Recently diagnosed - PSA 15.1 with only 1 core positive @ 3+3. At 44yrs old - any thoughts?

Zaarth, good for you. You did your research, made a decision that works for you, and you've chosen a top guy to do the job. You'll do fine. Now, between now and then....empty that little thing as often as possible. Eat well, exercise, and get on with life!

Well done, Zzarth! I know how you must feel, as I just crossed the decision point a few weeks ago. My treatment (CyberKnife) will probably be a bit delayed due to other consultations, prep, etc., but nevertheless, the feeling of at least a "first closure" that you get when you make your decision is a major milestone.

May we all have smooth sailing to a happy ending!

"Happy Ending?" ... like reading a book?

I'm confused. :)

Congratulations on making your decision. He's one of the best to my way of thinking.

Zzarth said...
"Happy Ending?" ... like reading a book?

I'm confused. :)

Sorry - I realized the potential for multiple interpretations after I hit "submit." I'll let you decide whether you want the "family" version that I hope all continues to go well for you, or the X-rated one, where I let you fill in the blanks.

Tall Allen said...
Congratulations on making your decision. He's one of the best to my way of thinking.

TA -- you were the first to point me towards Terwari in another thread ... TY

@halbert -- thanks for the heads up :)

Unless it's an emergency (which a PC diagnosis generally isn't), it's never stupid not to rush.

Praxton -- would you classify FLA as a "cure" even if only the PCa that was treated was removed, potentially leaving other G6 in the prostate? .. or only RT or RP which are non-focal ?

Zzarth - I'm certainly not the authority to say if FLA is likely to be a "cure." I'm personally of the opinion that for most of us, when considering initial therapy, the odds are high that there are at least micro-lesions elsewhere in the prostate, even if the biopsy doesn't find them. For that reason, for initial therapy, I would personally head for whole-gland treatment so that if there really are other foci in there, I'll get a chance at them, too. If you really do only have one focus of PC, then FLA may well be the magic bullet.

I really haven't studied FLA as primary therapy, though, so I'm sure that there is a lot more to it than my little mind has absorbed. I'm just writing from the perspective of my own options and what I have learned in discerning which one I prefer for my own case.

@Zzarth,

just so you know, it was probably the hardest decision of most of our lives - at the time at least.

i hear you, it's hard. There are several good choices, a couple of which are probably going to yield a solid result (no pun intended).

And within reason, some of these choices are ones from which there is no going back. There is only going FORWARD. That's scary, new, RARE an scary. Yes, it's double scary.


When I was at this stage, trying to discuss this with people so they could understand what I was thinking - this is all I could come up with.

It's like, you KNOW there is gangrene in the leg, and you WANT the leg, but you KNOW you have to cut it off or risk more of the leg, body, etc, dying - but still ITS MY LEG DAMIT!!! When it's gone its gone..there's no going back.

Now, we're not at that extreme but that's what it FELT like to me. Obviously, I was leaning heavily toward surgery and trying it on so to speak.

I also tried to think of my options in various ways.

Example: IF I have surgery, and IF everything goes according to plan and then BOOM I don't have problems with continence and after a reasonable amount of time don't have any problem with potency and can have predictable, solid erections like before - was it the RIGHT CHOICE? I tried to imagine the most positive of outcomes and then tried to imagine myself and feelings about the outcome and my CHOICE that got me there. It's also really good to envision and think about such things in that light - ESPECIALLY when you're going into it. A positive mindset is VERY beneficial to healing well.

Then, I broke it down and said "what is the chance that I GET that outcome?" "How can I maximally increase my chance of GETTING that outcome" Procedure choice, surgeon, facility, post surgical treatment, rehab, MINDSET, etc.

In the end, you know my choice and I'm happy I made it - but then again, I got all that I expected and more - in the area of speed to recovery.

Again, I posted my email if you'd like to chat. I spoke with a lot of people prior to making my final decision, sometimes that can be very helpful, if not only to try and help settle the mind and nerves and let it focus more on the decision.

But I get where you are at - I'm sure we ALL do. It's emotionally taxing and exhausting - and then tehre is life and works, and probably kids for most and this damb ELECTION!!!! but don't get me started.

;-)

Thanks guys... appreciate all your views ...

I'm flip flopping, I thought I knew, but then I read a few stories here about RT after RP, and issues with RP .. not just ED, but the actual act of having sex, and even with an erection, the difference in intercourse after to RP.

Anyone know any articles on not just ED, but actual sexual function, and how it "feels" ... or anyone here have first hand experience of what their sexual intercourse "feels" like after RP, say, with no ED, ... the lack of ejaculate ... how does it really feel? ... same thing with RT, is it a big difference? ... I assume there is no ejaculate at all with RT, right?

Zzarth

Post Edited (Zzarth) : 10/12/2016 8:36:58 PM (GMT-6)

SidneyJoe,

Welcome to the forum. Another member has started a thread for you so folks can say hello without having to skip through five pages to find you. You should look for responses on that thread. Here's a link: Initial post from SidneyJoe--high PSA

Zzarth, I can share my experience on the subject and most recent question: Yes, the dry orgasm took a bit to get used to, but I can say for myself and my wife, it's a non-issue--and it has it's benefits (no mess). A little "astroglide" keeps things moving, as it were.

From the sensation standpoint, personally I think the orgasms are better. More intense, longer lasting. Sometimes, it feels like what I've read women write about the 'whole body orgasms' that they can have.

I can also share, on the subject to general ED, what my surgeon told me, before the fact: In his opinion and experience, post RALP ED is significantly dependent on (a) the surgeons skill level, (b) the specifics of the surgery (how close to the nerves did they need to cut, how easily did the nerves come loose, etc), (c) the patient's overall health pre-surgery--things like overall fitness, other medical issues like BP and obesity, and (d) sexual functioning pre-surgery. The way I understood it was that if your sexual functioning is graded on a 0-10 scale, with 10 being how it was when you were 18, and 0 being can't do a thing to get willie to rise to the occasion, by our middle age years we've all move down the scale some. Best case, following RALP, we can expect to move down the scale a notch or two. Worst case, of course, is to wind up with nothing.

Personally, I had a night erection just a few days after the catheter came out. Surprised the heck out of me (and woke me up in pain because willie was tucked down by the heavy pad I was wearing to sleep, ouch). Starting about week 4 after surgery, we started messing around, and never looked back. Yes, I take 2.5 mg of cialis daily, and yes, lube is required (both for me and for her, she's through the change) but no biggie.