Without knowing your gleason grade and clinical staging it would be difficult to make a recommendation on a treatment optiion.
As Dr Strum preaches, the biology of your cancer dictates the most effective treatment.
The 1st step is to know your risk type. You can find this on the Prostate Cancer Research Institute's website. There are also several articles for the newly diagnosed that are very helpful.
Some say that side affects are not important; I disagree. Approximately 50% of the posts on this forum relate to side affects; they are not important until you have to deal with them, then they become very important.
Most treatment for low and intermediate risk PC have the same cure rates, so the only real difference is the side affects. Get 2nd opinions from a prostate oncologist, a surgeon and a radiologist, and not from the same center or from referrals, as these have a built in conflict of interest. The 2nd opinions should have no connection to one another.
The best advice is to take your time and not act quiclky because of fear. We can answer most of your questions regarding various treatment options and their side affects when you have a better handle on your staging.
Some tips on staging:
Forget a bone a Ct scan unless you are in the high risk catogory, these will only cost money and provide little useful information.
A color doppler ultrasound and an MRIS will help in proper staging.
A PAP and PCA3 test are inexpensive and and give a better idea of the biology of your PC.
Get a 2nd opinion on your biopsy slides from Epstien or Boswitch.
Once you decide on a treatment find the absolute best artist to perform it as this will have more bearing than the treatment itself. There is a huge difference between the best, the good, and the average.
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.