Let me clearify: low risk G6 is small tumor (less than 3 cores and less than 50% core involved), PSA under 10. PSA doubling time >3 years. No nodule detected. This type of low risk PC has very little chance of killing you.
If you have a detectable nodule, a high psa, or a doubling time <3 years there is a good chance of the PC progressing into a harmful pc over a number of years. and you need treatment.
There is a subset of G6 which are varients that are very dangerous; they progress very rapidily, in 6 months, even if treated. These are the 2% that are usually fatal.
Even when G6 tumors escape the capsul they grow very slowly and are easily controlled by HT.
Basically 70% of G6 tumors will show no signs of progression; around 30% do progress, either by a rising psa or move to a G7. These are easily treated with any local cure at the same 95% rate. The ones that have escaped the capsul are controlled by HT, so there are very few fatalities.
It is important to verify that you have low risk and not just an undersampled biopsy. A color doppler Ultrasound does a good job as well as having a psa history of at least two years with at least 8 data points. This will uncover any undersampling of the original biopsy.
I didn't mean to overly simplfy this in my previous post.
Most people with G6 tumors don't have a lot to worry about
. the cure rates for all treatment options are in the mid 90%; the cure rates for community hospitals vs major cancer centers are in the mid 90%. I don't think that this is a coinsidence; It's much more related to the PC's agressiveness than the treatment or skill of the doctor. This is not true of the more advanced PCs. The small 5% of G6 that aren't cured are controlled with HT. So the 2% fatality rate makes sense.
The message that I was trying to convey is tht G6 tumors have a low fatality rate because many don't progress and the ones that do are easily treatable. Not that you shouldn't treat those G6s that don't fall into a low risk catagory or ones that show signs of progression.
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.