Maximum time I can postpone treatment after biopsy?

Hi, sorry to hear of your situation. More experienced people on this forum will soon answer your queries in detail. My Husband had RARP in mid September. Biopsy was end of April. He started ADT in August for about 45 days before the surgery. This was because of the wait for the surgery. Your case does not seem to be aggressive but there is no telling for sure. If you cannot undergo surgery in March, you may want to start on ADT right away in order to arrest the cancer and confirm the status by doing a PSA test every 2 months or so. I am just a lay person talking from my experience and you should consult with your Urologist/Oncologist regarding your treatment. All the best to you in your treatment journey.

Robotic assisted surgery doesn’t put very large cuts into your body and they heal pretty quickly. You might be able to get back to work at four weeks, but this is something you need to ask your doctor about. Did the doctor tell you it would take six weeks?I know I went back to work full-time after seven days, had the surgery at 62. My job didn’t require working with heavy equipment, or doing strenuous work.

I know when I had Surgery for my stomach when they opened me up more than robotic surgery it did take six weeks to recover. But then I’m 78, don’t recover as quickly.

I’ve heard a wide range of number of weeks people have taken off after a prostatectomy. Some people have taken two months most have taken less time.

@ shalom7777777 really did recommend a good idea. Getting on ADT will stop your cancer from growing and will shrink it. You may get fatigue from it, I didn’t, but others do. Because you are so active, you may not have that problem. Actually doing exercises, which is work for you, Alleviates a lot of that fatigue. That may be your best. Bet if the doctor says you need more than four weeks..

This study from 2020 reported in JAMA indicates that even with localized, high-risk prostate cancer, a surgery delay of up to 6 months has no statistically significant chance of worse outcome. —> https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2773817

The mistake that is often made - that often results in treatment-related regret - is not being fully informed and rushing the treatment decision without having established expectations —> https://jamanetwork.com/journals/jamaoncology/article-abstract/2786406

Just make sure that you’re fully informed, expectations have been set, and that you’re confident that whatever treatment you’ve chosen is right for you.

**Wishing you the best with your decision**

Just curious why you decided on surgery when you could treat with all the other options? Your stats don't seem to be high risk at all. These other options would allow you to continue to work, etc. Studies show surgery has almost the same long term results as radiation. Dr. Mark Scholz has some great videos online where he addresses 3+4 treatment, and even suggests AS in some cases.

Thanks for your responses. I have read those studies and done a lot of research. Tough when your head is telling you one thing and your gut is leaning toward another. I had not considered the ADT as I mostly thought it reserved for more advanced cases and in conjunction with salvage therapy. I will ask my Dr. opinion on that. Part of the frustration in the journey so far is navigating the medical field, at least here in MT. Many calls to try to push things along and get appts and scheduling. Dr shortages etc. This site has been a good source of info. You all's feedback is much appreciated.

I should also add that I have hip implants which have an effect on the precise imaging used in some of the more advanced treatment options.

Just my opinion I would not rush into surgery. I don't think it would hurt you much to wait until fall and seek out opinions from top doctors. Even if this means traveling to other states or online consults. There is no way in hell I would have surgery if I was a 3+4 with your other stats. Only way I would consider surgery was if I was maybe in my 50's and even then would be a last resort. There is a good chance you will end up needing some type of treatment after surgery in future anyway. Plus the side effects which all treatments come with. Bottom line is everyone has to make their own decision. Wishing you the best on what ever you decide.

Depending upon where you will get your prostatectomy, you can consider inquiring about a single-port robotic surgery, versus the multiple-port DaVinci robot used by most surgeons.

The main advantage of the single-port robot is a significantly quicker recovery. However, single-port DaVinci robots are not as widely used, they require a surgeon who has been specifically trained on this type of robot, and it is not used on patients with larger prostates and/or some complications. Similar results in terms of continence and sexual function post op. I personally know two people over 65 years old who successfully underwent single-port surgery and were doing all physical activities after 4 weeks. Fully continent immediately after surgery and recovered original sexual function within two months. Fewer surgeons excel with the single-port robot, so much diligence is needed when choosing the surgeon.

As mentioned in previous post I have had both hips replaced, One 12 years ago and the other 3 years ago. Has anyone one here had experience with getting more advanced MRI, or procedures involving more precision imaging ( proton, tulsa, etc.) with implants? I have read where there are newly developed ways to help minimize "artifacts" to get a clearer image, but again very few locations, high level of skill involved and it is still developing.

I would think with today's radiation technology like MRI guided, AI mapping, etc. Proton, SBRT, or even Brachytherapy could be done with someone who had hip replacements. This is why it is so important to get 2nd and even third opinions hopefully from bigger hospitals. Teaching hospitals at universities usually have the top docs with the most advanced equipment. Or what they call "centers of excellent". Of course I'm no doctor and kind of new to this journey myself but I would think any competent doctor would offer you many options with the stats you posted.