My Gleason, like yours, was 3+3 but I had four of 12 cores positive, three on one side, one on the other. At that point a Cincinatti cousin, who also happens to be a urologist/surgeon/oncologist (MD Anderson trained) told me: "You could die of this ---- but, you'd really have to work at it!" It was his way of telling me Gleason 6 wasn't bad news at all.
He asked me to do two things: One was to get the slides re-read. The other was to investigate HIFU, which is an approved therapy here in Canada. I thought of HIFU as being like watchful waiting, but with the kicker of "cooking" the prostate and killing the cancer cells --- at least some of them, and what you'll discover is that no matter what threapy you decide on some cells may escape, or have already escaped undetected, and may come back to haunt you.
I was very attracted to HIFU and settled on Dr. Bill Orovan in Toronto as he'd done some 400 of these. As they are done on an outpatient basis, and short term ( 5 to 10 year results) seem to be as good or better than surgery (long term results aren't available as it's only been around for about
10 years) it has it's attractions. Another thing you'll learn is that every treatment has it's risks, and HIFU is no exception.
However, before I signed up for HIFU the second pathology reading came back at 3 + 4 ---- a seven. My cousin, and a friend who is a urologist surgeon at Mayo, said, "that's it! If you might be a seven, go for the surgery. Get it out."
The HIFU people said Gleason 6 or 7 didn't make a difference to the validity of choice between surgery or HIFU, but if I wanted to do surgery that's what I should do. I decided on the surgery because I knew my personality type wouldn't be happy not having the pathology after treatment, and with HIFU there's no prostate to look at.
On June 29 I donated my prostate to medical science courtest of the daVinci robot and the pathology agreed I was Gleason 7. I also know the cancer was all contained in the prostate, the nodes were clear, and I have a 90 to 95% chance I'm cured. I'm glad I have the pathology. If I was 8 I wanted to know that.
From all of the above, I'd encourage you to get your slides re-read by a second top pathologist. The two pathologists I had read my slides were both top rated experienced prostate tissue guys. The second guy made a different call than the first and that altered my treatment choice.
When I had the surgery I elected to go to a city a two hour air flight from home to get the surgeon and the team I wanted. It wasn't easy to do this so far from home, but if I had it to do over again I'd go in a heart beat. First, even before they gave me the happy drugs as I went to the hospital that morning I was totally calm and I'd slept like a log the night before confident I was doing the right thing, with the right surgeon, with the right team in the right hospital. Then, afterwards, when I was discharged the next afternoon, I went back to the hotel, just up the street from the hospital, and found that to be the perfect place to recover. Clean sheets and towels every day, room service, and elevator, a coffee shop, a news stand, I got my hair cut, I went for walks outside in interesting places and a real bonus was that as I learned to cope with the catheter and pain meds I didn't have office friends, and relatives showing up to entertain. What a blessed relief that was. I was eviscerated on Monday and was ready to fly home on Thursday, but we were having such a nice rest in the hotel we stayed on until Sunday. To my surprise I found being away from home a big bonus.
Good luck and keep us posted on your journey.
Sheldon AKA Sleepless
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn --- perfect recovery spot!
Catheter out July 9, so far, so good
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"