One thing you want to find out is what percentage of the 3+4 had cancer? Also, what percentage of it was a four. It’s possible if it’s very low percentages, you could go on active surveillance for another six months to a year.

Here is a video with Dr. Laurence Klotz, one of the experts on active surveillance. He can give you answers as to why you would or would not be a good candidate for active surveillance.

If you have a high percentage of four, then you could get a PSMA pet scan to see if it is spread anywhere else. They only biopsy about 1% of the prostate when they do that procedure so a lot of the prostate has not been checked.

You might want to get a second opinion on your biopsy. There are doctors that are specialists in doing that and they can give you a lot more information about what’s going on but it will cost you $500.

Two of the best people that do this are

Dr. Epstein biopsy
https://advanceduropathology.com
Dr. Zhou

Send an email to Ming.zhou@mountsinai.org to inquire about a second opinion and ask for his specific instructions for the process.

The long-term results from surgery and radiation are about the same. If you get surgery and it comes back, you can get radiation. If you get radiation to start, then surgery is very difficult and only a few Specialists do it.

If you were to get surgery, you want to find out if your doctor could do nerve sparing, which can usually allow you to get an erection after.

If you get radiation, you will probably not have ED right away, after a couple of years, some people do lose the ability to get an erection. If you get surgery with nerve sparing, you may take a while to get your erection back, but it will usually come back.