Hey Steve. Welcome and at the same time sorry that you have to join our brotherhood. We are here for you.

I’m not a medical professional, just a two-time prostate cancer patient so please don’t construct anything I say as medical advice. I am just sharing my personal experience and opinion.

If I understand correctly, you’re starting a new teaching position next month. Congratulations! My wife was a schoolteacher for many years, so I appreciate the starting in Fall and finishing in Spring timing of things. Its just my opinion here but if I were in your shoes, I would ask my care team to do a decipher test on my pathology to determine how aggressive the cancer is and whether or not I have to have a sense of urgency in dealing with it. If the decipher test comes up with a high number showing an aggressive cancer you certainly may need to act sooner than if it’s a low or intermediate number. Unless your cancer is aggressive, you might be able to safely hold off on treatment until the end of the school year.

I’ve gone through low dose brachytherapy, surgery and radiation and understand the impact on daily life for each of the three treatment modalities. If you have a favorable Gleason 7, (3+4 instead of 4+3) and a low decipher score low dose brachytherapy might be a good option for you assuming that you can have it done at a center of excellence with an RO that has successfully done thousands of these procedures. Regardless whether you would choose to have this treatment now or at the end of the school year, your downtime would probably be less than a week assuming you’re in good health otherwise. For the record, my brachytherapy was not successful due to an underestimation of my Gleason score and a bad biopsy, but I still like the concept of brachytherapy for low risk cancer. I know several men that had the procedure low risk and have been cancer free for well over a decade. I don’t believe that it’s the best option for intermediate or high risk PCa.

You also may want to look into a procedure called HIFU. The surgeon that did my salvage pro tech to me also performs that procedure which also has a quick recovery time and a high degree of success for low and intermediate grade localized PCa. Again, you need to seek care at a center of excellence. My surgeon also does HIFU so if you’re in the Chicago area and need a recommendation, I’ve got one for you.

Based on my experience if I had to do over and had a received a decipher score showing aggressive cancer, I would’ve opted for surgery as my primary treatment. I would’ve bit the bullet on recovery time of about six weeks with the long-term goal of staying cancer free for the rest of my life. That’s the prize; staying cancer free for the rest of your life. That should be your top priority!

If you opt for radiation, you’ll likely have to go for 30 to 40 sessions five days a week so you have to consider the impact on your day-to-day activities while you’re teaching. You will also have to show up with a full bladder and an empty rectum. Try planning that each day on top of a school day! Additionally, you’ll likely experience fatigue after a few weeks as well as urinary urgency. Getting a good night’s restfull sleep might be challenging. You might be a lot tougher than I am, but I wouldn’t even consider going radiation while teaching.

This brings me back to my original point, if you have a low or intermediate decipher score you and your care team can decide whether or not it’s prudent to wait nine months until the school year is done to act on your treatment plan.

Best wishes for success for you for whichever treatment modality you choose.