Newly diagnosed with prostate cancer and still gathering information

A prostatectomy will remove the cancer. You may or may not have a recurrence later, but it will be treatable so not a death sentence. The prostatectomy may result in incontinence and or erectile disfunction. There are treatments for both and if the treatments don’t work, you can get an inflatable penis prostheses and an artificial urinary sphincter. I’ve gotten both in a single surgery and just wish that I had gotten them sooner. Remember that after having a prostatectomy, you can still have sex and can still have orgasms. Most doctors advise Tadalafil 5 mg daily after the surgery to keep blood flowing to your genitalia. The old “use it or lose it” applies.

I have no idea, I’m not a doctor. But it seems to me that for the # of positive cores, that radiation not an RP would be the choice. After all, why do thru the risks of an RP to then have to do radiation anyway?
As for one lesion, you need to wait for the biopsy and PSMA Pet scan. You may be in the lucky situation, where you don’t need to have an RP and risk incontinence, rectal issues, and ED. Just saying.
I’m getting prepped for my Proton Therapy with Gleason 8, localized with no Extra capular extension, and clean PSMA. I know the possibility of recurrence later but am willing to kick the can down the road. Personally I question any RP.

Jim, BOTH in one procedure? Wow, that seems like a very complicated surgery. You sound pleased so your surgeon is to be congratulated!
Phil

One thing to consider. Most surgeons have said that if you choose radiation, that RP is not an option if radiation is unsuccessful. Best wishes🤞

@brucemobile
My urologist, R/Os and PCP do not focus on just the normal levels of PSA (below 4 considered normal) but the rising PSA levels over time.

My PSA was 3.75 but had been rising steadily over time. I had MRI showed suspicious areas. Biopsies came back with 3+4=7 Gleason Score. My Mayo R/Os asked to do a Decipher test. It came back low risk versus the intermediate risk of the biopsies. I also had a bone scan and PSMA (both negative).

Please if you are in doubt get a second opinion. Also did your urologist mentioned the Decipher test to you? If not asked for one. It will give a more precise diagnosis of the risk level of your prostate cancer. It will make a big difference in treatment options just like a PSMA will also do.

You will see many of us promoting Decipher tests as they are very valuable information. You mentioned surgery. Has your urologist mentioned radiation. There are so many different radiation treatments with great results. Where you mentioned hormone treatments? The Decipher test would really help (like it did for me) the need for hormone treatments.

Getting second opinions can be done by having your medical records sent to other medical facility. Mayo, Cleveland Clinic, John Hopkins, UFHPTI (if you are considering radiation). If you are interested in radiation may I suggest getting an information phamplet form UFHPTI. It is free and included two of the books (Walsh and another) included in the package which is free. There is no pressure to go with them but they also do second opinions.

I was diagnosed at Mayo Jacksonville but did a second opinion at UFHPTI per my PCP recommending me to get a second opinion. The diagnoses and treatment were the same at both insitututions. The only diference was that UFHPTI had proton radiation treatment versus Mayo Jacksonville only have proton.

Good luck! From my experience and that is what I am passing on consider asking for a Decipher test and if you are still in doubt about best treatments suggest a second opinion.

No, I appreciate that. But it is not a universal understanding. PCRI, e.g., says that is outdated thinking. If you have a recurrence after RP, you will normally be doing radiation. If you have a recurrence there are options including radiation depending on the type of recurrence. I know men that swear by both. I’m not liking the possibilities of side effects with RP and I’m not good with anesthesia. So, it’s really a personal decisions with lots of factors to consider.

In all my research I have not seen anything about the Decipher Test. Thanks for the information.

I was also just diagnosed this week. I had six cores show positive for cancer. Three cores were 3+4. Two cores were 4+3. And one core was 4+5. I also have to get a PSMA pet scan done before Deciding on what treatment to do. I live in Pennsylvania, but I’m only an hour away from John Hopkins. I joined this group to try to clear my head.

I was also just diagnosed this week. I had six cores show positive for cancer. Three cores were 3+4. Two cores were 4+3. And one core was 4+5. I also have to get a PSMA pet scan done before Deciding on what treatment to do. I live in Pennsylvania, but I’m only an hour away from John Hopkins. I joined this group to try to clear my head.