Hello - My story starts with a PSA at 13.8 [Jan 2019], up from 4.2 [May 2016]. It was retested at 13.87 [Feb 2019]. I completed TRUS biopsy in Feb 2019. Results were 3 of 12 positive; 1 core Gleason 3+4 in L anterior apex involving 15% of 1 of 3 cores; 1 core Gleason 3+3+ from R lateral [microfocus of adenocarcinoma] & 1 from R anterior apex Gleason 3+3, with 1 of 3 cores in R anterior apex involving 30% of 1 of 3 cores. I completed at CT bone scan - results negative for metastasis. I met with the Surgeon who felt active surveillance might be a good plan, subject to further info from an MRI. I completed a 3T MRI in Apr 2019 - prostate volume 47 ml, PSA density 0.28 ng/ml/ml - they noted 3 tumors, with one described as "focal lesion within L apex and mid gland peripheral zone - PI-RADS4 - no evidence of extraprostatic extension, no pelvic lymphadenopathy". Given these confirming results the Surgeon suggested treatment - surgery or radiation. Thus I would forgo a fusion-directed biopsy. I've also met with the Oncologist who discussed my situation, described as "favourable intermediate-risk prostate cancer, clinical T1c". We discussed different radiotherapy - LDR & HDR brachytherapy, external beam radiation alone, and Sterostatic Body Radiation Therapy [SBRT] - which they suggested might be a good course of treatment in my case. I've since been trying to educate myself, reading Dr Scardino's Prostate Book, checking this site and reviewing articles and videos.
Questions - Any value pursuing the fusion directed biopsy? How are people's experience with SBRT?