Let me add my welcome to the forum as well. One of the options you mentioned was CyberKnife and I chose that as my treatment course with a 3+3=6 Gleason, PSA of 4.3, 1 of 12 cores positive with 15% involvement. No physical symptoms and DRE was normal.
During the course of my investigation and research I consulted with
open and robotic surgeons, a brachytherapy specialist, another radiologist that uses IMRT, and proton therapy at Loma Linda Medical Center in Southern California.
As you're learning now, most of the treatments for initially diagnosed low risk PCa have similar success rates. For me, it became a matter of minimizing potential side effects while getting the best shot of eliminating the cancer. I built a matrix that listed treatments across the top and side effects and other factors important to me along the Y-axis and ranked them according to my priorities of quality of life after treatment. At the end, I ended up with CK and I have no regrets.
I agree with another poster who suggested that choosing a primary treatment based on secondary options was foolish. I think you should go for the best option possible and CK, like other forms of radiation, has back up options too although to date very few have been needed.
I encourage you to consult with a CK radiologist directly if you are interested in this procedure. Most other radiologists or surgeons will not be familiar with this hypofraction approach or why CK is particularly effective for low risk prostate cancers because of alpha/beta ratios and dosage patterns.
I had my treatment in June 2010 and have zero side effects. No urinary issues, no bowel problems, no ED, no fatigue. My PSA has steadily dropped from pre-treatment PSA of 4.3 to 0.83 at the end of December.
Other treatments will probably be equally effective for you in treating the PCa but all will have varying degrees of side effects. Make sure you understand them all completely before you make your decision. I also suggest that you consult directly with a specialist in the area you are considering. Don't ask a DaVinci surgeon about
open surgery and don't ask a IMRT specialist about
brachy or protons or HIFU.
As others suggested, I would also get a second opinion on your biopsy report.
Best of luck to you.
Dx: March 2010
PSA @ Dx: 4.3 (Latest PSA = 2.8 after elimination of dairy)
Gleason: 3+3=6 (confirmed by second pathologist)
Biopsy: 1 of 12 cores contained adenocarcinoma at 15% involvement and no evidence of perineural invasion
Bone scan and chest x-rays: Negative
Prostate Volume: 47 cc
PSA Velocity: 0.19 ng/ml/yr
PSA Density: 0.092 ng/ml/ccm
PSA Doubling Time: > 10 Years
Treatment Decision: CyberKnife radiation treatment in June 2010. Side effects: None