Recently diagnosed: Treatment options for early stage prostate cancer?

ozback11, I did research on all the options and talked with several people who went through the prostate cancer journey. I also had two uncles that had prostate cancer. One was in his late 70's and had a lot of other issues that were going to end his life prior to PC - Thus, he went with watchful waiting. The other uncle did not catch the prostate cancer until it had metastasized to his bones, and he ultimately died from PC.

In the end, a radical prostatectomy aligned with my personal goals and expectations for life going forward. Being 57 and retired for less than two years, I wanted a treatment plan that gave me the best possible chance for 30+ years of prostate cancer free life. A radical prostatectomy is the most invasive option, but is the only treatment plan that removes the entire prostate that has confirmed cancerous cells (I had the prostate, seminal vesicles, and nine lymph nodes removed). Other treatment plans try to kill all the PC cells, but rely on imperfect imaging tools to direct the treatment. Also, a RP allows for a complete pathology to be performed after the surgery. For myself, this was very important. I wanted to know that all the known cancer was addressed/removed. I am a relist, cancer is cancer, and you never know if it will come back. This brings up another advantage of the radical prostatectomy - If the PC comes back, radiation can be used, but a RP cannot easily be performed after radiation.

I had a Gleason Score of 7 (4/3) and could not even imagine going with watchful waiting. Waiting for the cancer to metastasize just did not make sense to me. If I was in my mid 80's and had other underlying conditions, watchful waiting could have been an option.

It sounds like you have done your research and picked a center of excellence for your surgery. For myself, Mayo-Rochester was amazing and I could not be happier with the doctor and support staff. The recovery was not that bad, except for the first week with the catheter. After the catheter was removed, everything was went so much better. Also, referred shoulder pain was quite uncomfortable for the first few days.

Good luck and praying all goes well with your surgery!!

Jim

72/73 RP @ Johns Hopkins Aug 2022
Recovery excellent
I wanted all identifiable cancer removed.
With salvage tx as a backup.
And I did require salvage tx radiation together with short term ADT
1st post salvage tx PSA < 0.02 undetectable reported 1 week ago.
Obviously praying and hoping for long term undetectable PSA
It's a war with PCa and I wanted all available weapons.
Good luck and best wishes.

Thank you for the reply Jim. I really appreciate it. One thing I am struggling with is making sure I have picked the best surgeon to handle things. Any advice on who is the best of the best at Mayo Rochester ?

I did a lot of research on surgeons to make sure I chose the best one I could find. I did not want anyone that was still on the learning curve. Rather, I wanted a surgeon that focused on radical prostatectomies, had performed thousands of RPs before mine, and not a "jack of all trades" that performs a plethora of different surgeries.

For me, it was Doctor Igor Frank, located at Mayo-Rochester. He was the second surgeon in the US to perform the robotic assisted RP and the first at Mayo. He has also been a trainer for other Mayo surgeons. Dr. Frank and his staff were absolutely incredible throughout the diagnosis, surgery, and follow-up. As you know, there is always a chance for surgical errors, unnoticed cancer outside the prostate, micro metastasis, etc... Given all these variables, I felt very confident with Dr. Frank and his ability to recognize potential issues and make the right decisions during the surgical procedure.

I know you are only two weeks out from surgery, but I would make certain your current surgeon is the best you can get. There are a lot of great surgeons out there, but also a lot of mediocre and bad surgeons. Your quality of life, for the rest of your life, will depend on the skills of your surgeon and his/her staff. I drove 4 1/2 hours each way to Mayo-Rochester. In my opinion, the 4 1/2 hour drive was not far at all. Even if I would have had to fly to get the best possible surgeon, I would have done that.

I am one year out from my RP and consider myself to be about 95% back to normal. ED and bladder control were not a problem for me, but I really was not that concerned about it. I was significantly more concerned with having the best possible chance to live 30+ more years with my wife.

Best of luck with your decision and please let me know if you have any additional questions.

Jim