Radiation vs. surgery

VG - I'm glad you've got Dr. Walsh's book, that's how I began too. If you balance it with the Scholz compendium you'll have a clearer picture of all the treatment modalities. In your particular case, "Invasion of the Prostate Snatchers" would be very interesting and a potential eye-opener. Dr. Scholz co-wrote it with a former patient, Ralph Blum.

Absent an MD degree of course, I will still maintain that G6 with a relatively low PSA (which of course can come from several sources) and, presumably, low positive volume in the cores - or cylinders - is a reasonable place to think about Surveillance. Notice I said think about, not commit to. If you can tell us the positive volume of your cylinders that would be helpful.

The Epstein read could well be critical here and I'm glad you're going to see an RO. If you're able, a second opinion from another urologist is a good idea. If your insurance covers it and/or if you can afford it, one of the genomic tests like Decipher would also be great.

Good luck on Tuesday.
David

Vivagreen, as Tudpock says, prognosis is great either way.

If you choose surgery, make sure the surgeon has good experience. ie. You're not the 2nd one he's done
If you choose radiation, make sure who's doing it is very experienced as well as experience can equally affect side-effects here as well.

Specifically re surgery: ask what is the risk of ED/incontinence. Some surgeons may discover during surgery cancer is more widespread and will be aggressive to remove all cancer. This will often determine incontinence/ED. Ask yourself if you're willing to accept this risk.

Re: Radiation ask specifically the areas they will radiate and possible side effects. ie will bladder/rectum areas be affected. Like the surgeon, make sure he/she is experienced.

Best wishes.

My two cents

I'm choosing radiation therapy and actually started it however my enlarged prostate led to urinary retention that led to catheterization and finally a paraphimosis which is very painful. The retention started after only the 4th treatment.
My primary urologist warned me to get my enlarged prostate opened before radiation but quite frankly I forget to ask the RO about it.
So now I'm having Greenlight laser treatment to open me up enough to tolerate the radiation.
Radiation is a pain in the butt because you have to go there through the week for in my case over 50 time's.
They place a balloon up the rear but one gets used to that. I think it's to provide a buffer so the radiation does not effect the rectum.
I had to consider my state of health and safety. I Am overweight and have sleep apnea and Afib so the surgery risk was higher.
In any case you have time with G6 and lower PSA
My second biopsy showed an increase in volume and one of the cores was upgraded to G7 upon slides sent to John's Hopkins.
Just to note - since my first biopsy it's been 3 years
So listen to the good folk here and do research and be informed.
Listen to the doctors as well but always get second opinions

Good luck

Glen Heinsohn