Newly Diagnosed and Dreading It

On 10/1/2024 I had my biopsy after a 4.7 PSA (and fairly high scores on the more "advanced version" of it). I hoped beyond hope that it was the result of lifestyle that could be curbed, so I requested a delay of a few weeks before taking the test again and not doing any of the activities that can impact the score, no sexual activity (or masturbation), stopped riding my bike, all of it. Unfortunately that didn't help, I had to get that biopsy.

The day of the doctor already mentioned he saw something "concerning", so I knew it was coming (hell, I knew it was coming anyway), and the next day confirmed it: Gleason 3+4 on one core - and as we all know, on 7 is just a 7 across the board.

Because the rest of my cores were very low, I was deemed to be perfect for active surveillance and I felt I dodged a big bullet. Of course that mean more biopsies but if that was the worst of it then so be it.

Then the Decipher came back. 0.68. Well, crap. Now it's all hands on deck, man the battle stations because that means trouble. That was yesterday.

This is my second cancer (and not a metastasis). I figured losing my kidney to cancer would better prepare me for this, and in some ways it probably has. But I won't lie, this isn't the same and I'm scared out of my mind.

I don't fear the surgery or even the cancer, the same doctor that took the kidney with DaVinci will use the same robot to remove the prostate (should I go that route which all signs point to likely). What I fear is the quality of life changes afterwards.

I've read some good and bad, it's hard to draw a bead on it. It seems like 100% incontinence, at least in the first few months. I can deal with this, as horrible as it sounds, if it's short term. A diaper my whole life is not something I feel I can deal with and I cannot help but to fixate on this. I've order the recommended reading, I understand there are things you can do, but in the end it's going to do what it's going to do.

ED is also not something I'm looking forward to. My ability to keep and maintain an erection has been almost a point of pride, I've been the Ever Ready bunny my whole life, so this is (no pun intended) very deflating. Coupled with dry and possibly painful orgasms, the prospect is horrible to me.

Fortunately my doctor was already part of the Center of Excellence group of hospitals, so I have that. I have the means to seek advice from MD Anderson and intend to do so before I engage in my treatment, but in the end it's going to be not fun.

And I'm positively mortified about this. Enough that all my prep, all my being a realist and pragmatic still doesn't help much. I'm even seeking out a psychologist that specializes in cancer patients because I'm having a hell of a time coming to grips with life after losing one of my key "man parts".

I don't have a question per se, mostly just saying hello and to jump into the big pool of men sharing my concerns and misery.