Posted 5/12/2020 7:53 PM (GMT -6)
Hi everyone, great forum, and I've spent the last day or so getting acquainted with it and reading LOTS of good info. Very helpful and reassuring to say the least, thanks!
In my case, after seeing rising PSA levels (6,7,8) starting in 2018, I found a good urologist through Kaiser here in Oregon, and had my first biopsy in July of 2019. Three of the twelve samples showed 3+3, with 2 of them involving 5% of the core, and the other one involving 80%. An MRI was done soon afterwards, and the imaging confirmed the biopsy results, and found no other affected areas in the pelvic region.
I elected to start active surveillance with PSA tests every 3 months. During the next year and a half, my PSA results went from around 8 to 12, and I had a 2nd biopsy in April of 2020, 22 months after the 1st one.
This one showed malignancies in 6 of the 12 samples, and as before, they were all on the right side. Two of them were graded 3+3, three were graded 3+4, and one was 4+3. My urologist discussed treatment options of RP, EBRT, SBRT, or BT. A bone scan and CT were ordered, and I completed the bone scan today, which thankfully came back negative.
A good friend had a RP via DaVinci 11 years ago, and we've had multiple conversations about it. He's still cancer-free, and although his urinary function is not 100%, he has no regrets about his course of action. That said, I'm leaning towards SBRT, and my urologist said he will set up an appointment with a RO to discuss. In the meantime, I was able to speak with a 2nd urologist to get his opinion, and like my primary urologist, he said ultimately the choice is mine, but said if it were him he'd do the RP because of my age.
I'm 54, and my concern is that if the side effects from RP by chance don't improve over time in my case, then that would become a quality of life issue for me. On the flip side, if I choose SBRT and the cancer recurs, then my treatment options are more limited than if I would have chosen RP in the first place. Both urologists said that they believe the success rate of both treatments are equal. I'd like to avoid the very real side effects of RP, but do want to leave my options open in case of recurrence. It's a tough decision.