Hello! Glad to have found this forum – seems like a lot of very helpful people here. Been doing a lot of reading. I appreciate those that have taken the time to write informative replies, articles, and blogs.
After an mpMRI found a 7mm lesion near the base, I was recently diagnosed with prostate cancer with several positive cores. The local pathologist rated the lesion at 4+3. On a 2nd opinion request, Dr Epstein reduced that to 3+4, but also added cribriform morphology. 59 years old, PSA is 4.7, gland is 62cc, DRE normal, T2A per UR. More notes in my profile.
I’m not sure if I should be considered favorable or unfavorable intermediate risk. Regardless, I am studying for what treatment to choose. Although I like my UR (1,200 RALPs) I am probably going with radiation.
The RO I have seen (has treated 1,500 for PCa) suggests either 8.5 weeks of VMAT with cone beam CT scanning, or 5 weeks of the VMAT with a seed boost. He said he is personally biased towards the seed boost for someone my age looking to live 20+ years, and does not recommend ADT for me. He has a SBRT system but does not use in on PCa at this time (not the “standard of care” in his health system).
I can probably easily get a referral to another cancer center in town that I believe has the Tomotherapy and Cyberknife systems, but as of now I am unaware of their prostate cancer program.
I have mild urinary issues with BPH and understand the seed boost will make that worse for a couple months, but I can get through that. Does radiation eventually help with BPH caused flow issues? Do you guys think I should look at another RO with SBRT or other? What questions do I need to ask to help decide? Of course continence and potency comes into play too.
This is a stressful time.