Posted 3/24/2020 4:52 AM (GMT -6)
OK, it sounds like he's got 2 tumors (not unusual, PC is usually multi-focal), one in the peripheral zone that likely has escaped the capsule and is possibly invading the nerve on one side. The other is in the center, and is protruding a little.
Good news is, no evidence of anything outside the immediate gland area. Nothing in the pelvis, lymph nodes, etc.
We will see what the second biopsy says.
That being said, even if the G6 diagnosis holds, he probably needs treatment. And, I would think that something like SBRT would be great for him. It poses less risk to the nerves (lower chance of ED) and can be calibrated to hit a slightly wider area than the gland itself and so take care of any little beasties that have escaped into the pelvic bed.
With the nerve involvement, surgery would probably guarantee significant ED and with the tumor on the edge of the peripheral zone, chances of bad incontinence goes up with surgery.
It does look like the answers are coming. Hang in there.