44yr PSA180 Gleason9 non-metastatic. Surgery or Treatment?

@tdoriausername
Actually, chemo is usually only done when the cancer has spread to other places in the body. If it’s isolated in the prostate, they would give you an ADT and an ARPI (Zytiga or a lutamide). If only a couple of metastasis outside the prostate, they would use SBRT radiation on it.

They really do reserve chemo to more severe cases.

@codymcquade
Because it’s much simpler to test your blood or tissue. Blood, tissue and urine are the main testing media to test for cancer. See attachment.

There’s also no standardized test designed to test sperm for prostate cancer.

@tdoriausername
That is currently the plan, except i will try to stay away from chemo and stick to RT as much as possible.

@dinu Good plan

@dinu Check with your VA insurance and see if they cover second-opinions appointment. We got 3 extra second opinions appointments after my husband's prostatectomy because of the seminal vesicle's involvement. Our insurance covered all the fees. One of them was through their telehealth program, which the chief urologist at University Hospital Ulm reviewed the medical paperwork, including surgery notes and pathology report. We saw another chief urologist and the radiation oncologist in person. All four opinions were similar: wait & see with 3-month PSA test. After 2.5 years, the urologists wanted to do 6-month PSA test, which we firmly said no. They agreed and let my husband continue doing 3-month PSA test.

@beaquilter Guten Tag from Germany! We have some family members in NC too. Such a beautiful state.

@prettypass2000
Since I was able to link my PCa with my military service, it is not rated as service connected. All expenses incurred for treatment (opinion, PSMA, PSA, etc.) is reimburseable via the VA FMP program. I do have to pay upfront snd then submit the receipts for reimbursement, but it is easier than trying to convince the many doctors/specialist to sign up into the VA payment system.

Strange as it may seem, men your age usually go for surgical removal of the prostate. The reasons are many. First younger men can recover faster. Surgery allows complete staging of the removed gland. You can do radiation after surgery. With so many years to live, the chance of getting cancer from radiation treatment is higher. But the big negative is ED and urinary issues.

Hi all,

latest update on my case. I am scheduled for RARP, with potential nerve-sparing, on 26.03.2026. I am going to start taking Tadalafil 5mg to improve blood flow in the penis, for a better recovery.

@dinu Wishing you speedy recovery!