Had my quarterly visit with surgeon/uro recently. We went over the 2nd opinion pathology from Epstein. Same as original path except more info on the one +margin -- it was lateral, 3mm, Gleason 3+3=6, and intraprostatic. Uro seemed pleased with that. I asked if there could be any cancer still in place from the intraprostatic incision. Said he didn't think so. I guess the G7 cells I had are safely back in the original pathologist's freezer now. Hope so anyway. Had another doc (relative) tell me tiny flecks of Pca can break loose and float around, too, even before surgery. Didn't pursue that with her. Maybe she was referencing the perineural invasion?
Along with the PSA test I had before visiting him, also had first T test in my life -- 223. i think that explains my sleeping difficulties (getting worse), zero libido, skin irritations not healing as fast, dumbbells not building much muscle, generally achy and bla. A little mental fog, though I'm hanging in there. Also cry on rare occasion -- like when my team loses (but who wouldn't - ha ha)
I broached TRT with uro (formerly City of Hope guy). To my surprise, he is of "saturation theory" school regarding TRT, but told me "if you polled 200 uros on this, I would be one of the more aggressive ones on this". Said he is already treating some men in this boat. Also told me he would be ok with starting me on it now, but if I wanted to wait another visit or two (they are every 3 months now), that would be fine, too. Six more months would put me two years out from the surgery. All PSAs have been undetectable (half of the tests of the ultra sensitive type).
Have a while yet before I would start, but have been reading everything I can get my hands on plus the prior posts here. Can sense I will really struggle with this, whereas getting from diagnosis through surgery was not really that bad, other than the associated administrivia. But this decision starting to feel a lot like I imagine Russian Roulette with one bullet in my .357 might be like (it's a five shot). I do feel pretty crappy a lot of the time, but am not keen on putting myself in a worse spot, either. Gives new meaning to phrase "pulling the trigger". I am sure being beaten down (lots of job and other stress), with low T, cloudy thinking, etc., makes it more difficult.
I know nobody can decide on TRT for me, but any input would be welcome.
Jan '08-'11 PSAs 2.2 2.5 2.7 2.6, DREs-
Jan '12: PSA 3.6, DRE+
Jan '12: MRI inconclusive
Feb '12: PCaDx pT2a, 4/12+ (3 @ 3+3, 1 @ 4+3); 3% tot cores; bone scan-
Apr '12: RALP; 3+4=7; pT2c pN0 pMx; 30%; 3mm r lat margin of 3+3=6 so pT2+; EPE-; PNI+; 8 LN-; SV-
PSAs: (all undetect); most recent 09/06/13: < .015
Post Edited (Bobbiesan) : 11/16/2013 7:33:28 PM (GMT-7)