There are risks in any decision and certaintly risks in any treatment and no 100% garentees.
The largest risk in AS is underestimating the initial biopsy results, this is why it is imperative to get another biopsy or a color doppler ultrasound within 6 months.
If it truely a G6 then there is a 70% chance that it will not progress. This is well documented by studies from Hopkins and Klotz. If it does progress to a G7 or if psa doubling time is less than 3 years then treatment should be given and the results are exactly the same as if treatment was given immediately. This is also well documented. Progression, if it occurs, almost always happens within 3 or 4 years.
These are simply the facts, but are often overridden by emotion, as 25% of those on AS choose treatment without any signs of progression.
The treatment success in a G6 is in the high 90% regardless of the treatment chosen. The chance of permenant side affects are well over 50%. You have to do your own risk benefit analysis, but the risks of AS seem very favorable especially when you consider that 60% of men your husband's age have some sort of PC and only 4% actually die of it and these are almost always those with G8 or G9 cancers.
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.