Sorry for your diagnosis Watchman3135, my case is very similar to yours, I was 55 years old at my cancer diagnosis with similar numbers to you.
My father and two uncles passed away from Prostate cancer so I started watching my PSA many years ago. Each year as part of my annual physical I’d have the digital exam as well as a PSA test. For years it was in the 1.6-2.0 range then in 2017 when it increased to 3.0. Three months later it was 3.4 so we decided upon a biopsy. I tried to get an MRI and/or MRI guided Biopsy but my insurance would not cover it. I did the normal Biopsy which came back 2 of 12 cores positive 3+3= Gleason 6. After positive cancer diagnosis the insurance then approved an MRI. The MRI was done on the newest technology MRI machine which was installed just months before my appointment. The MRI saw nothing, PIRADS 1.
I spoke to multiple Urologists and Radiation oncologists from Yale and Sloan Kettering in NY. I looked into all of the options but decided on Robotic Prostatectomy with a doctor who had done over 3500 robotic prostatectomies using the DaVinci machine. This decision is not to be taken lightly as the odds for permanent side effects are more common that not. Erectile deficiency and incontinence issues in many if not most cases.
I didn’t like Active Surveillance. The two friends of mine who were on Active Surveillance both had to eventually get treatment so what was gained by waiting, at least in their cases?
During/after my surgery it was found that the cancer tumor was about 8-9mm and it was already outside the prostate wall. But luckily there were “no margins” in my case as the doctor cuts outside the prostate wall and everything was contained within the area he cut out. I was surprised at the finding; how could the MRI completely miss the tumor? but it did in my case.
I followed all the post op suggested recovery walking a minimum of 5 miles per day starting less than a week after surgery, doing kegel exercises daily. I took a medical leave from work for 12 weeks.
I’m happy with how things turned out for me. I’ve got no side effects at all and my PSA numbers remain at zero. During the healing process I did have some minor urinary leakage, what they call stress incontinence, but this went away after a couple of months.
I swear that I’m without the common side effects because of the skill of my surgeon but he says it’s because I’m in relatively good shape and followed all his instructions. Who knows maybe I was just lucky, at least so far.
My brother had not been checking his PSA numbers so at my urging and his girlfriends too he finally got his checked. Unfortunately, he found cancer too. He selected Proton Radiation therapy and so far, he’s had no side effects and no further PSA increases.
I’d suggest that you get 2nd, 3rd and maybe even 4th opinions with Drs from differing treatment options, read as much as you can then decide for yourself. I wish you well with whatever option you chose.
Although I was already planning on retiring my cancer diagnosis definitely helped push me to retire on 12/31/20. And my DW joined me retiring the same week! We are very happily retired and loving life.
