Plus PSA 7.6 and 9/21 cores positive for cancer. I would appreciate any insights from people who have had to make this decision, and anyone who started on surveillance and then switched to removal.
For the last 4 years of AS I had plenty of time to get information. Books from John Hopkins Hospital with years of recording patients outcomes and other PCa books.
I quote one chapter: " Localised cancer options are robotic assist laparoscopic prostatectomy and prostate radiation therapy. In general if one is young and in good health the option choice is often surgical removal as this is a highly effective means of long term cure. RT can be an excellent alternative to surgery with similar cure rates and less adverse effects and is often the choice in older or less healthy population as well as men reluctant to undergo surgery."
So here we are, the specialists don't really give a straight answer. Apart it surprises me that RT comes with less adverse effects. With treatments you have immediate effects and side effects that can come after10 years or more so , is it easy to compare??
So it stays a personal choice without clear parameters.
I was diagnosed Gleason 3+3 and 4 out of 24 cores disease after a starting PSA of 4.65 in August 2019. After consultation I went on AS as I was told PS was a "sloth like" cancer. I had periodic PSA checks showing an increase to to 6.08 until repeat MRI and biopsy in 2021 which revealed Gleason 3+4 and 5 out of 25 cores. The recommendation given was for treatment. The options being radiotherapy or surgery. I am scheduled to have RALP on 25th July, nearly 3 years after initial diagnosis. I am 67 years old. I have received great support from my local urology department but I have an unfounded suspicion that they see greater success at aiming available resources towards patients who are relatively fit and are within an unspecified age bracket. I therefore wonder if the same treatment options would remain open if I stayed on AS. I suppose the decision is based on: 1.How aggressive is your PC? What options remain open if your choice is to stay on AS?
When you say "with treatments you have immediate side effects" -- you mean RT treatments? But then one sentence earlier you said RT comes with less adverse effects. So, I was not clear what you meant.
I will be following you. My situation is very similar. It seems you are going in tomorrow for RALP. I'll think good thoughts for you and that your recovery is swift.
