How long did you wait for second (third) opinion ?

Thanks Psychometric for exact timeline. It means that all was done in about 3 mos. total form biopsy to surgery - that was very fast and efficient. Wishing you super successful surgery and very fast recovery 🙂 !

PS: What was your gleason and PSA, if I may ask ?

Gleason 7 (3+4), 6/12 cores positive, PSA 6.68, PSMA negative, Decipher 0.56.

The local surgeons and ROs stopped short of recommending RARP vs. RT. My primary care provider recommended that I seek a second (third? fifth?) opinion at MD Anderson. They had a cancellation opening that coincided with spring break so I was able to get down there pretty quickly.

Why RARP and not RT? Both local ROs recommended against SBRT/CyberKnife because it might worsen existing urinary issues (frequency, weak stream). My local urologist performed a cystoscopy and didn't find anything notable, but started me on oxybutynin to help with mild bladder irritation. The ROs at MD Anderson went even further than the local ROs and dismissed RT altogether as a viable option for me. The surgeon I saw at MD Anderson (John Ward) is also an expert in focal therapies. The entire MD Anderson team recommended RARP as a "no brainer" for my particular case.

Why am I not going back to Houston for treatment? Mainly logistics - Columbus is a 3-hour drive and my sister will be able to go with me instead of me having to drag my 85-year-old dad to Houston. I was also able to schedule the surgery 10 days earlier than at MD Anderson so that I can use my two-week summer work break for a 'free' (i.e., not wasting PTO) recovery period. It was an extremely difficult decision, because MD Anderson is a (the?) top cancer center and I was very impressed with Dr. Ward, but Ronney Abaza is also a world-class surgeon. Dr. Abaza and Dr. Ward both expressed confidence in removing the cancer and a return to continence within six weeks.

I'm single and not sexually active so my priorities are cure and continence. I can't do much about the former but since my diagnosis, I've cut out sugar and caffeine and switched to a Mediterranean-ish diet, along with continuing to run and work out. So far, I've lost about 10 lbs. I'm also two weeks into pelvic floor PT with a specialist. Hope that all helps.

Thanks so much for sharing all of the info about your path to wellness < 3.

It helps a lot in several ways, actually. It gives me ideas about acceptable time-frame, logistical considerations, treatment options and about process of decision making. Thank you for finding time to write all of that !

It is wonderful to hear that you made such positive changes in diet and exercise and to see how it already shows great results :).

I am sure that surgery will be successful and I agree wholeheartedly that getting well is a priority over any other concerns regarding side-effects that might or might not happen. At least my husband and me think the same way and we would also prefer to have surgery over any other method.

Just one more quick question -did you get referral for PT from your surgeon or you found therapist yourself ?

Have a wonderful day and thanks again for helping :).

I work with a PT and asked her for recommendations for pelvic floor specialists. One of the PTs she recommended was in my insurance network and the office is close to mine, so I went with her. I had already started following Michelle Kenway's YouTube routine based on recommendations from this or another message board. I was mainly hoping to confirm that I was doing Kegels correctly, but the sessions quickly advanced from basic lying, seated, and standing Kegels to focusing on engaging the pelvic floor while doing 'normal' motions such as getting out of bed or bending over to pick something up off the floor. All while breathing normally - it's definitely a challenge but hopefully some neural pathways are forming.

One thing I didn't expect was the initial verification process for correct Kegel technique. I guess I should be somewhat used to rectal exams at this point, but I'm not. Yuck.

Thanks for additional info. :). Maybe we can at least try to find PT place in this time of endless waiting for consults. My husband started doing Kegels at home with help of some books, videos and Survivor's posts (member here on this forum) but personal training with PT could probably give better results. BUT with our luck local specialty PTs would alllll be booked till August too *eye roll.

You're welcome.

Are you in the US? Those do seem like pretty long wait times.

Yes, we live in CA and will stay here as long as we can (it is becoming awfully expensive to live in the Bay Area ). It is also so overcrowded that we have to wait for weeks for any other app. (in general med. practice). Any time we need a specialist (like orthopedic surgeon or allergist for example) , app. are 2 or 3 months out. And all of that with PPO , we can choose any place to go and do not need referral. There are many doctors that do not accept new patients, period, queues are so long :(. It applies to private practice as well as to medical groups and it is especially long wait for 5 star doctors. It does not matter if it is a Zoom call - wait is so long. I lately resorted to go to local mini urgent care if I need app. for simple sinus infection etc., otherwise would be in agony for a week or longer just to have zoom call with P. care. The same applies to dentists - any doctor or dentist that is top notch and well known and experienced is overbooked. But in situation like this it just so hard to wait ...

Thanks for sharing. Where did you decide to get RARP done? Could you share a Dr name at MDA you felt good talking with. I live in Houston and starting a similar journey after a Gleason 7 and 8 score in 3 of 12 areas was detected from my biopsy last week. Absolutely no symptoms but PSA was 4.3 and MRI caught the lesion . 66 in good health. Will be getting input from MDA and Methodist teams on next suggested steps . My Urologist is a surgeon in private practice but uses Methodist hospital facilities. Going to listen to a roadmap but think Robotic removal seems most likely with best outcome. TBD Thanks

I'm having the surgery on June 16th with Dr. Ronney Abaza in Columbus, OH.

I saw Dr. John Ward at MD Anderson. He exuded confidence and took the time to answer all my questions (most before I even asked). It was a very tough choice between him and Dr. Abaza but the Columbus logistics are much easier. You'll probably see a multi-care team at MDA and they can steer you in a clear treatment direction. For me, it was surgery.

Side note: Brian Davis at MDA is also supposed to be very good. I doubt you could go wrong down there, whichever type of treatment you end up getting.