G6 decision

Welcome to the site....Sorry you have to be here..

I just wanted to mention that most surgeon "try" to spare the nerves... But most will tell you that they have to wait and see once they get in there if they can spare the nerves.

my PSA is currently 3.9 and was never higher than 4.6

Welcome and sorry you need to be talking to us.

Well, looks like it's growing so treating now is a reasonable suggestion. The problem with waiting is to know when to treat - not too soon so you can delay the side effects but before the cancer leaves the prostate. Not easy to figure that out.

Surgery at this stage is a reasonable option but you have you looked at the radiation options - external beam (IGRT or IMRT) and seed implants? You should at least talk to a radiation oncologist before deciding for sure.

I am not trying to push anyone treatment but just wanted to make sure you've considered all your options before selecting a treatment. At G6 and your PSA it's likely that any treatment will do the job. There are trade offs between them and choosing is really the difficult part.

If you're in generally good health now it might be a good thing to deal with surgery now. ED issues are difficult to predict because so much depends on what the surgeon finds during surgery.

Andrew

Definately look at radiation treatment options as they are as effective as surgery and will normally have fewer and less severe side effects. You are probably a candidate for brachytherapy monotherapy either with permanent seeds or High Dose Rate. Check these two websites; for seeds www.prostrcision.com and for HDR www.cetmc.com.

I do have the PSA tie-ins to each biopsy. I will get those and post. As to the radiation, I did look into the different options. In my case, CTCA recommended surgery and local radiologists are a little concerned about current symptoms, i.e., urgency, etc. and the down the road effect of the radiation on my quality of life. Seeds are on the table but at my age and no other health issues, they always lean toward surgery.

galaxyIII said...
As to the radiation, I did look into the different options. In my case, CTCA recommended surgery and local radiologists are a little concerned about current symptoms, i.e., urgency, etc. and the down the road effect of the radiation on my quality of life. Seeds are on the table but at my age and no other health issues, they always lean toward surgery.

Glad you did check into that. Having symptoms like that does push the decision towards surgery.

At a certain point it does come down to what would your prefer? I have a brother with PC and he went for surgery - no question in his mind that that was right for him. I had a few health issues that complicated surgery so I went with IGRT. We've both done just fine.

All the best,
Andrew

GalaxyIII: You have come to a good place with immeasurable help and knowledge from those that have "been there, done that" with respect to being told we have PCa, learning about the beast, deciding on a treatment path and moving on. I found forums such as this, where you can learn from people that have gone through the various treatment options out there, was invaluable in terms of helping me make my own decision. You'll quickly see that there are guys out here that have done pretty much all of the various treatment options, and to that end I will try to refrain from promoting my own choice of treatment as this is a very personal decision - likely one of the biggest decisions you'll make in your life. As others have said however once you make it, don't look back - go forward and beat the beast!

At this point you probably already know that with your statistics you have time - time to learn about the various treatment options - so don't panic!

One question - have you gotten a 2nd read on any of your biopsy slides yet? Particularly the latest test? Labs such as Bostwick and Epstein are two of the best and a 2nd opinion is usually a good thing.

There are also a number of great books out there as well - Dr. Patrick Walsh's "Guide to Surviving Prostate Cancer" and Strum and Scholz' "Invasion of the Prostate Snatchers" are two that I found incredibly helpful during that part of my journey.

You will also want to talk to and if possible meet with as many of the medical experts in the different treatment approaches as you can. When you do, be sure to ask for their specific outcomes post treatment - % regression free, continency (and have them define what "continent" means - to you and I it means NO issues, while others may qualify that with "only one pad per day" or "only when straining;" same goes with ED. They all have these statistics and if they say they don't or are unwilling to share that would be a cause of concern for me.

As part of my journey to learn about the various treatment options I downloaded, purchased, and copied a number of studies and results that I would also be happy to share with you, so again if you are interested shoot an e-mail my way and I'll reply right away.

I would also be happy to discuss further with you if you are interested, just shoot an e-mail my way (my e-mail can be found by clicking on my handle, A Yooper.) I continue to be ecstatic with my entire treatment experience.

We are all out here to help - my very best wishes to you in this journey.

Galaxy III,
It sounds like your AS days are about over. You need to research the best decision FOR YOU! All of us looked at our options and chose what was best for us. Do the same. As was mentioned, there are no do overs.
I wanted it OUT, so I chose surgery but I will not push it on anyone. Read some previous post here. There are many of us that have used every method to beat this thing. Then talk to some doctors.
A lot of us who had surgery found our Gleason score go higher after our pathology report. Mine went from Gleason 6 to G7 after surgery so I was glad I took the route I did when I did.

Good luck with YOUR decision. We are all here to help you beat this thing. Come back often and ask any questions you have.

Bill

I think all treatment options (radiation or surgery) should work for you, and even with your progression, you are steal dealing with a low risk Gleason 6.

Even with the greatest surgeon, the ED outcome is very unpredictable. Too many men here with post surgery ED issues, even those that had the "nerve sparing" specific operations. Too many variables, from person to person.

And with radiation, less to deal with on the front side, but no guarantee how you will be effected later on.

I don't think it would hurt to continue AS for a while longer, at least until you really lock into a treatment plan that you feel good about Once its down, its down, and you will have to live with the results.

david