Hello to the group

[GayLaw]

After two negative biopsies and an inconclusive MRI, I was recently diagnosed with prostate cancer after a saturation biopsy (40 cores). Results showed a Gleason 3 + 4 with PSA of 12. Currently considering treatment options, though current recommendation is radical prostatectomy. I am 49 years old and African American.

[Tall_Allen]

It is not unusual in African-American men for cancer to be "hiding" in the anterior. It's a good thing you had the saturation biopsy. What percent of the cores had GS 3+4? It's a good idea to get a second opinion from Epstein's lab at Johns Hopkins ($250).

For your "favorable intermediate risk" PC, you have several good treatment options in addition to surgery, all with similar expected oncological outcomes. They are:

• SBRT (external beam radiation in 5 treatments)

• low dose rate brachytherapy (seeds) as a monotherapy

• high dose rate brachytherapy (temporary implants) as a monotherapy

(You do not need hormone therapy or any kind of combination therapy)

You have to seek out specialists in each of those to get the real skinny (outside specialists will give uninformed opinions). Don't let anyone tell you you're too young - there is no evidence for that. I did not include IMRT or protons because they are unnecessarily drawn out and costly procedures with no better outcomes than SBRT.

[EdinBmore]

Get second opinions for urologists, radiation oncologists, and if trying to reconcile different opinions (and specialists will disagree - each will try to sell his approach as the best treatment), then, consult with medical oncologist (he tries to reconcile options and offer "unbiased" opinion). Also, you might want to visit National Comprehensive Cancer Network online and and read about treatment options for different "degrees"/stages/grades of prostate cancer. Basically, they provide decision "trees" of available treatment options. Can be difficult for a layman to understand it all (and there is a version written for laypersons)but I found it helpful in narrowing down my choices. Give yourself time to learn as much as you can, ask questions, make sure that the docs know that you're gay and what your priorities are. Good luck to you.