Husband just diagnosed positive pc - his # 6

Don't rush for a second opinion as your PSA results will confirm if Cancer is there or getting worse. Listen to all options given, then make a choice, and then maybe a second opinion on what is best to do. Remember each Consultant has their own favourite option, so it is your choice in the end.

Patty,

You didn't mention your husband's age. This is important because radiation is usually recommended for older (>70) patients and removal (RRP) is normally recommended for younger patients. This is because the robotic operation is major surgery, whereas the radiation is relatively easy - no hospital stay, no cutting. If you husband has Gleason 6 then he has plenty of time to interview doctors and decide what to do.

A major downside to the RRP operation is that it can take a year to regain full continence again. On the other hand, with the radiation there can be prostate irritation and swelling. I had that and had to use Foley catheters for almost six weeks until I could pee on my own again. Also, with radiation, the prostate is still there - so then you can have BPH issues later on. With the RRP the prostate is gone forever so no BPH problems.

I my case I had some radiation issues years later - numbness in my penis, loss of erections, and now bladder irritation that is keeping me up at night - typical symptoms of frequency/urgency/nocturia. I had my radiation five years ago - haven't had a good night's sleep in a couple of years. Thought this was from retention so I had a bipolar TURP operation three months ago - but still have a very sensitive bladder. Urologist calls this radiation cystitis. Very annoying.

Also, after the RRP you can later have radiation if the cancer returns. After radiation, it is a much more difficult operation to remove the prostate later.

The RRP success depends on the skill of the surgeon and surgical team, but the with radiation it's mostly controlled by the computer, so surgeon skill isn't a big issue, same with Proton Beam.

I had HD Brachytherapy - two sessions. Most external beam radiation is 40 sessions, very fast and easy, however. Proton Beam is also 40 sessions, very few places where this is done.

If I had to do this all over again I should have gone with the RRP because then I wouldn't have had to deal with BPH symptoms later. I have had a PAE and TURP, but am still taking Flomax twice per day. I didn't go with the RRP because I was concerned with permanent incontinence, but what I got was the opposite - retention, BPH aggravation and insomnia issues.

No way around this, difficult choices.

On the good side, Gleason 6 is fairly benign, and some doctors say this shouldn't be called cancer at all. You have a lot of time to decide what to do, if anything. Not doing anything (active surveillance) IS a treatment option but caused me anxiety. Getting a 12 core biopsy every 18 months was nothing fun. After I got my radiation and my PSA dropped to almost zero my anxiety went away.

My very best to you, Tom

thank you so much TOM. HIS DR. did give the wait and watch option which is what we will do until we can get other opinions .

ive heard once you get radiation, and it returns,its much harder to remove or cure. SO SCARY BUT I THANK u FOR THE INFO!

by tge wsy hes almost 62 years okd

Hi Patty,

As others have mentioned, your husband has time on his side.

A Gleason 6 is considered by many as not a cancer that will spread. It is at the bottom of the

scale ranging from 6 to 10.

If I was your husband I would have 3 monthly PSA tests and see what's the results. If the PSA rises dramatically ie doubles in a year, THEN it's time to consider options. It is also very probable that the PSA will stay constant over time in which case having no treatment is the best policy.

If you're comfortable with your husband's medical team, and that includes general practitioner & specialists, accept their advice. Wait & see is often the smart strategy. You will not get a lot of meaningful advice from this site, considering everybody's journey is unique and specific.

My PC diagnosis was agressive, localised & required attention; stage one cancer, carcinoma. I was headed for terminal outcome. I chose radiotherapy, not surgery, my choice.

Anti hormone treatments began January 2018 until May 2018. Radiation treatments began end of July 2018 for a month; 21 short bursts of radiation to targetted area of prostate.

Emotional side effects apparent all of last year, substance abuse didn't help, of course, not smart

Chronic side effect of radiation proctitis developed since February this year, ongoing, manageable. 'Normal' sexual ability returning, slowly. Nothing how I was before with sexual relations but something is returning, which is a 100% improvement on how I was 6 months ago.

You should trust your immediate medical team, otherwise ask them more questions.

I wish you & yours well.

The good thing is that you have time to research your options. And also good is you husbands age. He is young enough to choose any of several treatment options. I was 65 when I was diagnosed with a non aggressive prostate cancer - adenocarcinoma. My PSA was 5.9. A biopsy confirmed prostate cancer. 2 out of 12 samples showed cancer cells. I was told about several treatment options that would work for me. Included in the options was the 'wait and see' option, where you go every few months to get checked to see if the cancer has progressed. I met with an oncologist who was very knowledgeable and took the time to go over all treatments that were available for me. I didn't do the wait and see options because I thought if there was a treatment that would get rid of the cancer and be done with it, I would rather do that. Radiation was an option that sounded good. 36 short radiation treatments over 5 weeks. Then he told me about Cyberknife. Still a radiation treatment - but it was 5 sessions of treatments... 45 minutes per session. That sounded better... I was told that for both of these options, they want you to drink a large amount of water to make your bladder full. This was to help the bladder stay out of the way of the radiation for less chance of burning. The 3rd option I was told about was Brachytherapy. Low dose radiation seed implants. One procedure and you're done. It is done as an outpatient procedure that takes about 45 minutes. I liked the once and you're done idea. You are put under anesthesia for it. The low dose radiation helps not burn the bladder and colon. After you can pee for the nurses a time or two, you can go home. As with any treatment, there are side effects. Frequent urination, some burning when urinating and at times some urgency to urinate. It gets better fairly quickly. The low dose radiation from the seed implants is gone about about 8 months. It has been 2 years for me now and I have no side effects from it and everything works as it should. No incontinence or erectile dysfunction. Do your research on all treatment options. And what ever you decide, make sure the doctor has performed that treatment successfully many times. And like others have said in this forum, a doctor wants to do what his or her specialty is. So a surgeon may recommend surgery. Look at all your options and research the side effects and the success stories. I wish you and your husband the best.

Tom, I think the HD Brachytherapy is a bit different than the low dose seed implants that I had. Isn't the HD where they insert lines into the prostate for a time period and then remove them? From what I remember reading, they do this a few times over a few days. The low dose seed implants have worked for me. I liked the fact that it was a one time treatment. I was put on Tamsulosin (generic Flomax) and Dutasteride in the beginning to help with urine flow, and to keep the prostate from enlarging. After about 6 months, I was taken off both of them with no ill effects. I am going into my 3rd year and all seems to be pretty much back to normal. My urologist told me that after 8 months to a year, all side effects should be gone... and he was right. The side effects I experienced got less with time.