Originally Posted by elibra
My husband is 43 years old and was just diagnosed with prostate cancer. His psa is 6.4 and has a gleason score of 6. Cancer was only found in 1 of the 12 biopsys done. The urologist did say also that his prostate was small during the ultrasound. We have decided to have prostate removed b/c of his young age. We are not sure if we want to go the robotic or open. I have heard pros and cons for both. The urologist we saw said he believes he would also qualify for the nerve sparing. Any thoughts or suggestions would be appreciated.
Welcome to the board. I am sorry for his diagnosis at such young age of 43.
Young patients have lot to lose with the present treatments for PCa. None of them can assure cure but all have risks and assure side effects, which may be nasty and cause permanent damage.
Radicals (surgery and all types of radiation) may provide cure to guys with the status of your husband with a contained case. However, both can cause incontinence and ED which is the less one young male wants at the 40th.
I was 50 when diagnosed with PCa (twelve years ago) and choose open surgery after consulting 4 specialists. My wife had to sign an agreement indicating that she would accept the fact that we would not fathered more children. My case was worse than your husband with 6 out of six cores positive to cancer. Gleason score (2+3) 5 (low aggressiveness) and I also had in my mind the will in “getting rid of it”, but at the end could not succeed in doing such. RT later also did not provide me cure and now I am on hormonal treatment.
I am continent and still have sex but ED persists and nothing returned to its normalcy. RT has added its side effects and caused me sort of permanent bowel discomfort but I am continent.
With the stats of your husband (confirmed) it would be wise to research for a different approach of therapy such as AS recommended by Allen above. With a continuous proactive program of vigilance (periodical biopsies, image studies and blood tests), one can continue his life “as usual” and plan a treatment for future action. We always worry for spread however low aggressive prostate cancer (Gleason patterns of 1 to 3) is sort of “sluggish” in advancing which provide time for us to educate in the matter of PCa and the treatments. Some do get anxious at the beginning but will relax after knowing details of the disease.
Consider also on the opportunity in availing in close future, of newer drugs/treatments now with successful conclusive trials.
A newer drug named Zytiga (abiraterone) is close to become a “silver bullet” to control cancer and classify it as a chronic disease.
The side effects are relatively less than the ones we could expect from radical therapies.
In any case if your husband feels peace of mind in treating the cancer now I would recommend him to get several second opinions on his diagnosis (DRE, Image studies, etc) from specialists, including a review on the biopsy samples, before committing to a treatment.
He should be aware of the risks and side effects involved with the treatment of his choice and should procure for the best care giver and facilities. The outcome depends a lot on proper diagnosis, experience of practitioners and the latest modern equipment.
Be aware of biased answers or opinions from the doctors. Prepare a list of questions to better access the pros and cons when consulting.
Wishing you luck.