Cancer Treatment Centers of America

I am considering CTCA because: PSA is 18.52, Gleason is 3+3, 22 core biopsy with 3 areas pre-cancerous and one area cancerous one core 9%. MRI & Bone scan show no signs of spreading to bone or lymph nodes. However, could be at or in the seminal duct (MRI was not conclusive). I am hoping to do immunotherapy and last resort Nerve sparing da Vinci surgery.

I'm also considering focal laser ablation but my greatest concern with this procedure is even though it has less side effects (short term), radiation treatment seems to have side effects that effect ED 5 years later which continue to get worse and they are not reversible.

If considering radiation beam therapy and you are in the USA, you might investigate Proton Beam Therapy. But like all radiation therapies the question remains about what one does if PCa (Gleason 6 is not PCa in my view) returns.

The answers to the many questions I had led me to have a Robot-assistaed Prostatectomy. That's done and dusted with no PCa in lymph nodes (post-op path tests). I am only seven weeks post-surgery, but am happy with the decision.

I wish you good outcomes.

I agree with stewarta. Gleason 6 is low risk when compared to higher grades. Has your urologist suggested active surveillance instead of surgery? Here you seen more than one urologist? Was your MRI reported on by a person specialising in prostate images? This is key.

also you say your PSA is 18. What about earlier or later PSA tests? Or do you have only one?

I am in the USA. I was having trouble with emptying my bladder and also varying weak stream my GP did a DRE and I had two PSA tests done about 3 months apart and then refered me to a Urologist. I have seen two urologist. The first one did a cystoscopy and then just wanted me to jump on the table and do green light (PVP) surgery to destroy the giant third lobe. He wasn't concerned about the high PSA score and didn't think a biopsy was needed. I didn't like the idea of retro-ejaculation so started to look into the PAE procedure but I was still concerned about the high PSA score. That's when I went to the 2nd urologist. He poo-pooed the PVP procedure and said it would be a bad idea because with the third lobe pressing into the bladder, there is a chance the laser could damage the bladder during the procedure. He wanted me to do a biopsy but I insisted on an MRI before I would allow a biopsy. Unfortunately the MRI showed 4 areas of concern which is when I then agreed to do the biopsy. (I have already shared the results in an earlier post).

Based on the results of the biopsy, the second urologist wants to do a Robotic Suprapubic prostatectomy because of how large the prostate is and because of the cancer. He said we could do active surveillance but that would require a PS test every three months and a biopsy every 18 months.

So that's why I was considering visiting CTCA or someplace like the Sperling prostate center.

Unfortunately Sperling is not in-network with Blue Sheild/Blue Cross and they charge $30,000 to do the focal laser ablation procedure.

I'm not too excited about any of my options. Eventually (at age 56) I will have to deal with the cancer. I'm just thinking it is easier to deal with it in the earlier stages now instead of later.

I probably shouldn't say this but I have actually thought about doing nothing and just let it play out to whatever happens, happens. But that's not fair to my wife (and kids who are all adults now). It's not logical thinking and does not set a good example for others around me.

Thanks for your comments. All your thought are good. I am not rushing into anything. I was only going to CTCA for a 2nd opinion and more knowledge on my condition and o get their recommendations. They have offered to pay for my flight (and my wife's flight) to come out. They have agreements with several nearby hotels which we can stay at and will only cost us $75 for 3 nights. In those 3 days, they will meet with me and will evaluate my test results (which I have already had performed locally) and then. give me their recommendation based on my goals. No decision to act on their recommendations is required and if I choose to delay doing surgery or other procedures they recommend until later, they will fly my wife and I out for free a 2nd time at no cost.

Oh, I almost forgot, I don't plan on doing any more biopsies. It wasn't that bad. I just don't think it is healthy to go poking around like that. I wasn't even going to do the first one but with the combination of the PSA at 18.5 and the MRI T3 showing 4 areas of concern, I figured I needed to know what I was dealing with.

Interesting.

May I ask which facility are you considering visiting? I ask as I am looking into US hospitals as well. Until I read your post I was unfamiliar with CTCA.

Given what you found out about the PSA and four suspicious regions, I agree that the first biopsy was useful. After all, PCa cannot be confirmed without a biopsy.