@pesquallie
That seems to be the "knife tip" that we all dance on: we want to regain our virility and sexual capabilities...which takes testosterone...but testosterone is the enemy that sees PSA start to increase again because any remaining post-prostatectomy cancerous prostate cells, start making that PSA in the presence of testosterone. What to do? What to do? Damned if we do, damned if we don't.
I am well aware of - and have written - that we are the "unlucky ones"...that subset of prostate cancer patients who have had unexpected or expected bad outcomes. The "lucky ones" who had successful surgery by competent urologists who did not leave any cancerous prostate tissue behind in our bodies. It is hard to keep that in perspective: only 10% of post-prostatectomy men had "surgical margins" reported in their surgical pathology report, meaning they had obviously Extraprostatic Extension (EPE), and therefore the surgical margins that saw the urologist leave cancerous tissue in your body, which is now our journey to endure.
Imagine that...nearly all of us on this blog are the unlucky 10%. The guys with Gleason 3 + 3 = 6, prostate membrane-contained cancer, successful removal with successful preservation of the neurovascular bundles that allow for sexual activity without issue, are not on this blog. They don't need to be. We all must endure the reality of the fact that physicians truly do "practice" medicine. None of them have perfected it. They write-off our life-altering bad prognostic status as "bad luck." They go home or shoot a round of golf after their work day, and we sit and wait for the bad news, wondering when it will land.
I have thought no less than weekly for the last 14 months since my prostatectomy, that I should have done like my father who lived to 99 years, 10 months "WITH" prostate cancer. His last five years were bad with monthly UTI's and other issues, but he lived 95 years without problems and with that cancer that likely started in his late '60's. My maternal grandfather lived to 96 "WITH" prostate cancer. He got a shot (Cipro???) straight into the prostate every month for 20 years. He died of Alzheimer's - the 'ole: "You'll likely die of something else before your prostate cancer kills you." It is all hindsight now, but I ask myself "why" I allowed my urologist to do the surgery when I could have had a few more years before it got really bad. I was diagnosed with a bad pT3b because I had slight left seminal vesicle invasion (no tumor or nodules, just cells). Well...I just paused asking myself "why" I am writing this? Again, it is all hindsight...I can't change a thing. My life is now lived in 6-month increments with lots of thought and worry about what my "next" PSA value will be. So far it has been great, but my urologist said that in his experience, he sees about 33% of his post-prostatectomy pT3b patients end up with recurrence (BCR) "within" five years post-surgery. I hope I will be one of the 66% that does not have BCR.