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You should know that the National Comprehensive Cancer Network (or NCCN, for short), which is a non-profit alliance of 25 of the world’s leading cancer centers, has an active surveillance (AS) protocol, REGARDLESS OF AGE, for patients with either very low risk or low risk cancers. Among other criteria, a patient must have a Gleason 6 (or less) cancer in order to fit into either of those two categories. A Gleason 7 patient, whether they be a 3+4 or 4+3, is considered to be an intermediate risk, and they do not support AS as an option at that risk level if you have 10 or more years of life expectancy left. To learn more, you can Google "NCCN guidelines for prostate cancer".
Personally, I agree with their guidelines, and the only time that I have read about the acceptance of Gleason 3+4 patients into an AS program is when they were over 70 years old (that was in Dr. Klotz’s Stonybrook active surveillance study).
From reading your posts, I could be wrong, but I got the impression that you weren’t considering AS anyway. Just in case you are, though, I have to respectfully disagree with Frank and say that, IMO, it is not a safe strategy at your risk level.
Good luck with whatever you decide. Be well,
Alan M in the USA (practicing AS since 2007)
From a physician survivor, who did a lot of research before making a decision:
It sounds like you have an intermediate risk tumor; for such tumors, some radiation protocols provide significantly higher cure rates than surgery. This is not a just matter of opinion; there is solid data to support this.
The information is summarised in an article which compares cure rates for many different treatment options. If you seek complete cure, it tells you what you need to know to decide on treatment which maximises your odds for cure. It does not address side effects or social considerations; it is not the whole story, but a very big part of it. The data is presented graphically, relatively easy to understand. Many well educated layman will be able to understand the results; any doctor can (if he/she can't, find another doctor).
The article is "Comparative analysis of PSA free survival outcomes....", by Grimm et. al., British Journal of Urology International, Supplement 1, 2012.
I can email a copy to you or your doctor. The important data is in color diagrams; color reproduction is a must.
I advise you to consult a radiation oncologist at a university center. There you can be sure that the doctors will be familiar with the medical literature on the subject, and can advise you accordingly.
Some non-university centers can offer equally good information and treatment, but how is a layman to know which ones? This is why I recommend a university center. If there is a good center closer to you, they can tell you about it. Do not be swayed by advertising or recommendations from friends. Go to a pro; your life is at stake.
There is more detailed information in my Survivor Story, and I am a registered mentor.
