I’ve read that almost every man, if they live long enough, will have prostate cancer.
It will be harmless to them.
If it is an aggressive cancer, I’d treat it as you describe.
If it is one of the very slow growing cancers, and you are older, I’d seek alternatives.
Just my 2 cents and could be wrong.
It is what I’d do.
You need to research Radiation Seeds. A seed is inserted directly into the prostate tumor. The seed self dissolves over time. My uncle had this done for colon cancer for successful treatement.
3 friends of mine all opted for removal.
1 went VA other 2 went private and all are pleased with the results.
Dont get into intamacy discussions with them but others here I am sure will chime in.
Good luck and good for you being pro active.
Look into HIFU...High Intensity Focused Ultrasound...my hub had procedure (in Mexico by Florida doc)...tremendously successful..no drugs, no side effects, etc
PS...HIFU is now “legal” in US
Was diagnosed prostate CA 14 years ago at age 49. The most distressing aspect of the whole experience was the variety of treatment options, and that I could not get a straight answer from any of my doctors. The surgeon recommended surgery, the radiologist recommended radiology, etc.
I decided on prostatectomy, done via minimally invasive surgery. Yes, there were consequences that I am still dealing with; but I preferred to have a procedure that provided a definitive outcome — that is, a post-op biopsy that declared that everything was taken out.
Please know that there are many options, and in the end you will be fine.
Don’t do surgery without second opinion. Mine went to. 7.5 back to a 5 then back to 7 then back down. I had 3 biopsies, with one showing very small grey area which could possibly be cancer but doc said so small that the biopsy might have taken it. He says I’m just one of those guys whose PSA fluctuates.
Make sure no sex 48 hours before PSA TEST!
I’m back to checkups every 6 months. Upside he prescribed Cialis in case of ED probs, but it helped more with urine evacuation! Cheap now too cause it lost its patent.
Had it. Did the Image-guided radiation therapy (IGRT)/ Intensity-modulated radiation therapy (IMRT). Very successful in defeating the cancer. The problem is that most of the older treatment options have their potential drawbacks. There are several newer treatments that may reduce the after effects so you may want to do a lot of research on the internet before committing to a treatment option. Also the newer treatment may be really expensive so that may limit your options depending on your financial standing and your health insurance coverage.
In discussing this and the potential outcomes with my urologist he said, “In some men the nerve causing an erection runs through the prostate. In others, it runs outside the prostate.” I asked how he knows which it was. He said, “If the patient is unable to get an erection after the organ is removed, it was running through the prostate.”
I’d opt for radiation. Also, I had my prostate ultrasonically heated. The theory is that cancer has fewer blood vessels due to the way cancer grows. The blood supply cools the tissue. The idea is to heat the organ as much as possible without killing the good tissue. The cancerous tissue dies and is absorbed. My prostate shrunk considerably and I was very happy with the result. (I had benign prostate hyperplasia, not cancer. My PSA dropped but it wasn’t particularly high.)
Apparently, this equipment is very expensive and most urologists don’t have it. But, ask about it. I drove 250 miles to a doctor who had the equipment and stayed for a week locally after the procedure. It is done in the office under oral pain medication. You will have to have a catheter for the full week.
My Dad has it and choose alternative medicine because at least 5 doctors told him he had less than 90 days. Anyhow, that was almost 2 decades ago, and he is still around today doing well. He travels most of the time.
I am not a doctor, but I would look at all options including alternative medicine.
Ignore it.
Die when you die.
Many people live years after cancer diagnosis and still die of natural causes.
Why give your estate to Doctors instead of your children, especially when Big Med only adds 6 months longer?
Die when you die. It is okay. You were born into this life. Where is the proof that life is only a one shot event?
I’d exhaust any and all alternatives before submitting to radical prostatectomy. Wait and watch. If radiation,drugs and all else fails, find a urological surgeon skilled with the Da Vinci robot or laser surgery.
In my experience, surgeons usually recommend surgery. I am not suggesting that they are wrong, but surgery is what surgeons know best.
I would strongly recommend going to one of the large cancer treatment centers for a second opinion, even if your insurance does not cover it (my obamanationcare insurance covers virtually nothing). They see a much larger volume of patients with very similar conditions. For example, I have friends who swear by Cancer Treatment Centers.
https://www.cancercenter.com/prostate-cancer/
Always avoid surgery if you can and it sounds like you can. Take radiation and then seeds before you think about having surgery. I’m a 15 year survivor so things were very different then. I had 25 radiation treatments - today it can be as few as 5.
Either way remember don’t panic. If treated early and aggressively most tomes you will be okay. When they ask you what appointment time you want say you want the first one in the morning. That way it won’t disrupt your day and if the machine breaks down (happened twice) they can reschedule you for the same day in a slot someone else had to give up.
Afterward they will check to see if the cancer has moved into other parts of your body. Bones first. Don’t worry about these after treatment tests, they are not problems most times. Just be thankful you live in America where prostate cancer is a minor threat. In the socialist Europe 1/3 of men end up dying if they get this disease.
Two of the smartest people I know had to face this decision. One is a Princeton PhD in Physics and the other is a Harvard Med MD/PhD in anesthesia. Both were very well connected in the medical world and did extensive research.
Both chose the old fashion, nerve-sparing open surgery route.
The reason was that the prostate was removed whole, not cut up in pieces as with minimally invasive or robotic surgery. This allowed the pathologist to fully examine the ex-planted prostate and determine how far along the cancer was (staging) and how/if/where it had spread.
Both have full sexual function and urinary control.
My father-in-law was a Princeton/Harvard Med/Hopkins surgeon and he chose the radioactive seed route. The seeds turned his prostate into a clump of scar tissue, but it stopped the cancer. He died at 87. However, he lost sexual function and urinary control at 80, so his last seven years were spent miserably in diapers. He really regretted the radioactive seed decision.
I had two surgeons recommend NO surgery because of this. I joke, that if I'm 'lucky', I will die of something else before the cancer gets me.
However, since you have a surgeon that recommends surgery, it seems to me that this is the likely best route for you. I would, though, get a second opinion. I chose the Mayo Clinic for mine, and I'm glad I did. It's a 600 mile trip for me, but it's worth it.
>> Surgeon is recommending surgery (radical prostatectomy)
A surgeon will ALWAYS recommend cutting it out.
I received an elevated PSA during a blood test in June.
The doctor scheduled me for a MRI and CATSCAN. I got the catscan first then immediately went to the room for the MRI. When the MRI was done, they moved me to an operating room. I asked why and the quack said they always remove the prostate. I told him that he hadn’t even looked at the imaging results yet. He said it didn’t matter, I needed surgery. I put on my clothes and walked out.
Weeks later the insurance company said they would only pay for 1 imaging procedure, because the MRI and catscan were redundant. I had to pay for the MRI out of pocket.
I switched doctors and the new doctor said she’d just watch the progress over time, because the 2 imaging procedures were inconclusive (i.e., they could not tell anything).
I asked about a biopsy. She said biopsies are too risky. Because the prostate is so small and it needs 12 needle probes; there’s a 5% chance of infection from fecal matter; additionally, there’s a 5-8% chance of spreading any cells from the prostate to other organs and a 25% chance of spreading through the prostate during the healing from the biopsy. It’s just better to watch it with blood tests over time. She did mention something called a 4k test that supposed to be better than the PSA, but it’s not available from my insurance.
Additionally, prostate is the slowest spreading and growing of all cancers. It could take 7 to 10 years or longer. I’m in my mid-70s now. I’ll probably outlive the cancer.
Right now, though, I just started on by 12th season with shingles. And yes, I have had the vaccine, both the newer one and the older one. They took the typical shingles burning down to just itching, but it returns every year oalmost on the same day each time.
#MeToo on this one.
Several years ago, HIFU was unknown, cryotherapy was spotty.
The choices were surgery, external beam radiation (IMRT... modulated and image guided), or radiation with seeds.
I talked to a lot of people, and the recommendations were 50-50. Being somewhat cowardly about the immediate downside possibilities of surgery, I chose radiation. So far, so good.
If you opt for surgery, there’s a chance it will come back. I met a couple of people who had radiation after their surgery failed. For one guy (relatively young) it was six years after. For another fellow, it was 18 after.
If you have radiation, surgery afterward is not an option, because everything is kind of gooey in there, and besides, if it comes back, it is likely to be outside of the gland.
Here’s one thing I haven’t seen mentioned in the previous comments. When you have this, hospitals that are going to treat you realize you are worth something like $20 to $50,000 in insurance payments. Some of them have instituted a multi-doctor appointment where you meet with a combination of a radiotherapist, a surgeon, and a medical oncologist. They look at your tests, and help you decide (or pitch) which of their respective approaches is best.
Are you a VN veteran? Prostate cancer is a “Presumptive Illness” for VN Veterans. VA is well-versed in treatment of such.
We men folk will all get prostate cancer if we live long enough. A urologist once told me that if you die at 90 from a heart attack an autopsy will show your prostate is cancerous cancer.
Are you a candidate for robotic surgery? Robotic surgery spares the nerves that allow for sexual function and urinary continence. Plus you can be back at work in a couple of weeks.
Ask your urologist. If s/he says no get a second opinion. The benefits of robotic surgery are just too great to move forward without aggressively seeking out all of your options.