Pre-surgery Predictions: Anxiety mounting before surgery

I also had much anxiety before my surgery, really for most of the year prior to my surgery. Anxiety is part of the process seems like. For me things looked better coming out of the surgery than they looked going in. I was undetectable at 3 months and am optimistic that I will be undetectable at 6 months. All I can do is focus on one step at a time, let tomorrow take care of itself. Wishing you the best!

Unfortunately, you have given us no information that would let us say what we think.

What was the result of your biopsy? What was your Gleason score? What’s your most recent PSA, or PSA at diagnosis.

Are you on any drugs yet?

Have you had a decipher test?

Were any of these things found in the biopsy intraductal, ductal, large cribriform, Seminal vesicle invasion, EPE or ECE. (Extraprostatic extensions extra capsular extensions). They can make the cancer much more aggressive.

You have to realize that everybody is different. Talking with somebody that even has a similar case may give you no idea about what’s going on in your situation.

There is a group called ancan.org That has a meeting next Tuesday at 6 PM your time. Between 40 and 50 people show up At most meetings (they are weekly) there’s always three or more doctors. People that live in your area will be there. If you get there 10 minutes early, they will go over your case details and give you advice. They have been doing it for over 15 years. You have to install GoTo meeting On your device, And you’ll be able to see everybody there. You could go to the website and review previous meetings to see what’s going on.

@ridersup

Cornell Weill has a patient program that allows volunteer patients to talk to potential patients. I had a video consultation with an RO at Cornell Weill and was able to talk to a patient about their experience with radiation.

Appreciated. Thanks

@jeffmarc
Thank you sir.

@jeff1963
One step at a time—agreed. I have to gain a bit of ground on that front using the usual methods like keeping my hands busy and my feet moving while trying to wrap my head around the physical realities my version of disease comes with. I appreciate the time you and the others took on my behalf.
Thanks

As @jeff1963 noted, anxiety (and second guessing) is part of the process.

Your testing has led you to a treatment decision and you have made one.

Try to have confidence, or at least comfort. Both Prostatectomy and Radiation have similar long term results and your thoughts have led you to surgery.

I chose surgery for my Gleason 9, and I needed salvage radiation treatment (SRT) to the pelvic floor and pelvic lymph nodes immediately thereafter because my PSA was detectable at .19 post-op (called "persistent").

Since completing both treatments, thankfully I have been undetectable at < .02, working on almost 3 years now. And I have no regrets with my decisions.

Best wishes for a comfortable decision and successful treatment.

I had surgery two months ago. I was actually locked in completely on surgery as the best option for my situation (3+4=7, contained on imaging, somewhat aggressive profile with Decipher score of .61) I chose surgery because I felt it gave me the best treatment options if I had recurrence.

Short version: everything went very well. But, there were bumps in the road during my decision process.

Four days before surgery, in an online support group meeting, the moderator (who provides medical care in hospital settings) and a focal center doctor did a 90 minute presentation explaining that focal therapies are where everyone should start (small caveat of if you qualify) because surgery is so terrible. It was literally 90 minutes of focal therapy great, surgery bad. At the end, the moderator told me that I need to reach out to my surgeon and cancel if I had doubts, even cancelling up to the point of being rolled into the operating room. (he knew nothing of my imaging). I didn't have doubts until they told me for 90 minutes that surgery is bad and Focal is good. It shook me up. I then had to do a bunch more homework to realize many things;
• Many insurance policies do not cover focal therapies because several are still considered experimental.
• The recurrence rates after focal treatment is really high (so it's sort of kicking the can down the road approach)
• And finally, my cancer location made me not a good candidate for focal.

Which is not to say that there aren't tons of people who get focal therapy and have great success. It just wasn't right for me and I didn't like the recurrence numbers. Focal might be right for you. It just wasn't an option for me.

After that, I was locked back in on surgery 100 percent. Yes, recovery takes time and managing the side effects takes time. In my case, my surgeon said that my post surgical pathology report was "as good as it gets." I was very fortunate and this isn't the say yours will be the same. But, surgery was the right choice for me.

If you don't have spread past the prostate, I've heard people describe surgery as the choice of doing the surgery, getting through recovery and then living your life. But, everyone is completely different. Their pathology, their numbers and how their body responds.

So, I don't know your medical pathology, so I really can't advise what is right for you. All I can do is share my decision process.

Whatever you decide, you just have to own it and move forward. Hang tight-you got this.

(side note: when I told my son, who is a rehab doctor about the support group moderator and what he did , my son said that their behavior might not qualify as malpractice, but definitely was unethical to advocate medical treatment without knowing my pathology and medical situation.)

I was diagnosed last year (3+5=8) and presented with the same two treatments. I chose surgery without hesitation (I’m 59yo).

Unlike most people (I’m probably not quite wired the right way 😉), I had zero anxiety. Diagnosed in October, given treatment options in November, chose surgery in early December, had surgery in early January 2026. No regrets. None. Not a one.

Side effects, yes, the usuals (incontinence, ED, dry orgasm being the Big 3), and some discomfort for several days after surgery (hats off to @jeffmarc - I was off work for two weeks following surgery, then a week of half days, and a full month of no overnight/on-call work…and I should have taken more off, frankly), but all in all, fairly uneventful recovery minus some heart stuff that popped up (that probably would have come to light on its own eventually, anyway).

Once a decision is made, I like to put my head down and get on with it, no second-guessing (my wife and her family are complete opposites, which leads to some hilariously frustrating days at times). I put my energy to working toward making sure I’m doing everything I can to ensure the best outcome possible (doing kegels before surgery, smartening up on dietary recommendations post-surgery, etc).

Good luck on your surgery, and looking forward to reading about how you’re doing in the days and months ahead!

@turtbean
Thanks for this. Of course everyone’s case is unique but there’s something of great value to be found just listening to those that have actually been through it. I ask the doctors as many questions as I can but in the end I will face it as I have faced adversity my whole life: own it and follow through as best I can.