Looking for people who had a G6 diagnosis and opted for RARP

I was diagnosed 2 years ago with Gleason 3/4 (5%), T2, Second opinion by a different hospital downgraded to 3/3 (T1). Active Surveillance (AS) was not a great option due my "MRI invisible" lesion that would mean frequent biopsies to supplement MRI data and I had hematospermia (blood in semen) as well along with family history of cancer. (The blood thing is a great motivator for treatment). Pathology after "nerve sparing" surgery was upgraded to T2 Gleason 3/4 (30%). No incontinence, but ED is still there at 17 months.

I would recommend going slow on your treatment decision. I recently attended the Moores Cancer center PC Summit. They gave a very good presentation on AS that shows no increase in mortality or negative outcome by choosing AS and then later choosing a definitive treatment. The one caveat to this statement is that you must stick to your AS protocols with routine PSA monitoring, MRIs, and biopsies.

Best of luck moving forward!

@tuckerp yup, this is the hardest part of PCa. I want the cancer out and gone but there is a potential cost. I have spoken to a couple of people around my age who had surgery and both made full recoveries. They both had that attitude of “it’s cancer, get it out”. One was actually told that by his urologist. One thing I go back to is, is how is the stress of AS effecting me? Probably not good. But would this stress be replaced with the stress of potential side affects?

With a family history of PCa, have you had a genetic (germline) test to see if you inherited and gene mutations related to prostate cancer?
You might not have inherited any and therefore have less reason to worry about family history.

I had a similar score at 57 and decided to have the surgery a few months later after my 58th birthday. Both my father and Grandfather had PC. It killed my grandfather and gave my father a hard time until stroke got him at 73. AS was talked about, but after reading as much as I could about long-range outcomes, I decided to go ahead. I was younger, so recovery outcomes looked better. Also, I was younger which meant the cancer had more time to turn ugly. Those were driving factors. I also never wanted to have another one of those biopsies! In all, it was, for me, not about getting it handled right away; it was weighing the variables with a diagnosis that allowed for options. I did well with the surgery. I had complete control of my bladder from the point they pulled the catheter. I did not, however, get any training on penile recovery. I now think that is as important as choosing a good surgeon. I did get sorta-kinda erections, but nothing great. However, I did continue to experience really nice orgasms. I just started, 7 years later, trimix. It has been pretty spectacular, but I think if I had a recovery plan 7 years ago that included a pump and some daily Cialis, I might not have need for the trimix. No regrets, though. It just made sense to me.