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I have recently been diagnosed with prostate cancer, I am 60 years old and otherwise in good health. My PSA level is 5.5 and my cancer is a 4 + 4 on the Gleason scale. Involving 1 of 2 cores 5% of the tissue in right apex. Also 3 + 4 in the right central.
I have spoken with two surgeons and they recommend surgery to remove the prostate.
I have also gone to Scripps Proton Therapy Center and Dr. Rossi thinks I'm a good candidate for proton therapy without the use of testosterone suppressing drugs.
I am considering the proton therapy due to less side effects and similar long term success compared to surgery.
I live in Southern California and am retired so I can make arrangements to be near the center.
I am married and enjoy an active sex life and wish to continue to do so.
I'm hoping someone has dealt with similar experience and can offer opinions.
Rick:
If you are that close to a decision, I suspect you have done a fair amount of research. In general the more research you undertake the more likely you are to make a good decision for yourself. One's personal values play such an important role.
You mention an active sex life which suggests its importance in your value system. I suspect you have a better chance of remaining sexually active if you choose protons rather than surgery, but as you probably know by now there are no guarantees when it comes to PCa treatment outcomes.
Perhaps a rereading of Bob Marckini's book "You Can Beat Prostate Cancer..." will help you finalize your decision.
Best wishes Don O.
Hi Rick,
The outcomes for both surgery and radiation are pretty much on par in terms of survival overall. As you would no doubt be aware, Gleason 8 put's you in the high risk category and active treatment is required.
So you need to weigh up the pro's and cons. With surgery comes the risk of incontinence and impotence, Radiation can also cause impotence, but mostly after many years have elapsed. My pre treatment stats (psa 6, Gleason 7 4+3, T2B) were similar to your own. I completed EBRT in March 2008. Almost 8 years on, my psa's are low >0.17, and I am still potent. I am now 65 years by the way.
John, do you mean your psa is "greater" (>)than 0.17 ng/ml or as I think you mean
(<) "less" than 0.17 ng/ml. I suspect after reading many of your learned writings it was just a typo??
James
Sounds like you have done your homework, It appears you have low volume disease and that's good. If sexual function is really important to you, you might consider FLA (focal laser ablation). Since your tumor is small and only on one side you could be a good candidate for this procedure. You would need to get a 3T-MP-MRI to know for sure but that is a good idea even if you choose not to have a FLA procedure. It can find high risk tumors that are missed by the blind biopsy.
Things I like about the FLA treatment option:
1) Virtually no urinary or sexual disfunction...short term and long term.
2) If you have recurrence all of your options are still open including repeat FLA.
3) Very short recovery period ...couple of days.
I have not had this procedure because my disease was bilateral and large volume but I would have if I qualified.
Not trying to change your mind...Just information to consider...This is a relatively new procedure and most doc's don't even know about it.
