A couple of months ago I was asking for advice here on treatment options. I consulted two RO (HDBR and cyberknive) and a urologist/surgeon. Finally I decided to have surgery based in the surgeon experience (more than a thousand of manual LRPs, actually some of my friends were his patients) despite his personality, total lack of empaty and communication. I also were not happy with the idea to having an additional tretment for my enlarged prostate and with the lack of precise information, no pathological report, no early warning of recurrence, if I have chosen the radiation way. On the other hand I considered that maybe radiation was more effective in the case ECE was present, MRI showed some contacts with the capsule, but any choice have an uncertainty component.
Surgery was mostly uneventful, some pain (kind of spams or gas or both) that completely vanished after 12 hours. I still have occasional spams after urinating, but they are not too bad. The main incisions developed a couple of light seromas that I hope will heal by themselves. I have mild incontinence only when standing up or walking, but the pads get now 60% less in weight than the day the catheter was removed (200/500 g. per day).
Today I have got the pathological report. Contrary to what I thought most probable, it clearly remarks that there is not ECE and margins are clean (organ confined). But... it shows a big jump in grade from 3+3 to 5+3. Therefore, I think I made the right decision on my treatment (just by chance). I went to the mskcc nomogram and it predicts a specific survival of 99% in 15 years and a BRS of 60% in 10 years,which it does not seem too bad. Of course I understand this is based in a mskcc cohort and it is plain statistics. I would greatly appreciate your expert opinion about
what can expect. First PSA in February.
67 years old.
PSA: 2008:2.8; 2012-2016: 4.5-5.5.
May, July 2017: 6.1, 7.6
mpMRI, July 2017: PIRAD5 5.
Dx August 2017,Gleason 3+3, 2 cores, left 5%, right 3%, greatest tumor length: 3.5 mm., left.
Prostate ebout 100 g. DRE +.
Manual LRP, november 6, 2017.
Pathological report: G 5+3. Clean margins, not other features.
Post Edited (jmadrid) : 11/28/2017 5:16:04 AM (GMT-7)