Hello and welcome, Jim. To our little corner of the world.
For starters (and I am an
open surgery & salvage radiation guy), why don't you consider AS? You had a 32 core biopsy and they only found 1 positive core? You posted that it was Stage 1, Gleason 6, and with a PSA of just a little over 4, it sounds like the makings of a non agressive cancer (of course one day, that could change over time). At your age, and with your insisting on the importance of continual sex in the manner you are accustomed to, that might not be a bad path to consider. With 32 cores, they have had a pretty good shot at your prostate. If AS is done in a responsible manner, its a very viable alternative. If things change to the negative over time, then you would still have your normal treatment options in front of you.
Sex is important to most all of us here, but with those of us with more serious levels and agressiveness of prostate cancer, sex gets moved down the list. Many of us (I am 57) go by the old rule - cancer first, incontinence second, and sex third.
But with your posted stats right now, it appears that you have all the choices in front of you. All have risks, all can effect incontinence and ED, either right away or later on, but there are many answers and possibilities to dealing with those issues.
Again, another reason to consider AS at this point. Life and sex as you know it, goes on as normal, as you continue to monitor your stats over time. Just something to think about
Your kidney stone story put the hurt to my head, that was terrible!
Keep us posted.
David in SC
57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.33rd Biopsy
: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3Open RP:
11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09Path Rpt
: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence: 1 Month ED: Non issue at any point post surgery, no problem post SRT
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped 9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4, Caths #11 and #12 same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, Caths #13 & #14 same time, 3/6 Cath #13 out - 4 days