With your intermediate risk PC you have the option of surgery, external radiation, seeds, or a combination of seeds and external. All have approximately the same cure rate for localized PC, but all have different side affects. Research all your options and choose the one best suited to you.
I chose a combinaton of seeds and external (IMRT) because I wanted the highest dose of radiation with the least side affects. The only side affects I have had were 4 weeks of urinary frequency and urgency that didn't affect my normal activities. When sitting or driving I had to go about every hour; when active it was about every 2 or three hours. The procedure was about 45 min and painless, much less than a biopsy and I was golfing the next day.
The downside to radiation is that you have to wait up to a year to see if you have a reoccurance, in surgery it can be 6 to 9 months. Also you can get a better pathology from surgery as they have the prostate tissue to work with. Radiation does a better job in killing the PC cells in the prostate bed and other hard to get at places in the prostate.
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.