47, Robotic Prostatectomy April 26 @ Mayo

Hi Aaron,

If it were me 1 year ago with your stats & numbers, I'd today be on active surveillance (AS) under the care of Drs. Ehdaie or Coleman at MSKCC, New York, NY, and I still be capable of making a good splash .  

My PSA was only 4.4, but the Gleason was 4+3.  RALRP was my best option, and all things considered, except for no ejaculate my outcome has been most excellent so far (including 100% dry from moment catheter was removed).  If you can swing it, get yourself to MSKCC in NYC.  See Drs. Ehdaie and Coleman.

My main point here is assuming the stats you mention constitute all of the there-there, then your situation does not sound to me to be of the highest urgency.  Take your time, seek out testing and diagnoses from the best you can find (IMO MSKCC is one of them), carefully consider, then decide as you go.  In addition, prayer is IMO a huge factor.

Wishing you the very best,

n-mac.

Aaron, you are still very young and you have many treatment choices. With your PSA of 3 + 3, and cancer cells found in only one sample, you should really look at all your treatment options. Do some research on early stage prostate cancer. There are many website discussion a variety of treatments. Reading the other discussions and treatments here prove many of them do work. I had the lose dose radiation Brachytherapy seed implants 2 years ago. With most treatments, there may be side effects, but most are tolerable and with mild pain relievers can be dealt with. You can see which treatments offer you the least side effects for your situation. Do yourself a big favor and do some more research. What state to you live in? Then check what treatments are available in your area. Look up all the options that are available to you. What ever you choose, make sure your doctor has performed that procedure successfully many times.

The best of luck to you...

Aaron ask your Doc to gather up the pathology samples and send it to any of the top three genetic testing companies. They will determine whether it is high or low grade cancer and that will tell you if you are a candidate for AS. 

Ask Doc why he did not do this and also ask him how many RP he has on his belt? Also ask him to approve a 3t MR and gather all this data and now you can make an educated decision. Based on what you shared with us it appears your a perfect candidate for AS. Your antennas need to be up next time you visit. God speed.

Take your time. Don't let this Dr rush to surgery. A few of the previous blogs laid out the numerous steps needed to happen BEFORE any surgery or other major treatment occurs.

I'm post RARP almost 1 yr post op, but I am 68 and had 10 of 12 samples with cancer and Prolaris testing intermediate range for aggressiveness.

Researching isn't easy but you will beglad.

GOOD NEWS: YOU HAVE TIME

There is clearly a theme in these replies - - don't rush into treatment!!! You sound like a perfect candidate for AS. It seems harsh, but the fellow who said your doctor is nuts is spot on.

You have months and probably years before to majority of the fellows responding to your post would recommend treatment.

Consult with an oncologist, not a uroligist/surgeon or Radiation Oncologist -- they have personal motivation/biases to steer you toward surgery or radiation. An oncologist has no `skin in the game,` so to speak.

Take your time! You've got PLENTY of it. ...

Good luck.

My advice is active surveillance is offered as an option, give it some serious thought. My pathology was gleason 9 at 52 yrs old. I had the radical prostatectomy first (which I now regret as the PC had escaped the capsule invading seminal vesicles and bladder). Metastasis to the lymph nodes. So I had external beam radiation 39 shots and now take hormone injections and Zytiga. In addtion during the radiation I developed a bladder neck stricture which required a TURBN procedure and radiation proctitis. The treatments began in Mar. 2017 and currently I have no libido, no erections, my penis and testicles have shrunk to tiny size. I am incontinent, I now have chronic bowel problems and severe pelvic pain.

Mine is a bit of a horror story compared to others who have been through the procedure with minimal problems but if I had the option, I would have passed on all of it.

I cannot agree more with those who wrote that

3+3 is not cancer; 

that you need not treat it; and

that you should obtain a second or third opinions.

Mosski is so right when he writes "cancel the surgery".

3+3 need not be removed.

There is a very good chance that you'll have 3+3 for many years and that it will

not develop further. And that it will not cause you any problems.