Welcome to Healing Well. Sorry you have to be here but I think you will find lots of support and lots of good info on this site. I am one of several brachytherapy (seed) patients who post here and will try to give you some perspective from my angle. If you would like to see my "journey" with the seeds, feel free to cut and paste the link in my signature.
Your post raises a whole host of issues and I'll try to repond to all of them:
1. A six core biopsy is hardly state of the art as you surmised (unless it is done in conjuction with a color doppler scan). Most men here have 10 or more...I had 16. So, sorry to say, that alone should give you some question about the competency of your current urologist. At the very least you should inquire as to why he took so few cores.
2. The question about prostate size is pertinent. Most radiation docs like to seed prostates that are 50cc in size or smaller for best results.
3. You should consult a radiation oncologist and a prostate oncologist (in addition to a surgeon) before settling on a treatment. You definitely want to become educated re the options. You may want to ask them about color doppler staging given the small number of cores in hubby's biopsy.
4. BT alone is frequently done for men with Gleason 6 graded cancer OR G7 men with a small percentage of cores and/or a small percentage of cancer in the cores. You will want to discuss this in depth with the radiation oncologist and the prostate oncologist. They may want to add IMRT to the BT depending on their assessment of the cancer.
5. BT is HIGHLY CURATIVE in men who are eligible for the procedure. The success rate is as high as for men who have surgery but with much less onerous side effects. If quality of life is a concern, I suggest you seriously consider this option. You may want to Google "New England Journal of Medicine Quality of Life" to read an interesting study re that topic.
6. The books I suggest reading are Walsh's "Guide to Surviving Prostate Cancer" (a good primer), Strum's book (title escapes me now) and a brand new book by Blum-Scholz called "Invasion of the Prostate Snatchers". Despite the title of the latter, it provides valuable perspective that I believe every patient should have..especially about quality of life.
7. Experience matters. Whatever treatment you choose, please make sure that the doctor has done hundreds of procedures. Studies show that success is better at 250+ procedures and then it levels off. It's no guarantee, but it gives you better odds.
8. There are men who bounce back quickly from the surgery but I would say the norm is that it takes a while...don't be fooled by the da vinci ads.
9. The scans at this time are very unlikely to show anything and are likely a waste of time and money with G7 and PSA under 10.
I have tried to be fair in my assessments about but I can tell you that I am absolutely biased in favor of brachytherapy based on my research of this cancer as well as my own personal experience...so that's my qualifier.
Please feel free to email me or ask any other questions. This decision IS a big deal. You don't have to rush and you should get all of the info available before jumping. Best of luck and please keep us informed about your hubby's path.
Age 62 (64 now), G 3 + 4 = 7, T1C, PSA 4.2, 2/16 cancerous, 27cc. Brachytherapy 12/9/08. 73 Iodine-125 seeds. Procedure went great, catheter out before I went home, only minor discomfort. Everything continues to function normally as of 9/10/10. 6 month PSA 1.4, 1 year PSA at 1.0. My docs are "delighted"! My journey: