Hopingforthebestinnj, welcome, sorry you needed to find us but glad you did.
This is a very personal decision and what's right for you, may not be right for others. The good news is, either option gives you a very high chance of cure. As Tall Allen alluded to, I had my surgery done by Dr Ash Tewari, at Mt Sinai in NYC, so I can speak to that.
First off, the reason I chose surgery...
I'm the type that needs instant gratification. I wanted it out, I wanted to know for sure if I had a true Gleason 6(which is what my biopsy showed, which was ultimately upgraded after surgery to a G7(3+4), so upgraded but nothing sinister, and I didn't want to wait a year to see my PSA slowly and gradually drop. I wanted a 3 month PSA test showing undetectable, so that I would know the surgery was (apparently) successful.
Why I chose Dr. Tewari...
He was thorough, he is very experienced (about
6000 robotic surgeries at this point), he was compassionate, and he was honest. He didn't try to tell me surgery is my best option. He assured me I'd be cured, but he also told me radiation would cure me too and before making a decision I should meet with a radiation oncologist. (Which I did, both Brachytherapy (MSKCC on Long Island, and CYBERKNIFE (Dr Jonathan Hass at Winthrop). I also met with two other surgeons, including Dr David Samadi.
I discussed all this with my primary care physician, he told me that Dr Tewari is the only one that will actually care about
you AFTER the surgery.
Tewari told me not to think twice about
incontinence, it will not be a problem, and he was right, I was continent (no need to wear anything, his definition of continence) at about
He told me that his overall rate of success in the ED area is about
80-85%, but was honest in telling me that because of the position of the tumor , at the Apex, he put my odds of regaining full erectile function at 65%. As it turns out, I did well in that area too. Can't say it's as good as it was before surgery, but it's 90%, and I never have a problem doing the deed. Most of the time it's as pleasurable, sometimes even more so.
Here's the big big thing about
Dr Tewari, in my mind...
When he removes the prostate, the tissue is sent to pathology for frozen section, while you are still under, to be examined. In my case, it showed a positive margin. So with me still under and
open, Tewari was able to go back in and cut some more, until he got a negative margin. To me this makes so much sense, and was invaluable. NOT ALL SURGEONS DO THIS.
I'm not going to tell you that the first two weeks of recovery were easy, they weren't. But once the catheter came out (10 days) things really started to sail along.
I am 14 months out of surgery and as of my last PSA test in January, I'm undetectable on PSA (knock on wood, no pun intended)
So in short, if surgery is a way you want to go, I would highly recommend dr Tewari. Remember though, this was my experience, and everyone is different. But you'd be in really good hands.
Of course, Cyberknife is an excellent choice as well, as are LDR and HDR Brachytherapy in your situation.
Good luck in whatever decision you make, and keep us posted.
Post Edited (Pratoman) : 2/26/2016 6:44:31 AM (GMT-7)