Loved it, thank you

Thank you for your channel. It is really helpful! I live in the US. My RP and e PLND is scheduled for next week. I'm really concerned about PLND due to its possible life-long complications. My circumstances are as follows: Firm yet no nodular DRE. MP MRI showed 1cm lesion in the peripheral zone with no ECE. PSA 19.4 yet at the time I had CP/CPPS. Systematic biopsy showing (1) 4+4, (4) 4+3 and (1) 3+3. Gleason 8. PSMA Pet showed avidity in only the prostate. No other avidity at distant sites including the nodes and seminal vesicles. BRCA 1 and 2 negative. I'm also asymptomatic in the pelvic region. I'm wondering that, in my setting, can I forego the ePLND? My thinking is to go ahead with the RP only, test PSA every 3 months for two years and if it starts to rise, repeat the PSMA to find it then deal with it. Thanks so much!

Thank you Doctors. This was very interesting. My husband was just diagnosed so we are trying to learn all we can.

I did not understand why I had to suffer a biopsy. PSA 2000, bone scan showed extensive mets to upper skeleton, I mean everywhere. PSMA PET Scan after biopsy simply confirmed the bone scan and showed-up a met in a pelvic lymph node. The biopsy was done after the bone scan for what? All it did was raise my PSA to 3500 and I was put on ADT immediately anyway. Result of the biopsy - I couldn't sit down for a week and needed a catheter for six weeks afterwards. It's eventual removal was horrendous for two days after, pissing pure blood, then pushing clots until it cleared up. I sometimes wonder if you doctors and the guidelines you follow understand anything. From what I can make out all it did was give me a Gleason 9 diagnosis, SoC sucks.

If systematic biopsy is still recommended for focal treatment planning, what happens if the initial focused biopsy turns up PCa that requires treatment? Does the patient then have to undergo a systemic biopsy for focal treatment planning?