This is an update to two separate posts from last spring about my prostate cancer. Despite PSA scores that continued to be lower than the one that lead to the previous biopsies, my most recent biopsy revealed two additional tumors that like the first one are also 6 on the Gleason scale. The tumors are small, but since there are more of them it might be wise to consider treatment. My cancer is still stage one, and since I’m also slim I might be a candidate for nerve sparing robotic surgery (for which only stage one patients with BMIs of <25 whose tumors are not on the surface of the prostate qualify) from which odds are excellent that I would recover with full control of my bladder (after 3-6 months of post-operative incontinence) and no loss of sexual potency (though it will take between 6-12 months post-surgery to get that part of my anatomy working to its current capability). I’ll have an MRI at the end of the month to determine whether any of the three tumors are on the surface of my prostate; if none of them are I’ll have the surgery in early February.
If on the other hand the MRI reveals a surface location of any of the tumors I’ll revert to active surveillance in the short run and consider other treatments in the intermediate run, including some that look promising but will not be available for a few years. Since I’m stage one there is no urgency to beginning treatment. I’m only considering surgery now because robotic surgery has excellent outcomes for stage one patients, especially younger sexually virile patients with no prior history of incontinence (the average age of patients is 65–nine years older than me). Meanwhile I’m keeping a positive attitude and increasing my exercise regimen to prepare for surgery should my MRI allow me to proceed.