Hello all. I am a 40 year old who was just diagnosed with prostate cancer. My PSA is 3.7 and my gleason score is 3+3 (6). My uro recommends sugery and I have concerns about the possible effects. I have been going crazy trying to get information and data but does not seem to be much for my age group other than surgery. Any feedback or suggestions you may have would be greatly apperciated.

Thank you

Bagster,
I am going to assume that other than your PC you are in pretty good health. At age 52 I opted for the retro-pubic surgery as it gave my surgeon better visability and the opportunity to fix some stuff we didn't expect. In my case this was the best choice. Research the other possibilities and talk to folks who have chosen different methods before making a choice. MOST IMPORTANTLY, research your surgeon. The person holding the knife (or robot joy stick) is really the one who makes things work or not work. Talk to other patients in your area. If possible, talk to the nurses on the hospital floor where you will be recovering and ask which doctors have the best outcomes. I did this and changed doctors. Don't worry about offending anyone, there are no "do overs" after surgery. In my case, 14 months after surgery, life is almost normal. All the equipment works and I'm beginning to have natural erections (Viagra has been working fine since month six). DO YOUR HOMEWORK! This is too important a decision to trust to just one urologist's opinion. Good luck and please keep us informed of your decisions and progress.

bagster, may God bless you as you go through this.

I'm 48 and when I was diagnosed there was no question for me - I wanted surgery and I wanted the cancer gone. As a result I didn't really research radiation. My PSA's were 4.7 and 4.3, free PSA 17% and Gleason 3+3=6.

Even though I'm still having a surgical complication involving my urinary system opposite from the 'normal' incontinence experiences I'd do it again in a heartbeat.

Tomorrow (10/25) makes exactly 3 months since my RRP.

One way or another get it removed! It is the most likely way that you will be cured. At your age it is the only logical way to go. I had mine out 4 weeks ago with the ROBOT. Life is pretty much back to normal. You can read my previous posts about my experiance.

I can't tell you what to do but I will tell you what I did and how I feel about it. I was 52 when I had my nerve-sparing RRP done about 14 months ago and my PSA now remains at the undetectable level. I've been told, "You will not die of prostate cancer." I like that.

The RRP carries basically two potentially long-term side effects--incontinence and ED. Incontinence has never been an issue with me. I've had 100% urinary control since about 4 weeks after the surgery. Except for when there's a surprize sexual stimulation (wife walks out of the shower looking for bra, etc.) and I will leak a few drops. Doc says it isn't unheard of but isn't very common. ED is still an issue though it continues to improve. The guy just won't get up adequately for unassisted penetration. He eventually will though if the improvement continues at the same rate. It will have been a very long couple years when he does and once he does, I know I will have an it's-about-darn-time attitude. I won't sugar coat it, I already feel that way. It's a real difficult thing for a man to not be able to get an errection. It's a real difficult thing to have your wife do something that used to take about 5 seconds to get a response only to see absolutely no response. There have been times I felt like maybe it wasn't worth it. Rationally, I know it was, but it doesn't take long to get tired of having to plan, prepare for and set up a butt load of equipment, medications and lubes to be intimate with the woman you love. I said my ED is improving, and it is way way less of a problem than at first, still, I can't wake up early, roll over and "start something" unless I first get up, pee, get lubed up and put on a ring to make him get up too.

I figure one way or another the thing has dramatically affected at over a year of my life. A lot of things have had to be addressed, dealt with, worked around, accepted, defeated, yada, yada, yada. However, with a PSA of 1.4 and an non-palpable PC, I was blessed to have had mine discovered as early as I did. And like my Dr told me, even if it took 20 more years for it to become life-threatening, there's often quite a few good years left in many a 73 year old these days.

Based on my research here and from other sources, at 40, most will say surgery is your highest probability for complete cure. If you choose that route, there's no way to predict what will happen in your case but odds are real good that you will be cured and have no long term urinary or sexual effects. There ain't no guarantees, though, and you may have to make some compromises or adjustments along the way.

DB

Hi Bagster, the thing I didn't see mentioned in the other responses if the fact your age is what makes urologists push for surgery. You could have radiation but with no gaurantee the PC won't come back, and there aren't many options if it does come back. I was told the prostate becomes very tough and fiberous and is nearly impossible to remove after radiation. If you were 70 or older I would say yea, go for the radiaiton, who wants surgery. I am 23 months post robotic and was told by my uro I am considered cured of PC at my last check up. But I strongly agree you need to check out your options as far as surgery whether to go conventional or robotic. There are about 50 robots in this country and some uros learned in Europe where it has been around longer. I was 48 when I was diagnosed but you are much younger. Don't be affraid to seek out counsiling for your self and your wife. Don't forget she is going through this with you and her life will be afected also. I got a lot of releif posting on this board and realised I'm not that bad off. I can always be worse. Post often and about anything. It makes us feel good to be able to try to help. Burmashave

:wave: Although Surgery is the most probable way to go at your age. DO NOT rule out radiation.. Research that option as much as possible..Surgeons are more apt to push surgery.. Radiation Onc. are most apt to push radiation..In my husbands case(69yrs old)Urol. suggested surgery. We were undecided so we went to an Oncologist, who recommended radiation. he said that the two are very much successful..So needless to say we choose radiation.. My husband had 8 weeks of radiation and 2 hormone shots. We are now waiting for further testing..The key word is research and opinions..Good luck in whatever you decide to do.. :angel: *Cure for all *

One of the best doctor is at the Mayo Clinic in Rochester, MN. He is Dr. Horst Zincke. He is one of the top 1000 doctors in the US. He did surgery on my son for testicular cancer and my husband for prostate cancer. Both are doing fine. With surgery, you still have the option of radiation if the cancer should comes back. I would hate to have radiation first and then find out there was still some cancer remaing and be without further options to fight it.

Thank you all for your advice and help. I am currently on my way to see a doctor in Boston for another opinion. After all the research and opinions I am leaning towards the surgery. My only concern is the side effects to the little guy, as well as getting this stuff out of my body. I will keep you all posted on the outcome of tomorrow's visit. Thank you all once again it has been a tremendous help as well as a comfort.

Hi Bagster
I'm 44 and had the robotic surgery. My recovery went very well I'm dealing with incontince and ED. I'm seven weeks out of surgery and I've been told to be patient. My PSA is below 1 now. I've order the pump to get some help. I would plan on some ED problems after surgery. Because it takes the nerves sometime to recover but the odds are good that everything will begin working again according to those I've talked to and I have started to see some progress but not enought for me. But I'm inpatient in that area. I would do the robots, love your wife all you can before, and take it one day at a time.

Like I said in other posts, I'm 14 months post RRP and have had an undetectable PSA four checkups running. I haven't had to wear any sort of pads for over a year. I was continent within a week of removal of the catheter--'cept for when the wife "flashes" me which is a whole other story. I probably have about 75% erectile function (without a ring on him but with stimulation) and it seems to be still progressing toward the time I can achieve an adequate if not near normal erection without any mechanical aids. Anyway, you're possibly in for a life changing experience that will occupy a significant part of a year of your life and will affect you in some way even longer. But take heart, the odds are very good at your age you'll be fine in the long run. You may become impatient with some of the side effects, but odds are very good that they too will pass.

Don't take this as medical advice, but my understanding has been that the best odds for cure are with the surgery. It also keeps your options open for future treatments if necessary and usually carries a statistically better chance of no long term side effects. And be aware proponents of the different treatments have different definitions of the word "cure." The surgical faction usually uses "undetectable PSA for 10 years" as their benchmark. Others allow a much much broader definition that may allow a death within a few years of treatment to be excluded from their statistics. Just be sure to compare apples to apples in your decision making process.

Dr. Patrick Walsh's book, Surviving Protate Cancer, is one of the best resourses available. He goes over everything you may want to know.

We look forward to hearing good news from you in the future.

DB