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I am 56, PSA jumped up after a year. Had biopsy done, 3+3=6 Gleason score in 5 areas of prostrate. My doctor says it's best to remove it; after discussing some options.
He has done 75 surgeries and is very detailed. I am scheduled for surgery in 50 days.
My friends that have gone through this have varied options.
Is 75 surgeries enough?
Is surgery the best option?
After reading most of the information on this website, I wonder about the route I should take. My friends work in the doctor's office and hospital. One said the surgeon is very good and the Da Vinci operator is excellent. I can go to an Chicago hospital, but I wonder if it's worth it? Why put my family through that?
Any advise is welcome. I understand the risks, but not scared. Just trying to make sense out off all this.
Unless the doctor can give you a good reason why you need treatment so soon you should go on active surveillance. A Gleason 6 is almost considered pre-cancerous at some prostate cancer centers now. Seventy-five surgeries is not optimum; three hundred is but if he has a good reputation i.e. other doctors would get him to do their surgery then he might be a fast learner.
I always say that the longer you can wait the better the treatment will be and the side effects will be less when you do get treated. Also consider brachytherapy; it gives good results and the side effects seem to be less in the first 5 years.
It would be helpful if you could give us your biopsy specifics. location, % cancer per core....etc. My first thought would be to get a 3T-MP-MRI. This should rule out any high risk hidden tumors that the needle biopsy may have missed. If the MRI does not show high risk tumors you could go on AS safely.
Regarding future treatment, I would recommend checking out Focal Laser Ablation. This would be MRI guided and is very precise. They can remove the tumor with no long term side effects like urinary and sexual disfunction. Any of the primary treatment options like surgery and radiation will give you a good chance at a cure but come with those long term side effects I mentioned.
First I would like to say, WOW, thank you everyone for your advise.
Here are the biopsy details:
Right Base PTI 40%
Right Lateral base PTI 40%
Right Mid PTI 5%
Right Lateral Mid PTI 30%
Left Apex PTI 30%
Left Mid Suspicious
Left Lateral Apex HGPIN
All other areas benign
CT scan came back clean.
I think I will get another option from a well regarded Urologist at Loyal.
Your Gleason score implies a non-aggressive cancer. Other indicators include PSA score and PSA velocity (you mention neither). Chances are there is no urgency for you to rush into one of the most aggressive treatment methods. Generally speaking the more research you undertake at this point,the greater the likelihood you will make a good decision for yourself. Your research will also enable you to ask good questions of the various clinicians you are likely to encounter as you proceed.
As part of your research effort you may find the following book by Bob Marckini helpful: "You Can Beat Prostate Cancer..." His chapter on the advantages and disadvantages of several methods of treating PCa is usually of particular interest to the newly diagnosed. This book is readily available, an easy read and well worth its modest price. Although this book is nearly ten years old at this point much,if not most, of the information remains relevant.
Regards Don O.
Buzz there is no need to rush into a treatment decision at the present time. I support the advice that other posters have given you. Do some research and look at your options and potential side effects from treatment choices. Feel free to ask any questions that may be on your mind. Us old PCa warriors are all here to help you.