PC is either agressive or non agressive. That's why the treatments for low risk PC show similar results and cure rates between the best institutions and the local hospitals are similar. Also why the cure rate for immediate treatment and delayed treatment is also the same.
The basic stats are as follows: 70% of low risk PC will never progress. 30 % will progress slowly and if treated on signs of progression have the same cure rate as if treated immediately, about
3% of low risk PC is agressive and will kill you in 5 years regardless of the treatment; this will manifest within 6 months as psa rises quickly.
Now, what are your options:
Have treatment now and live with the side affects, but will know you have an excellent chance for a cure.
Wait and see if the PC progresses and get treated then and have an excellent chance for a cure or it may never progress and you avoided all side affects.
If you get treated you have the options of surgery, seeds, external radiation, HIFU, and cyrosurgery. All have the same cure rate in low risk PC, but all have very different side affects. You will have to research and see what side effects you want to live with.
In any case, the odds are in your favor that you will live a long prosperous life regardless of what you do.
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.