Good evening @paulchen, welcome to Connect. I am glad you found this forum where the mission is to share experiences and increase knowledge about quite a number of medical conditions located in more than 75 groups. I am not a Prostate patient. My life partner is and has been a prostrate patient at Mayo since 2016. So I have been in the room and listening for quite some time. His PSA journey was similar to yours. And a biopsy confirmed the existence of Carcinoma. After listening to all of the test results and making sure we understood as best we could every piece of evidence that would help him make a decision, he chose surgery.

He chose radical prostatectomy for a number of reasons.
#1. The cancer was contained within the prostate boundaries.
#2. Before surgery, he would spend 3 months on lupron to reduce the testosterone build-up.
#3. After the three months during which he had more time to think about his decision, he was still confident
that surgery offered the best chance to be cancer free.
#4. He was very impressed with the surgeon he chose and felt that his "team" was also totally committed to
doing whatever they could to relieve him of the cancer threat.
The robotic surgery went reasonably well. It took longer than expected because they ran into some cancer cells around the margins. So, for several hours, the surgeon would "dig a little deeper" and send the tissue to the lab for an immediate response. The surgery was not closed until there was no longer any cancer to be found.

After following the recommended recovery protocol, he returned to his regular life which is dominated by his passion for landscaping on a hill above the Mississippi River.

Mayo continued to follow him closely and he sent in samples every 3 months and then every 6 months. Just before he got to his two-year check-up, one PSA sample had indications of cancer in those troublesome margins. And so he went to Mayo for 30 consecutive days of radiation. That was 4 years ago and all of his PSA tests have been the desired "undetectable".

One of the processes that impressed us both about the Mayo team was the practice of shared decision-making. I was surprised that he was so open about his thoughts, worries, and questions. He has confidence in their approach to handling patients in difficult situations.

One of the things I really liked was that no matter when I called Mayo for him, someone from his team always answered the phone 7/24. There was no waiting until tomorrow or next week.

I wish you well and encourage you to make the most of this opportunity to learn from other patients.
Do you have immediate questions about the treatment options?

May you be safe, free, and protected from inner and outer harm.
Chris