Just found out I have prostate cancer...

Here's the irony... I get testosterone injections weekly. So i could lower my test levels by stopping that, but my doc suggested against it.

The difference between your situation and mine, is you're 74, i just turned 51, so hearing i've got 15 years left (potentially - i know) sucks. Choosing to do nothing is scary, especially for my wife, but to me the risk of major side effects sounds way worse than planning to deal with it if it becomes worse.

The three months is just post surgery. If things are stable, I will go back to active surveillance and have an MRI every two years with a yearly PSA.

I am surprised that insurance would cover the MRI without some indication that the cancer is growing. I usually do 4 to 5 PSA tests per year because I need to be careful as I am on TRT.
I found a local lab that will do the test whenever I want for $40.

If I were you, I would have testing done every 3 months and ask your medical team if a change in your diet to a Mediterranean type diet or some other type of diet would slow down this gleason 6 cancer. Good luck and don’t go off the deep end. It may never be more than a Gleason 6 .

I, too, am on TRT. Have heard mixed opinnions about TRT with respect to PC. Have you had any conversations with your Doc about stopping TRT?

My two cents... I had a discussion with my Doc about my future just recently, I was diagnosed with stage 4 in 2018 at age 58, I endured the complete "slash, poison, & burn" regiment (surgery, chemo, radiation). I was cancer free for 5 years. It just came back.

She said, "All cancers that go untreated will ultimately grow and eventually become fatal". So, she says, the key is constant monitoring and treatment(s).

Juat something to chew on.

I definitely can understand your concern over ED and incontinence. For myself (different for everyone), prioritization #1 was a cancer free life (1000 out of 10), #2 continence (distant #2), and #3 erectile function (distant distant #3). I retired a few years ago (just prior to being diagnosed with PC) and was very much looking forward to 30+ years of cancer free life. Also, watching my uncle die a painful death from PC that metastasized to his bones probably biases me toward addressing the PC versus watching it grow. If I was in my mid-80's, my treatment decisions might have been different, but who knows?

Bottom line - If you want a good outcome and great quality of life post treatment, go to a center of excellence like Mayo-Rochester. My outcome was absolutely awesome. Not that there was no short term pain/challenges, but long term I am good to go.

Best of luck with your decision!

Jim

When you had the biopsies done did they do it under anesthesia? If not should have.

If was not offered I would have gone to a provider who does. If you did not have anesthesia and through the transperneal area you probably had done rectal. I agree that is not a good thing to go through. My original urologist wanted to do rectal because I have heart failure.

I had my Mayo urologist consult with my Mayo heart failure doctor who allows me to do Sprint Triathlons as my body had adapted to less blood flow and I have no exercise restrictions. Heart Failure Specialist told Urologist there was NO problem with anesthesia.

I did not want it done rectally because of the increased risk of serious infections. It was done with anesthesia and through transpernial area. I had no pain after (asleep during) procedure and quite frankly would not have know it was done if did not see test results. You have to speak up though and be an active participant in your care, asked questions, get different opinions.

You are young so making decision at your age requires some more thought and opinions. I had low risk prostrate cancer diagnosed through a Decipher test where biopsies showed intermediate. I still chose to have radiation treatment but chose proton.

It is really important on whether the cancer is only inside prostrate. What grade and Gleason score you have. For peace of mind suggest getting the test that can really give you a good diagnosis. I would asked for PSMA, bone scan, and Decipher. None of these are painful or involve anything other than an injection. The Decipher is a test done on the biopsies taken and you don't have to do anything extra to have it.

I am 76. Was 75 when I got radiation treatments. I did not want and did not have to have hormone treatments based on my Decipher tests (why I think is important). The treatments did not stop me from swimming, walking, water aerobics. The only thing I could not do was bike ride and that was because having Space/Oar implant could move if bike ride. Took me some time to get back to same ability for bike riding. I am doing my first Sprint Triathlon in November after treatments ended in July.

To some knowing they have active cancer in their body is not something they want to have or deal with. With some it is not that worrisome. It is why you will see almost everyone say to you do what is best for you not what others have done.

I plan to live a very long time and don't want those years worrying about a cancer I could have treated and cured. You are right watchful waiting is okay for some stages of prostrate cancer but you are very young and most radiation treatments are curative. My urologist told me I would die of something else not prostrate cancer based on my stages and type.

I did not want to take a chance he could be wrong and have cancer spread to my bones, or lymph nodes. I got several opinions and consultations and took every test available to get the most accurate information on my cancer diagnoses. Went through 30 rounds of proton radiation at an excellent facility UFPTI in Jacksonville Florida. Many others on MCC were treated there also.

3+3=6 does not have the ability to metastasize and spread. Any ammount of 4 does have the ability to spread. That info comes from Dr Sholz at The Prostate Cancer Research Institute among many others I have found over the last 10 months of research.
I am 55 years old and was diagnosed 10 months ago. PSA was 4.9. Blind biopsy found 2 cores @ 3+3=6.
I sent my slides to Dr Epstien at Johns Hopkins for 2nd opinion, he said one core was 3+4=7.
Drs at JH recommended active surveillance but wanted MRI and targeted biopsy to confirm we are safe on surveillance.
MRI showed 3 spots 3+4=7. Targeted biopsy just 2 weeks ago found 5 cores all 3+4=7. I am officially off active surveillance and going to treat it with Brachytherapy - Seed implants.
So being 3+3=6 you are safe, live your life and enjoy but you have to continue to make sure that is Gleason 6. Ask your docs instead of just watching PSA can you do an MRI followed by targeted biopsy in maybe 6 months to make sure you are 3+3=6. In the meantime, you can send your slides for a 2nd opinion.
I hope this helps. Good luck and God Bless all of us.