When I found that my PSA was significantly elevated and the PSA increase-velocity was high, I did about 40 hours of online research. The common theme for maximizing the best possible outcome was finding the best surgeon/medical center available to you. For me, this turned out to be the Mayo Clinic in Rochester, MN and Dr. Igor Frank. The Mayo Center has the latest technology and Dr. Igor Frank is a highly ranked surgeon. He was the second surgeon in the US to perform robotic assisted prostatectomies and has been doing them since 2005. Also, his area of focus is very narrow - He performs prostate and bladder cancer surgeries (my research found that focus and repetition were both highly recommended when looking for a surgeon). Please note - You need an experienced surgeon for a radical prostatectomy, your quality of life going forward will depend on it. Based on my age (56) and Gleason Score (7 --> 4/3), I chose the radical prostatectomy and lymphadenectomy. This is the most aggressive option, but I found it gave me the best chance for long term survival and alternate treatment options (if needed) going forward. As mentioned by many others, this decision is personal and is based on what is best for you and your situation.
I am very active, in good shape, thin, and on the lower portion of the age group that has prostate cancer. Recovery from the robotic assisted RP went quite well. For me, the first week was the worst part - Catheter (#1), referred pain in the should from the gas used during surgery (#2), and bowel movement constipation/difficulty with catheter (#3). I used Oxycodone for the night I stayed in the hospital. After that, my wife kept my pain in check by alternating Ibuprofen (3 tablets, 200 mg) & Acetaminophen (2 tablets, 500 mg) every 3 hours. This kept my pain to a low level, very tolerable. Please note - Nothing could control my referred gas pain (occurred when I sat up). I spent the first five days walking or laying at an upward angle in bed. For the first week, anytime I would completely sit up, the referred gas pain in the shoulders was very high.
Overall, my body feels almost normal after three weeks (RP on November 3, 2022). I did find that I was more tired for the first three weeks, but a short nap really helped. For me, I do have incontinence issues following the FP, as I expected to have - leakage after drinking water, approximately one accident per night, unreliable bladder. This is not a big issue, but something that I am glad I was aware of prior to recovery. I am confident that I will regain bladder control, will just take time.
I am still waiting for my final pathology report. This has been a challenge - Previous tests lead my doctor to believe the cancer was contained in the prostate, but this is not known until final pathology is complete for the prostate, seminal vesicles, and lymph nodes.
QUESTION - Has anyone had a negative margin with the pathology report, and later had chemical reoccurrence of their prostate cancer? I found some data from Johns Hopkins that showed with a Gleason Score of 6 (3/3), reoccurrence was almost zero. Because I have a Gleason Score of 7 (4/3), I have not been able to find any data.

Take care,

Jim