Well sometimes I wonder if I should take up drinking again? Seems nobody moves fast and just wait around for another test to come back. One test they should have sent in 2/10/26 and didn't send in until 3/2/26 that was the Decipher test, takes 3 weeks to get results. I just want to get something started, still leaning to get it cut out, but won't even schedule until results from Decipher test. This is a NCI-designated Comprehensive Cancer Center, but not impressed! Was impressed on how they handled wife's breast cancer. One month from diagnose to completed surgery with many test and scans- all in 30 days. Seems Prostate cancer is handled a lot different at KUMC.
Did see RO for an hour and she said as best as I can tell from my quick note taking:
Radiation Options and Pros/Cons
• Radiation makes BPH worse
• Brachial seed. She does not recommend for me. High risk because of urinary issues.
• Radiation can cause issue with the rectum and bladder. Rectum spacer gel minimizes rectum side effects.
• After radiation, increasing Flomax, add Cialis to lessen urinary symptoms
• There may be bleeding post radiation in a couple of years.
• There may be bowel urgency/blood in stool down the line. In 1 to 2 years.
• Erection functions have better outcome with radiation. Nerves may be cut during surgery. However, radiation may cause blood flow issues from scar tissue after radiation.
Quick summary from RO of what to do:
• Hormone therapy – ADT for 6 months. Shrinks prostate by 1/3. May produce hot flashes, fatigue, and muscle/bone loss
• use some rectum gel
• add some markers
• Recommended radiation: 28 treatments IRMT or 5 treatments SBRT

Notes from Surgery visit as best as I can tell from notes:
The Surgery doctor, said done over 2,000 RP recommended:
• Stage? Clinical State is T1C, but what I said was also accurate, I said T2 N0 M0 (confuses me clinical stage vs what I thought) Seems there are other stages than clinical and one of them is the one I said. Confusing!!!
• 5th Rib Issue, cannot biopsy to small of spot that showed on PSMA test
• SUV on Rib??? Chest CT in 3 mos. after PSMA. Can reach out to radiology for SUV result and why they didn't give us SUV on 5th rib. They gave my prostate a SUV of 11.1
• Cribriform - Gleason Grade Group 4. At higher end of intermediate.
• Staging is tricky in prostate cancer, can only tell after prostate is removed
• Goal is for cure and no biochemical reoccurrence.
• Benign surgeries cause issues. Stress incontinence for a year or more.
• The surgery is robotic and surgery is perfomed by Doctor. Residents may assist or observe only. Incision is through the belly. The lymph nodes are taken out. No lymphedema will happen. I said MRI said nodes were fine, he said they need to come out anyway
• Cons of surgery. Age influences outcomes. Prior aquablation and Urolift will make recovery longer and harder to connect urethra back up to bladder.
• Pelvic floor physical therapy can improve outcome.
, Will not schedule until he has the Deceipher test to see those results. And then at least a month out.

This is a mess of a post, but best I could do, felt most comfortable with surgeon, still confused on iwhat he thought of nerve sparing or not for long term?

No matter what I wait 3 weeks for that test they waited forever to send in.