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Beginning My Prostate Cancer Journey

I'm 66 years old and very healthy, very physically fit and active hiker/skier/backpacker/rafter/biker/etc. No known family history and no other significant health problems. My PSA was up to 4 at my annual physical in January 2022, plus my doc felt a small mass. He referred me to a urologist. By April my PSA was 6, and a 4K blood test showed 63% probability of some amount of aggressive cancer. Based on this I had a biopsy, with Gleason of 4+3. Grade group 3. Bone scan was negative for metastasis. MRI also negative for metastasis, and showed a 0.36 ml cancerous lesion confined to prostate. T2/N0/M0, stage II C.

It's looking like surgery or radiation, and I'm leaning toward surgery.
I expect to live at least 25 more years. It's feeling like with prostatectomy, I'll be confident all the cancer has been removed (absent any weird scenarios), and the side effects will be immediate, likely improve over time, and there are mitigations. With radiation, it seems that you don't know if the cancer has all been killed until sometime down the road when it either does or doesn't return. And the side effects come some years down the road, potentially including rectal or bladder damage or cancer. I don't know yet it my radiation would include ADT hormone therapy, but that sounds like something I want no part of.

So just wanted to bounce all this off the group, and I'm open and welcome to your thoughts and experiences.

  1. You are pretty close to where I was in 2013 when I opted for surgery vs radiation. At that time my PSA was 2.7 and the urologist felt a lump. The biopsy showed a Gleason 9 and follow-up scans suggested it was a contained Stage II. Following my 5.30 hours of surgery the pathology suggested the cancer had not spread. Some 5 years later it retuned and I was able to do p u radiation and hormone therapy. Today I continue to do well. My post-op PSA so far is undetectable at 0.02.

    I did recover urinary control in 4-6 months and erections were happening at 2 months. Like you I just wanted the cancer out and was pleased with the outcome. Just know there are no guarantees as we all react differently to treatments. Good luck to you. Dennis(ProstateCancer.net TEAM)

    1. Hello , Thanks for your feedback. I have learned so much in this community. I have a support group meeting tomorrow and I always feel so intelligent at the prostate cancer meeting. Thanks for sharing so much (guys). Diane (Team Member.

    2. Support groups are so important and glad you are also attending. Nationally we hear so much more about Breast Cancer detection and treatment than we do Prostate Cancer (PCa) because so often ... men do not speak up about this disease the way women speak up when it comes to their personal health.


      In my opinion we need more women to be involved, informed and speaking up about PCa particularly as it relate to the need for men to take a more proactive role in and responsibility for their personal health . Thank You for what you are doing. Dennis(ProstateCancer.net TEAM)

  2. I basically concur with Dennis Golden. It sounds as if you will do well with either radiation or surgery and the issue of hormone therapy should be thoroughly discussed with your urologist to be sure you fully understand why they are suggesting it and what it would mean to add hormone therapy or to not add it. The other good news is that if your PSA would start to rise in the future after your initial treatment, there are tests such as the PSMA (Prostate Specific Membrane Antigen PET scan) that can locate a recurrence in time for a secondary "cure" in many cases. So overall your future looks bright! And don't slow down on the sports/activities both for your physical and your mental health!

    1. YES... Try to stay as active as possible both physically and mentally. A prostate cancer diagnosis knocks you for a loop on so many levels. It is very easy to imagine a lot of negative outcomes which most likely will not happen . As Jim noted find our what to expect from hormone therapy and understand it can and does impact men in different ways ( some = not much ... others like me = not fun) I did post a video journal on www.theprostatecancercoach.com if you want to know more about my journey with radiation and Lupron on a returning cancer some 5 years after surgery.


      The newer PSMA testing is another new development in dealing with prostate cancer and more are on the way according to the research I have been seeing. These days I suggest that men view prostate cancer as a treatable condition vs the death sentence it was a few years ago. Hang in there most likely ... you will be more than OK ... Dennis (ProstateCancer.net TEAM)

  3. Just as an encouragement, my husband had a prostatectomy 14 years ago and is still living a full life. During the last three years his psa has risen but so slowly that no treatment is needed. The PSMA didn't detect anything but that's a good option down the road if you should need it. Like Jim Early said, keep involved in your sports activities. Add some good nutritional habits to that and you're in charge of this battle. Best wishes to you.

    1. Sue, I had a prostatectomy in 2013, and 2 years to the month later, I had a positive PSA of 0.01. After it was reconfirmed, my oncologist said that they wait until it’s at least 0.2 before they do anything.
      And I rather sternly asked, “After a prostatectomy, where else could a positive PSA come from other than prostate cancer that had metastasized before my prostatectomy?” After my oncologist gawked at me with no answer, I said that after having Gleason 9 prostate cancer, there’s no waiting, and I want treatment NOW!
      I had radiation, and I’m happy to say that last positive PSA was in June, 2015. And I haven’t had a positive PSA since. All the best to you Hubby and you. Len Smith Moderator

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