Just diagnosed a month ago. I am 54 years old, psa 4.1 Gleason score 3+4. I am in the higher end of intermediate risk. My PSA has gone up and down for a couple of years. 12 samples were taken for the biopsy, 7 of 12 positive T2b. urologist recommended Radical retropubic prostatectomy and mentioned radiotherapy. I have searched the net and found some good information and some contradictory. I talked to a radio oncologist and I am looking at brachytherepy followed by external radiation. Anyone have this therapy combination, results?

Thank you!

6 Replies

  • I am 62. My urologist recommended for me to have surgery. He felt it was the best option at my age. He advised against brachytherapy and radiation.

  • Hi Jay, question, Urologist recommended radical retropublic prostatectomy, I had DaVinci robotic prostatectomy, is this the same procedure? I'm your age, had surgery last September with very good results.

  • My numbers were not too different from yours. Looked into both radiation (both external beam and brachytherapy + limited external beam) and, because of both potential side effects and likelihood that cancer had not spread beyond prostate decided on laparoscopic robotic radical prostatectomy -- referred to by a (doctor) friend as "cold, hard steel" Had surgery at Memorial Sloane Kettering, Dr. Laudone. Highly recommend both hospital and surgeon.

    Also recommend (in addition to "usual suspects" book by Dr. Walsh [3rd Ed.]) recent article in (I believe) "Urology Journal" by Dr. Zelefsky et al. on L/T side effects of radiation-based vs. surgical approaches (L/T results not much different, sequence different). If you can't find article, call Dr. Zelefsky's office (Head Radiology at MSK) and ask them to send it to you. Also ask them to send booklet on actual procedure before-during-after brachytherapy

    Hope this is helpful Best of luck

    ps, I'm 68

  • I was diagnosed at age 54 too. Because my eldest brother had an aggressive prostate cancer I chose to not chance his route and had DaVinci removal. I am 5 years undetectable PSA and believe I am cancer free. My brother died 5 years ago from prostate cancer.

  • I was diagnosed at age 52 (75 now) I opted for radical surgery as brachytherapy was relatively new. My Urologist recommended surgery as did my primary Doctor and several other general practice Docs I knew. I am also a facilitator for our local PC Support group and have heard mixed results from brachytherapy. Although brachytherapy is the easier option, at your age, I personally believe surgery is the better option from what I have gathered over the years.

  • Hi Jay I'm in a similar position as you although my PSA was 7.5 and blessings was 4+3 slightly more aggressive. I was diagnosed at 54 in Feb and had my prostate taken out 29th March 16, my urologist has suggested I have a short course in radiotherapy as my cancer was close to breaking through the prostate wall, even thought it hadn't this is been suggested as a precaution just incase there maybe some nearby cells that got infected. I have my oncology appointment this Friday.

    Sorry that's Gleeson score was 4+3



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