Diagnosed at 46yrs

Hi Bilmant,

Unfortunately, you can't ever be 100% certain that it hasn't spread but from the biopsy the consultant will be able to identify where in the prostate the cancer has been detected and whether any of the samples show any evidence of cancer close to the edge of the gland or any evidence of perineural invasion which can sometimes indicate a higher risk of spread.

I'm sure that if anything significant along these lines had been detected, your consultant would have told you but if you wanted to satisfy yourself further you could ask (or may already know):
- How many biopsy cores were taken?
- How many of the cores were positive for cancer?
- Where were the positive cores located?
- Was there any evidence of perineural invasion in any of the samples?
- Was there any evidence of cancer being detected close to the edge of the prostate or the fatty tissue surrounding the prostate?

Overall though, without knowing how many cores you had taken or how many were positive, on the face of it given your combination of Gleason 6, low PSA, and no visible lesions on the MRI, it would seem very likely that it's both early stage and contained within the gland.

Edited by member 19 Jun 2023 at 21:36  | Reason: Confusing language!

Just to balance things up a bit from what Steve86 says about being able to handle the side effects emotionally of RARP, please don’t think that going down the RT/HT route is a walk in the park emotionally. You’ve got possibly up to 3 years of the following:

Hot flushes
Aching and stiff joints
Total loss of Libido
Erectile Dysfunction
Possible long term urinary and bowel problems
Weight Gain
emotional issues
A long wait (up to2 years after RT until HT finishes) to know really how successful the RT has been.

Everyone is different but given the choice I know which one I would have opted for…RARP!

Firstly can I say that I wish I had been diagnosed earlier as by the time they removed it, it had broken through the margins leaving me pT3a and looking forward (!) to salvage RT etc although post op PSA is <0.01.

Although your question wasn't addressed to me, I can add my 2c worth in :)

Apart from the first couple of weeks of discomfort that a couple of paracetamol fixed, the incontinence, although there, is only a mild inconvenience as long as I have relatively easy and quick access to a toilet. I feel the need to go and then have to make a conscious decision to hold it in. I can do that for about 5 minutes otherwise I get a small leak (5ml maybe). I am leak free at night. This is 6 weeks after RARP and it's getting better.
The ED will always be there for me as they could not save the nerves but I still achieve a very pleasurable orgasm, both with and without assistance. That may affect younger people more than it has me at 62.

Hey Bilmant,

Just seeing your post mate. I was diagnosed 18 months ago, same as Ulsterman, Aged 46 T3a and 3+4.  My histology was, unlike Ulsters, similar once in a petri dish. No positive margins and as I await my 4th PSA test next month, I remain hopeful. No continence issues immediately and potency is around 80% having had 80% nerve sparing. Work in progress.

I just might not have cancer anymore. Result.

Decho has balanced this thread out perfectly. We all have but the same goal.

Oh and for what its worth. Ive read all of Ulstermans posts. My best friend is from Fermanagh. I thought he was a strong character. But Bejesus.... Yer mans the man.

Wishing you warmth mate and im sure whatever choice you make will be the right one.

Jamie.

Edited by member 27 Jun 2023 at 19:34  | Reason: Not specified