5 years ago there were only a few doctors that recommended WW. Today there is a groundswell of doctors from every PC speciality arriving at this conculsion. As Scardio recently said, surgery is a pretty severe recommendation for those with low risk PC, because only 2% will actually die from it and 100% will suffer major complications. Klotz in his studies indicates that 3% of G6 pc is a varient and no treatment will result in a cure, regardless of the treatment or time of treatment. Hopkins says that delayed treatment is just as effective as immediate treatment.
So on one side you have all the data that says that low risk PC is just that, low risk and the cure is much worse than the disease, and on the other hand you have emotion that says "I just want it out now".
It's your body and your choice, but get all the facts before you make a decision that is entirely based on emotion. If you want to feel a little safer then get a color doppler or a 3D mapping to give you a better idea of the extent of your PC so you can make a more informed decision.
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.