52 with Favorable Intermediate-Risk Prostate Cancer: Surgery vs. Active Surveillance—Looking for Experiences
I’ve recently been diagnosed with prostate cancer and am trying to understand my treatment options. I’d really appreciate hearing from people who have gone through similar circumstances, particularly those with experience of radical prostatectomy or active surveillance.
I’m 52. My PSA was initially 9 and increased to 15.4 three months later. My MRI was rated PI-RADS 2. The biopsy found Gleason 3+3=6 prostate cancer in 1 of 12 cores; the remaining cores were benign. I’ve been told this is Grade Group 1 and that, based primarily on my PSA level, I fall into the “favorable intermediate-risk” category.
My urologist is recommending surgery, mainly because of my age and the possibility of recovering more easily while also having a longer period of life ahead. Radiation was not recommended because of my age and the potential for longer-term complications. We did not discuss hormone therapy in much detail, and based on what I’ve read so far, I’m unsure whether that would be appropriate for me.
Initially, I was hoping this was simply an enlarged prostate. Once cancer was confirmed, I hoped active surveillance might be a reasonable option, with regular PSA tests, imaging, and repeat biopsies. I’m now trying to weigh that against having surgery and treating it definitively.
For those who have faced a similar decision:
How did you decide between radical prostatectomy and active surveillance?
What was recovery from surgery actually like?
How did surgery affect urinary continence and sexual function?
If you chose active surveillance, how has that experience been?
Did anyone seek a second opinion or consult both a surgeon and a radiation oncologist before deciding?
Is there anything you wish you had known before choosing your treatment?
I understand that everyone’s situation is different and that online experiences aren’t a substitute for medical advice. I’m mainly hoping to learn from people who have been through this and to better understand the questions I should ask my doctors.
Thanks in advance for sharing your experiences and thoughts.
Just jumping in to say, you've clearly put a lot of thought into understanding your diagnosis and the choices in front of you. I can see why you are looking for experiences from others who have had to make this same decision. There are a lot of factors to weigh and it sounds like you have some pretty thoughtful questions. I am hopeful some of the men in our community who have been through this will share their experience. I know how valuable those first hand experiences can be. I also think the questions you've raised about seeking additional opinions and talking with different specialists are important ones to discuss with your healthcare team as you figure out what feels right for you. I really just wanted to stop by and say that I am wishing you clarity as you navigate all of this! -Kimberli (Team Member) I am 65 with a similar diagnosis. I consulted with 4 urologists with strong experience in prostrate cancer. None of them recommended surgery. 2 recommended surveillance, and 2 radiation. I would consult with additional urologists before making a decision. For me surgery is a worst case scenario alternative. Have had friends that have done it and they've never been the same. I can't imagine that being an alternative at your age and risk category. Good luck.
Thank you for sharing your experience. Consulting with several specialists and hearing different perspectives before making such a big decision sounds like it gave you a lot to consider. I'm sure hearing from someone who faced a similar diagnosis will be helpful to him as he weighs his own options! -Kimberli (Team Member)
