Feb 02, 2012 - 2:15 pm
My wife and I just had the consultation with the urologist after the positive biopsy diagnosis. I'm 57, Gleason 6, PSA 4.6, 4 out of 12 cores involved with one at 80% - all in the left node. The segmented picture of the prostate in the biopsy report showed some of the involved areas on the perimeter on that side. Does this necessarily mean the margin is compromised? Forgot to ask him. I would think if it was he would have suggested a CAT and bone scan but he said based on the info there was no need.
He's pushing surgery and then the seeds (which is his specialty). He also said I have plenty of time to decide.
I told him I was very concerned about side-effects and have been researching the less invasive treatments like proton, cyberknife, and tomo-therapy. His advice is I am too young for any of these, and that his group has done literally thousands of DaVinci's and seed implants. He showed me a recent article on how proton side effects were thought to be more prevalent than regular IMRT... which is the reverse of what I've read. Boy, it's a real mine field out there.
I asked him to send the slides to Mass General who I've already talked to - they've said they can't do the consultation until they get the slides. But my urologist said I should talk to one of the surgeons in his group first and let the hospital look at the slides first. Didn't really feel like arguing with him right then but the reality is I REALLY hope to avoid surgery.
Am I being realistic about this?