I was recently diagnosed with PC. I am 48, single, in good health, and have no other symptoms. It was caught with a blood test and I was told that the doctor couldn’t feel a tumor with a dre. My psa is 5.8 and they say I have a T1C with a Gleason of 7 (3-4). I have been to 3 urologists and 2 recommend surgery and one external and seed radiation. All make a good case for their opinions and I can’t find anything other then the doctor’s opinion that their approach is not the best.
Radiation guy truly believes that is the best approach and I have to admit that he makes a good case. In particular I am attracted to the numbers, I can understand them, and can live with the likely results. There seems to be less uncertainty about what life after will be like.
The surgeons tell me I have to think in terms of decades and surgery is the best bet for life expectancy. From everything I can find the results of the two approaches are nearly identical in terms of cure, life expectancy, and continence. Unfortunately, nerve sparing is a question mark for surgery. There seems no doubt that the nerves on the left will have to go and I can’t get them to give me odds on the right. One says he thinks he can spare it and the other says he can probably spare it. The biopsy shows the left side is more involved with all biopsies showing a cancer up to 80% involved with the Gleason’s of 7. The right had 3 biopsies, one 20% involved with a Gleason of 7, one 10% involved with a Gleason of 6, and one clear of cancer. The doctor recommending radiation told me that I am not a candidate for nerve sparing surgery at all. Therefore, the surgical approach seems to have the most uncertainty as far as potency is concerned. My internist also feels surgery is the best approach from a life expectancy view.
I also like the idea of surgery because it gives you a second chance with radiation if the cancer were to return. Again, there seems to be no consensus here either. The doc recommending radiation says there is an 80% chance I will have to have radiation after surgery anyway, one surgeon says 50%, and the other surgeon says there is virtually no chance. I am led to believe that the radiation is a one shot deal with the local life time max, eliminating the second radiological chance.
I believe they are all telling me the truth as they know it. I am looking for experiences, how you made the decision, what your life after treatment is like, or anything else you think I should be aware of.
Thanks in advance
Mike