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Sailen:
Unfortunately there is no right or wrong answer here, it is a personal choice. I would suggest that you read the stories of some of the survivors on this site who are of a similar age to yourself, as well as PSA, and Gleason scores. It will help you to ask the questions of your doctor and put you on the right path for dealing with Prostate Cancer.
Mike C
I had a TURP when I was 60, and 3 months after it my PSA was only 0.99, the lowest it had ever been up to that point. My diagnosis was similar to yours. My uro said I had slow growing low grade cancer.
He suggested that the PSA had gone down after the TURP because the vastly improved urinary flow had removed all the inflammation from the prostate.
I did WW (active surveillance) until a second biopsy confirmed an additional (although very small) focus of cancer and my PSA went up to 1.75.
Now here is the problem. Be very sure to ask any surgeon VERY CLEARLY, if they think your TURP will have left scar tissue that will make any prostate removal by surgery too difficult. When you get an answer, then go and ask someone else the same question. I was assured that the TURP would make no difference, but my surgeon - a TOP man - failed to get the whole gland out with the robot. Left me with 6 grams. He said the TURP scar tissue made him lose his bearings.
I now have a new uro who specializes in HIFU and he says that looking at my post operative pathology, he thinks I may be the guy who had insignificant cancer and could have WW much longer.
I am now doing WW with 4 monthly PSA's. If three PSA tests show an increase I will have a further MRI and maybe a template biopsy. If cancer is found in my residual tissue then I will either leave it or HIFU it.
There is no right answer to your question and I am NOT a doctor, but in my opinion you have a lot of time to decide and should not rush into any treatment.
I waited for 10 months and I wish I had waited longer. In fairness to the uro who did the TURP and who found the cancer, he also was of the opinion that I could wait (active surveillance - 3 monthly PSA, annual biopsy and MRI plus ultra sound scan), but I went to see a Da Vinci expert and took his advice and had the op.
Side effects from my TURP had been minimal. Urine flow was brilliant - I could have peed over a gate for Britain in the Olympics. The surgeon also preserved my ejaculation so, along with the absence of inflammation, everything worked better for me after the TURP.
After the prostatectomy, the usual side effects happened. Incontinence lasted four months but then cleared up completely. ED though is a different story. I get what uros like to call "tumescence", but none of the drugs make much difference, except for the headache, 18 months after the op.
Remember, even after my op I still have 6 grams of prostate which I have to actively watch, just like I had to watch the 60 grams before the op! So if Q of L is a major consideration for you, please do not rush, and take lots of opinions.
As well as regular PSA's, you can have sophisticated scans and further biopsies.
The decisions are not easy and whatever you do, there is no quick fix. My main concern with guys like yourself is that whatever advice you take about which way to go, if it involves intervention, make sure you and the doctors are confident that your previous TURP will not foul things up.(Please remember, like all of us here, I am not a doctor and can only give you my opinion based on what happened to me).
