Additional details regarding my diagnosis

[Guest guest]

My pathology report shows the following;

Age - 53 (54 in Nov)

PSA is 3.83

My Gleason's Grade - 3+3=6

Carcinoma involves one core, less than 10% of the tissue submitted.

All other biopsies benign, expect one that had " high grade parostatic

intraepithelil neoplasia.

Therefore, from all I have read, and from what my Urologist and

Surgeon have indicated, I have a very early stage prostate cancer.

My approach to treatment, and decision for which treatment to use,

will primarily be made based upon what I believed to be the surest

method of curing the cancer. In other words, my primary motives will

not be based on avoiding surgery, pain, or the possibility of

incontinence or impotency. Sure, I want to come away with the fewest

side effects, but again, I want the surest method of curing the

cancer.

I believe that at my age, I have a life expectancy of 20 plus years.

I want to have the best chance of living that long with the least

fear of reoccurrence, even if I have to live all that time with some

unpleasant side effects.

My thoughts are that with my early stage of cancer (PSA under 4, and

Gleason's Score of 6, only one positive biopsy in the Right Mid area

of the prostate) that the chances are very good that the tumor is

located totally within the prostate gland.

Therefore, having surgery is going to be the best method for

eradicating the cancer. I also think that using the robotic surgery

provides me with the best recovery options, as well as the best

chance to reduce the possibility of " long term " incontinence and/or

impotency.

After the operation, I fully expect some short term leakage after

they remove the catheter, and probably this may continue for some

time. Long term incontinence is expected to be less then 1% chance.

I also fully understand that after surgery, I will possibly not have

the same sexual experience as before the surgery. In my specific

case, I believe that the chances are very high that my surgeon will

be able to spare both nerve bundles. I believe that I have a very

low possibility of being fully impotent after the operation. The

most likely impacts are that I will not experience as hard of an

erection as before, and I will not have ejaculate. I also understand

that my orgasm may not be exactly the same as before, primarily

because there will no longer be a prostate. This means that as I

orgasm, the prostate will not contract to cause an ejaculation. That

must have a different feeling then it was before. Regardless, I

believe that I have a high chance to have erections and orgasms, even

though things will probably not be exactly the same as before.

Now, specifically for my case, here are my thoughts on active

surveillance, PBRT, cryotherapy and even hormone therapy. I don't

believe that these are my best long term options. Even though some

of them have had impressive results, I don't see any evidence that

they provide any better results in eradicating the cancer. In fact,

I and leaning toward the thought that I will have a higher

possibility of recidivism, and over a 20 plus year expected life

expectancy, I am thinking that I will have a higher possibility of

long term incontinence and impotency.

Radiation Therapy, and especially brachytherapy, the treatment in

which tiny radioactive " seeds " are implanted in the prostate appears

to be another treatment with the most promise, after the surgery

option. RT provides a far less invasive procedure then surgery, and

statistics indicate that it is about as good at curing cancer — at

least over 10 to 12 years. Regardless, this options is not shown to

be any better then surgery.

From the way that I am looking at it, surgery is the best treatment

that will allow my doctor to view actual site of the cancer and allow

him to do exactly what he feels is necessary to get it all out.

Also, the pathologist will examine the entire prostate gland, once it

is removed and confirm the original biopsy results. They will aos

examine my lymph nodes and determine if the cancer has spread outside

the prostate. This will allow the best way for my doctor, or other

specialists to determine if additional treatments are necessary.

So as you probably have deduced. I have made my decision to go ahead

with the robotic surgery.

Thank you all for your input.