7-10 years from now. I really just want this shit out of my body and will face the other consequences that arise. It took me a long time to get to this point but I think I am ready to do it. I have a beautiful strong and loving wife to help me, and great family of support. Interested to hear everyone’s opinion if they were in my shoes.
Replies to "I am 62 years old healthy and very sexually actuve. PSA jumps between 4.5 and 3.2...."
@ucfron
I have my prostate removed at 62. Recovered very quickly and was actually back at work in four days just on a very light schedule until the 8th day When I was able to work full-time. Since I spent most of my time helping people with computer problems, it didn’t require any physical exertion.
Because I had it at 62 and was relatively young for prostate cancer I had genetic testing about five years ago, 10 Years after surgery. I found out I have BRCA2 Which is the reason I’ve had four reoccurrences since 2010. Nowadays, they want you to have genetic testing earlier to make sure there’s not a genetic problem. Did any of your relatives have cancer breast cancer, pancreatic cancer and prostate cancer are all signs that it could be genetic
You can get hereditary genetic testing? Has it been offered to you by a doctor? You can get it done free with the below link, if you live in the United States. Do not check the box that you want your doctor involved or they won’t send you the kit until they get in contact with your doctor. It takes about three weeks to get the results and then a genetic counselor will call you.
`
Prostatecancerpromise.org
@ucfron
Sounds like you've done your homework and even then, it's a tough decision. I get it. So many options all with their pros and cons. Thanks for the mention of Protox. I'm thinking of shelling out for it as medicare doesn't pay.
Giod luck, brother.
Really comes down to what you’re comfortable with. I chose Tulsa (Mayo Rochester) at 65 years old for my 4+3. At 1 year I am cancer free. I know I have a long way to go but clinical data at 3 years out is showing Tulsa is right in the same ballpark as other treatments for recurrence. What sold me was all other options are still on the table if it returns. I liked the low risk of side effects as ED was not something my wife or I were ready for. My advice is do all the research, weigh the pro and cons, make the decision that is right for you, and never second guess that decision. Good luck.
Connect
@ucfron
Hello, My Husband 68 years had more or less the same biopsy results as yours and was also offered AS. We decided on Surgery immediately but being in Canada there was a long wait time. Waited 3 months then had ADT for 40 days. By God's Grace we were given a slot on 15 september (2 months earlier than our given date) and we grabbed it. Again by God's Grace everything went well and back home on 17th. We had to stay an extra day at the hospital because my husband had moderate bleeding from one of the incisions but that was stopped soon after they gave him some blood thickener. Clips and Catheters removed after 10 days and no pain or incontinence. A lot depends on the Surgeon's skills and I believe it is God who leads us to the safe place.