Welcome, you will get a lot of opinions on this site, that's why it's so good. With your stats you are the poster boy for all treatment options. The mapping biopsy gives you more confidence in your stats and reduces the uncertainty that you have agressive PC, your low PSA also confirm this.
There are a lot of studies on Active Survelience that show that 75% of PC in your range never show signs of progression in 7 years, and those that do are treated with no sign of matatsis in the future. Because of your young age the PC has a lot of time to grow, but with a good diet there is a high probability that you could go the rest of your life without being treated and if treated the cure rates are similar as if you were treated today. The key is to get a doctor that is experienced in AS.
Every other option is also available, similar cure rates and varing side affects ranging from severe to minor. Tudpuck and I are seeders and have had good results with minimal side affects; most of the others are surgery patients.
The Prostate Cancer Research Institute recommends "no immediate treatment" for your stats. Their web site has a lot of information on all treatment options.
Good luck on any treatment you choose as it is highly individual and you have to determine what is important to you. As long as your PSA doubling time remains greater than 3 years you have an excellent prognosis from any option. I estimate I went about
12 years from the time my PC was detectable to treatment and my doctor said I could have probably gone 10 more before it affected me; so you have plenty of time to research and get several opinions. Diet is extremely important in slowing or stopping progression so pay attention to it.
64 years old.
PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.
2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.
Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.
Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.
25 treatments of IMRT 6 weeks after seed implants. No side affects at all.
PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.