Hi Joes and welcome,
I second and third the motions of Hawkfan and Tamu. This little monster does not go away. And it is tricky. As you can see from my signature, the post-op pathology report showed cancer in both of my lobes (T2c, but luckily without getting out to the margins and staying at the same Gleason score), whereas the biopsy showed it in only the top part of the right lobe (T1c). The post-op pathology showed "definite neurovascular bundle invasion", while the biopsy report said no neurovascular invasion. I am an unashamed worrier, and I wanted the beast out Yesterday! The data that cinched it for me for Da Vinci Surgery were the following:
1. Surgery was presented to me as having a 91% cure rate. Any kind of radiation only had a 75% cure rate. A no-brainer to me in statistical terms.
2. DaVinci surgery had a lower co-morbidity rate, and a higher degree of sensitivity for getting out all of the cancer (and leaving in healthy tissue).
3. Through my research, I came to the conclusion, that once prostate cancer was detected, the whole prostate is no longer your friend and not to be trusted in the least bit. So, this is the reason not to wait. Any healthy prostate tissue can transform to be cancerous from then on. Any healthy prostate tissue cannot be trusted not to be harboring microscopic clusters of cancerous cells that cannot be detected unless examined microscopically after being completely removed. That is why they take part of the bladder neck during the surgery to make sure not one prostate gland cell is left (also to make sure the cancer hasn't crept up and invaded the bladder).
The surgery turned out to be minimally traumatic. The pain was unexpectedly minimal (at most, a 4 out of 10, where 10 is the worst) and handleable with Tylenol (I had never had surgery before, and was expecting excruciating pain, especially in that sensitive part of the body).
At six months, I am continent, but still waiting for Mr. Happy to wake up, since the doc had to take out part of the one affected neurovascular bundle. But I have seen some progress there, too. The main thing is the first post-op PSA in November that was >0.008. Due for another check on it next week, and praying it'll still be down.
My opinion is don't wait. Even the latest medical journal articles are not so pro this anymore.
All the best to you, and please stay in touch.
PSA (10/04): 2.9; PSA (2/06):4.4, on Androgel (serum T about 450) at age 56; negative DRE, no symptoms.
PSA (5/06):5.7 with a free PSA% of 8, OFF Androgel (serum T 163).
Biopsy (5/06): 4/12 samples positive; postitive samples only on right side; max Gleason 4+3=7 (in 2 of the 4 -from area nearest bladder.
DaVinci robotic-assisted laparoscopic radical prostatectomy + bladder lift + Right nerve plastic surgery (8/23/06).
Catheter out 4 weeks postop, due to internal pinhole leak at bladder-urethra junction.
Final pathology report:T2c-both sides,but in capsule; neg. margins, neg. lymph nodes, neg. seminal vesicles; final max Gleason still 4+3=7.
Follow-up PSA (11/06): <0.008; serum T: 195 OFF Androgel (at present).