Craig,

Yes, the side effects can be very worrying.  But your chances of permanent
side effects at age 49 are very low, so really you should be feeling
optimistic.

How come your doctor didn't give you the Gleason score?  Call him now and
get it.  And the "stage."  With those two readings and the PSA, you can see
the chances that the cancer has spread by consulting the Partin Tables

Your reaction seems to be quite normal.  I'm 47 and was diagnosed in March.
My PSA was 4.9, Gleason 3+3 and Stage is T2c.  I'm scheduled for surgery in
mid June.  I too was only worried about the after effects - impotence and
incontinence.  It was until I met the folks at Memorial Sloane Kettering in
NYC that I realized that the important issue is that I have now been
diagnosed with cancer.  For me, getting rid of the cancer is the most
important thing.  While I've not given up on being potent and continent, the
realization that I could die from this (my 1st cousin died of this 7 years
ago at age 49) helps me to keep things in check.  Find a medical team that
you have faith in - get rid of the cancer - and then worry about the other
stuff.

Good luck,
Sandy K.

hi craig - welcome to the roller coaster ride of your life.  first is
denial.  like i can't believe this.  are you sure.  then the anger
comes.  you get mad as hell.  your statement said it best about being 49
and single and concerned about sexual function.  then comes the thoughts
about being punished for past events.  and so, it goes till you get to
acceptance and that is when you make your decision.

as far as sexual function and the type of treatment it is a crap shoot
at best.  some guys make it through with little to no trouble, while
others had one hell of a time.  and it doesn't make any difference as to
the type of treatment.  they all will display this type of problems.  

and when you are standing at the beginning of this trail, it seems like
a long path.  

judging by your comments of what you do know.  2.7 is a good low number,
one core is a good sign of low spread.  it is probably gland contained
but only a biopsy could tell that.  if it is gland contained, that means
that the erection nerves that run underneath the prostate are not
affected yet.  as the cancer grows, it will attach itself to them, and
then they would have to be removed, if you decided to have surgery at
that later date.

biggest piece of advice i can give right now - sit down, relax, take a
deep breath and try to slow down.  it's a shock, but it's not a death
sentence unless you want it to be.  and right now, chances are very good
that it is quite curable.

~curtis

knowledge is power - growing old is mandatory - growing wise is optional    
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."

Craig,

I'll second what everyone else has said and add a couple of
observations.

"Freaking out" is what all of us do when we face a major, potentially
life altering, change.  It's a lot more common than we each suppose,
and it happens for all kinds of reasons.  I freaked out the same way
many years ago when I had a knee operation that went bad and
wondered if I'd ever walk again.  Just like you, I felt like an alien,
as if everybody else in the world could walk normally except for this
one freak on crutches.  Every time I turned on the TV and saw
somebody dance or run or just walk up steps I would think - I'm
now really different from everyone else.

Well, I can now say with the benefit of a little more experience,
it ain't so.  Whether you have an injury, or a problem with
incontinence or impotence, it really doesn't make you different
from other people.  You're still the same guy you always were.
You may be a little worse for wear.  You may have been around
the block a couple more times than the guy next door.  But there's
guaranteed to be another guy down the street who's got it
even worse.  All of us have problems that make us think we're
different and worse than others - but we're actually still all the
same - just human beings with problems, trying to deal with them
and get along.

As to the specific problem with sex, I'd like to say this about
that.  You absolutely will be able to have a sex life after treatment
for prostate cancer.  It may not be the same as it was before,
but it won't be gone and it won't be worthless.

Most men, especially young men (and in this group you're a
young man - no matter what the teenagers on the corner think)
do recover potency.  However even those that don't can
typically still have orgasms and can use some kind of aids -
from viagra to injections to vacuum pumps - to have
erections too.

If you turn out to be one of the guys that does have a potency
problem, don't turn away from women because of that.  I
think there are a lot of women out there who will look past
that and come to realize that love and sex with you are
possible and gratifying.  There are a lot of women who have
posted in this group who can testify to that.

Best of luck.

   Alan

   Take solice in the fact that we are all still here, many years later,
after going through all this. Bottom line is that you have it.... you'll
make a good decision in treatment.... and sooner than you think, it will all
be a bad dream!

Craig,
Everything said above is common including what you're going through.
Nothing can be said that'll ease it so forgive me when I regrettably
welcome you to this "roller coaster ride" also.  When my doctor called
me with the DX of the biopsy he said something that struck me oddly
and stuck with me.  He didn't say 'you have cancer' instead he said
'you have A cancer'.  To me his saying it that way lessened the
impact;  it didn't sound so mortal hence my first reaction was 'what's
the plan of action?' 'It's a low grade cancer caled adenocarcinoma and
we have time to discuss this and for you to weigh your options.'
Actually I didn't go through the usual stages of acceptance until my
post-op PSA's started climbing.  What I'm going through right now is
EBRT as well as Lupron.  It still could be worse
Speaking for myself only the biopsy, the Foley after the RRP(I opted
for surgery)and now the Lupron are the worst parts of my ordeal and I
feel so very fortunate...but that's me.  Every person is different,
Thank God, and we all react differently to such life alterings.
Write your questions down on paper.  Don't attempt to remember what
you need answers to.  Use this group in fostering questions.  Nothing
is too trivial to ask.  Read all you can and converse with people such
as you are doing right now.

Chuck McClellan
Trying to see the humor in it all.

Hi Craig,
I turn 66 in a couple of weeks and I decided to have surgery, I certainly
was not going down the 'watchful waiting' road - too much paranoia for me to
cope with that path. My surgery was  2 weeks ago and fortunately it went
well. I am continent and I already detect some movement down below! Like you
I am single but so what! If you approach this with a positive mind set
knowing you have support from friends and family and all the folks who
inhabit the news group you will come through okay. Prior to my surgery I
built myself up physically like I was going to be an Olympic athlete,
surgery does take it's toll so the healthier you are before the easier it's
going to be. The only side effects I have at the moment is a mouthful of
ulcers no doubt due to the tube down the neck and a challenged immune system
after all the antibiotics etc. If you are worried about future children you
could consider the sperm bank if that is an option in your country. Your
figures look good in comparison to mine , PSA 5.7 and cancer present in 2
sections out of 6 with a Gleeson score of 6 (2+4). It is a bit like Russian
roulette but at the end of the day I don't believe one can ignore it and
acceptance of the facts and a belief that in a way we are lucky to know we
have a choice of life albeit with change.
Get as many medical opinions you can, we are all different so my way may not
be yours. I considered Brach therapy but was not available due to the fact I
had a TURP 11 years ago and the placement of the seeds was problematic,
anyway the procedure seem a bit like a horror movie for me!!!
cheers
FredP

49

life is

From now to after your treatment, PSA doesn't matter.  You have PCa.   You need
the Gleason Score and stage to decide what to do.  If the Gleason is 3, you
have lots of time.  If the Gleason is 6 or 7,  you can wait two or three months
before treatment.  At 49, everyone says you should get surgery- either RRP or
LRP.  I was 59, and had an RRP.
 Take a few deep breaths and calm yourself. God bless.

Jan. 5, 2001,  PSA 5.2
Jan 10, 2001, PSA 10.4 (different lab).
Feb 20, 2001, cancer in 6 of 8 cores, Gleason 4 + 3 = 7
Apr. 25, 2001, a few PCa cells in seminal vesical, none in lymph nodes, margins
clear. Gleason 8 (9?).
Jul 9, 2001, PSA 10.5, began Casodex & Proscar.
Oct 10 to Dec 25, 2001, external beam radiation.
Jan 5, 2002, PSA 1.1
Jun 10, 2002, PSA 10.7, began Leukine injections.
Dec 12, 2002, PSA 12.5, added thalidomide tablets.
Aug 15, 2003, PSA 34.5, first Lupron injection.
Oct 17, 2003, began 24 week chemotherapy regime.
Dec 6, 2003, PSA 23.2
Feb 3, 2004, PSA 34.5, bone scan improved.
Feb 14, 2004, PSA 10.5
Feb 29, 2004, PSA 32.1
Mar 13, 2004, PSA 11.2, bone scan better than 3 Feb.
May 5  PSA 12.0 doc is pleased.
June 17   will get another bone scan.

I'm also 49 and had the sugery on 03/30/04.  I have no problems with leaking.
I'm running and lifting weights without any problems.  Without getting into
much detail I can tell you that I'm already having sex with and without the use
of the purple pill. It also seems like it's getiing better every week. I really
feel I may get very close to normal without any help from the pill.