Adding my welcome to our clubhouse. Sorry about
your diagnosis, but you'll get through this. You're surrounded here with people who have. I agree with the great advice you've already been offered here -- second opinion from Epstein. Surgery may turn out to be the right choice, but don't assume it is the best choice without first seriously looking at all treatment options. Most new patients want to "just get it out" and who can blame them. I also agree that the sciatica is almost certainly unrelated to prostate cancer.
There is a sweet spot in which surgery may be the best option. But on either side of that sweet spot are situations where surgery may add significant side effects without delivering much benefit. For very low risk patients (unfortunately not you) a better course may be active surveillance. For high risk patients (where the cancer has already left the prostate, or who have other clinical signs that suggest surgery isn't likely to be successful on its own), one of the many radiation options may be a better initial treatment choice because it can potentially target a wider area or because the patient is likely to need radiation in the future anyway.
I had surgery as my initial treatment 17 years ago - that was practically the dark ages compared to today - radiation treatments were only just beginning then to be thought equally effective. But if I presented today with the same pathology I had then, I'd probably opt for one of the radiation options that are now available. Especially with the benefit of 20/20 hindsight knowing that I'd have ended up having radiation later on anyway.
I'm not advocating for or against any one treatment, just encouraging you to thoroughly explore all options before you make an important decision. Best,
-2002-PSA 9.4, 5 of 10 cores 30-50%
-RP 2002 PT3B N0 MX Gleason 3+4 75% left lobe small focus rt lobe
-PSA low 0.01 slow rise to 0.4
-SRT 2010 1 lymph node targeted. Casodex during SRT
-PSA 0.00 thu 2014
-0.02 Oct 14; 0.04 Apr 16; 0.2 Oct 16; 0.51 Jan 17; 2.46 Jan 18, 4.19 Apr 18; 6.62
-May 18 start Firmagon; PSA 0.45 Jun; 0.08 Jul '18; 0.03 Aug '18
Post Edited (Bohemond) : 9/21/2018 12:41:12 PM (GMT-6)