Hello curious wife, welcome to the place no one wants to have to be. I'm sorry your husband has been diagnosed with PCa.
I suggest the first thing you need to do is have his slides reread by a different pathologist --- someone who has lots of experience with prostate tissue. My first read was the same as your husband's, a 3+3. The second read said 3+4. Both pathologists were experienced prostate people. I figured I was 6.5 !
If I'd remained a 6 I would likely have had HIFU with Bill Orovan at his Toronto clinic. HIFU has been used in Germany, France, Japan, all sorts of places, for several years and from what I could tell if you take the five year trend lines and extrapolate them out HIFU would hold its own, result wise, with any other treatment. In simple terms, again best I could understand, HIFU cooks (kills) the prostate not unlike radiation but without some of the issues. The things that attracted me to HIFU were that it doesn't rule out any other treatment afterwards if not successful, including surgery. It is non-invasive. The stats for incontenance and ED are attractive. While not enjoying the long term track record of surgery, tens of thousands of men have had this proceedure in the past 10 years. And, when I talked to a urologist friend with one of the big name clinics in the U.S. about
the negative reaction many doctors have to HIFU (see David's post above) he laughed and said I should have seen the what surgeons had to say about
da Vinci when it first came along. For me, HIFU was a pretty near no downside option as likely to cure me of this disease as surgery.
The reason the downside was pretty near, and not total, wasn't a medical issue for me. It was a personality issue. With HIFU there is no pathology afterwards. No nodes to have a look at. One doctor, not the HIFU doctor, said that was true, but what did I care? After treatment, be it surgery, or HIFU, the only thing that mattered was PSA. With either treatment the measure of success wasn't the pathology, it was a life time of PSA zeros. However, I knew that when I went from being a Gleason 6 to a possible Gleason 7 my personality type was such that I would not rest easy without a pathology report. And so I went the da Vinci route and now, with the combination of the 'excellent' pathology and my first zero PSA I sleep well at night. That's just me though. Others can be happy knowing that PSA is the real issue after treatment, and pathology is yesterday's story. And there are lots of people here to prove that right. But, I'm a happy camper with my pathology report. If my PSA starts to rise is isn't worth squat though, and if my PSA stays at zero, it isn't worth squat. Yet, I know without it I'd not be happy.
I think your decision tree is first, do you want surgery (the tried, true, and tested "gold standard") or are you happy, because it is a low grade disease, (confirmed by a second read) with one of the other treatment options. Then, if you are happy with one of the other treatment options the only valid reason not to have HIFU on your list of possibilities is cost. If cost is not an issue, then I believe HIFU along with seeds, freezing, watching and waiting, etc. deserves consideration. You may decide to go with one of the other options. Each has it's good points and not so good points. The only case I make for HIFU, is that if your decision tree moves you away from surgery, and if cost is not an issue, then it is a mistake to not investigate HIFU as you would the other options.
You'll find out that there are differences of opinion in this forum, as there are with doctors. You'll also come to learn if you keep coming here and asking questions that as much as we may have differences, it makes no never mind to any of us what you decide to do --- except each of us wants to help you make the best decision as to what YOU feel is best for you and your husband. In the end there are no right answers, just choices with consequences that you and your husband will have to assess and live with. Husbands and wives here have all been there, or are on the decision journey with you. In our dark hours folks here helped us, challenged us, bullied us, and held us, through decisions and treatments and now we all feel an obligation and need to help others --- not because we have an agenda, but because we care. I think the above exchange between David and Jeremy is ample evidence of this.
I hope the above is helpful and I hope you'll continue to vist, let us know how you're doing, and do us the honor of asking for help/guidance when you have questions. This forum is full of great resources.
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"
First post op PSA Sept 09 0.02
Oct 1st 09 -- dry at night, during day some stress issues, but better every week.