It is hard to say if you really can wait a couple years to decide or if you should make a decision within a month or so, as the surgeon suggested to you. A Gleason 6 is not a very aggressive cancer. But I would also remind you that the clinical pathology (the biopsy report) is just a prediction and estimate.
There are numerous times when the post-op pathology, after the removed prostate has been directly examined, revises the original assessment to a higher Gleason score. And, of course, sometimes the post-op pathology revises it downward also.
But with the hard spot on your prostate, I would think that you would NOT have a couple years to wait, as the RO said.
*****Edited Addition: This is particularly true since you had 6 of 12 positive cores. And, with that hard spot on your prostate, it seems quite likely that the tumor(s) are near the edge and, as you said, large volume. This is nothing to fool around with.*****
In my humble and highly uneducated opinion, I would think that you should be thinking now about
treatment in the very near future -- whether it is radiation or surgery.
As you suggested, the time to get it might be now -- before it has a chance to escape the prostate capsule.
Anyway, this is just one of many thoughts that others will be sending your way.
Good luck with whatever you decide!
Resident of Highland, Indiana just outside of Chicago, IL.
July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA Sept. 2011 was 5.7.
Local urologist DRE revealed significant BPH, but no lumps.
PCa Dx Aug. 2011 at age of 61.
Biopsy revealed adenocarcinoma in 3 of 20 cores (one 5%, two 20%). T2C.
Gleason score 3+3=6.
CT of abdomen, bone scan both negative.
DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
My surgeon was Dr. Matthew Tollefson, who I highly recommend.
Final pathology shows tumor confined to prostate.
5 lymph nodes, seminal vesicles, extraprostatic soft tissue all negative.
1.0 x 0.6 x 0.6 cm mass involving right posterior inferior,
right posterior apex & left mid posterior prostate.
Right posterior apex margin involved by tumor over a 0.2 cm length, doctor says this is insignificant.
Prostate 98.3 grams, tumor 2 grams. Prostate size 5.0 x 4.7 x 4.5 cm.
Catheter out in 7 days. No incontinence, occasional minor dripping.
Post-op exams 2/13/12, 9/10/12, PSA <0.1.
Semi-erections now happening 14 months post-op & getting stronger.
Post Edited (HighlanderCFH) : 1/26/2013 2:07:46 AM (GMT-7)