Hello All- Age 51, PSA 47.6, Gleason 7--Oh Joy!!!

Well, glad you posted Startech. I had robotic but there are moments where I wish I had open due to positive margins. But do some research and others will comment as you go through this part of the journey. Keep us posted.
Michael

Thanks Michael, is there a thread about your expereince?

Thanks Ed, its all good. Just trying to figure the logistics if go RP.

Startech, I just did the open RP two weeks ago but wasn't a good candidate for DaVinci due to previous abdominal surgery. One bundle spared but the other was involved and had to go. So far so good. I'm sorry you have to go through this, but you are in good company here. These guys are the best and the forum has been a great source of support. Learn as much as possible and all the best in making your treatment decision.

As you explore your options, might I point out that you should still get that colonoscopy under your belt before too long?  My situation was very similar - was going through a physical when the elevated PSA was detected and my primary, after referring me to a urologist and oncolgist, said:  "we got to get that colonoscopy handled" before you decide on what to do about the PCa - I did get it done, all negative and clear for another 5 years....and, very happy I got it done before and not after the dance with DaVinci.

StarTech,

(JStars here ... having 'Star' in a name is always a good thing).

I see you have almost a 100cc-er there. That's about what mine was (when it came out was 110 gms).

One thing that puzzles a little is how they would get that out using Robotic. It is not like that can dice it up and send it out in pieces -- it has to be removed in one piece.
(My doc recommended open surgery because of that size)... Not sure if there is a size limit on IMRT probably not, but you are way out of spec for Brachy (around 60cc is the limit there). But you are not considering that -- no doubt you have been informed.

My Uro surgeon did say a 100cc prostate would be 'A challenge' but do-able. And he did -- all zeroes so far at 2.5 yrs but my numbers were really minimal. However anecdotally collected results here do point to larger prostate/surgeries not recovering erectile functions very well (80cc and up). Must be tougher to get the nerves off without trauma -- plus a large prostate usually has already traumatized such nerves by pressing on them for years.

Hey one thing to REALLY REALLY consider with surgery. Since you have BPH no doubt about it, you now have the one good chance to go back to peeing like an 18 yr old by getting that monster out of there. With radiation the urinary issues will only get worse with BPH (at least for a while) -- and lord knows how they would do a TURP someday if you needed one after having radiation -- i shudder to think.

So even if they suspect some extra-capsular extension of PCa (and you might need rad later on to cover it), if I were you I would insist on the surgery and worry about any escapes later when you have Ol Prosty gone gone gone and U Pee Freely.

Good luck with whatever you decide tho ....

J

Hey Startech,

Welcome to HealingWell.

Before I can give any advice, I need to know some specifics:
Dobsonian, Newtonian, Apo Refractor, Schmidt-Cassegrain ?
6", 8", 10", ...
Alt azi, equatorial, or full Go To?
CCD element size and grid?
Live image stacking or post processing?
Can you split Trapezium?

How can you expect useful information without the details man!

You can see by my signature I selected surgery. Based upon my PSA of 23, by many, I was considered over the line for a single treatment. Radiation after surgery was strongly suggested. I decided to wait until "the last minute", typically 18 weeks, before agreeing to radiation. I was incontinent and had ED and hoped I would be fine by the deadline. I let the time window pass.
Did I make the right decision? It has been almost 2 years. My PSA is <0.01. I had the incontinence fixed with sling surgery. And if I get up the nerve to use Trimix, I can get up.

Here's my uneducated advice. Life will be different. But, if you keep your sense of humor intact you will do well.

Clear skies,
Jeff (Packing 6 inches of 1/12 wave Newtonian optics.)

Jeff,if I didn't know better, that sounds like a huge amount of DATA!
Welcome Star! i too was dx with a high Psa number so out it came. I did RRP and so far so good. Use the doc you trust the most and good luck.
Keep us informed ,and yes Jeff takes some getting used to. A bit of a smarty pants!!!!

Startech, I'm Located in San Antonio. The good news is that Urology San Antonio has a doctor that is considered one of the best in the country. I encourage you to include then as part of your research. PM me if you want to talk.

Hey Startech,

I couldn't resist. I figured with "Star" in your name, you had to be a fellow Astro geek. It's kind of a cult with it's own language. There aren't many places where you can say "Hey, let's go to Lou's place tonight and check out his 10" Dobber." without being suspected of being some kind of sex offender.

It's ok if you didn't understand anything I wrote before the smiley face. Not many people do.
The info you really needed to hear was after that.

Good luck to you.

Jeff (Always willing to show my 6 incher to anyone interested. )

Hey star -- here's my suggestion, for whatever it's worth: try to make a day long appointment at md Anderson where you see a urologist, a radiation onologist and a Medical oncologist. All three can have valuable input. For medical oncologist, maybe you can see choristopher logothetis. You may be able to get a consensus recommendation. Best wishes.