Brachytherapy, IMRT, Nanoknife or Active Surveillance

[Aussieguy1]

Hi

I recently obtained a second opinion from Professor Stricker, NSW, Australia. I’m in Tasmania.

Active surveillance now for a little over 12 months. Sought a second opinion from second urologist mentioned above.

Professor Stricker stated that due to 80% volume in two core samples and 5% in one other I should consider Low dose Brachytherapy, IMRT or Nanoknife. I’m Gleason 6. MRI PIRADS 4. Now rather then feeling happy with my decision of Active Surveillance I’m feeling a little concerned.

Last PSA 5.4. Latest MRI only difference is tumour size now 8.5mm from 8.2mm.

DRE felt left sided nodule. MRI left posterior perhipheral zone at the gland apex.

Any opinions, should I stay on Active Surveillance or get a referral to a Radiation Oncologist? I know the decision comes down to me, just seeking your expert opinions.

Thanks Ian.

[Darryl Partner]

You might ask your first urologist what s/he thinks about prof strickler’s suggestions

[Aussieguy1 in reply to Darryl]

Thanks Darryl. I did so via a Tele consultation, he assured me that Active Surveillance is the way forward. PSA to be done again in October.

Thanks for your reply.

[DD2020]

Might not hurt getting a radiology oncologist opinion. With felt bumps on dre, have you gotten a good MRI to see if you are close to the prostate margins? Are you positive it's all G6? If either of those have worrisome answers, get the second opinion.