Let's look at the facts and not conjecture. Only 2% of Gleason 6 patients ever die of PC; If it does show signs of progression any local treatment has the same cure rate as immediate treatment. The deaths from a G6 come from varients that manifest themselves with in 6 months and death occurs within 5 years REGARDLESS of treatment.
The biggest risk from AS is misidentifying the grade of PC. There are several ways to alliviate this risk. 1. get a color doppler ultrasound and 2. Monitor the PC over a period of at least 2 years. 8 to 10 psa data points over 2 years can accurrately indicate progression. If it does progress it will do it very slowly; that's why it's not terminal.
If you undergo treatment you will be 100% certain of side affects and a very good chance of permanent side affects that will affect your quality of life for the rest of your life.
Your G6 will not turn into a G8 in two years; So you have plenty of time to monitor the situation with out undergoing a drastic treatment. Many well noted surgeons are now coming to the conclusion that oncologists have know for years; the cure for low risk PC is more harmful than the disease.
If you choose to get treatment the facts are that for low risk PC every treatment option has the same cure rate. (This ought to tell you something), so the side affects are the most important part of the decision choice. Spend your time and effort researching the side affects and the doctors.
You can "what if" yourself crazy thinking about
all the things that can happen, but the facts are with a G6 you will live to an old age and die os something else 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.