Recently received prostate cancer diagnosis: need a second opinion.

On this forum you ll get too many opinions. The choice is based on your age in my opinion. Talk to a specialist in urology, radiation guy, medication oncologist. Hope all the opinions are the same. Best of luck.

To get the most expertise in prostate cancer find a Genito urinary oncologist. They specialize in prostate cancer, Medical oncologist do all different types of cancer and cannot specialize in that one area

Did they find anything else besides the Gleason 4+3? That is a little aggressive, but not real fast moving. Same as I have and I’ve been around for 15 years with it.

SBRT radiation works quite well. My brother is also a 4+3 and he had it about two years ago and has had no issues since.

Your age is also a factor, If you’re over 70 then SBRT Can be quite sufficient. You do want either CyberKnife or MRIidian If possible. CyberKnife is more focused than regular SBRT but MRIdian Has a narrower beam and has a smaller chance of affecting nearby tissue like the bladder.

I just turned 65 so I’m Medicare covered now.

I was G7 4+3 and had SBRT and six months of ADT. Others in my support group had the same, some had traditional radiation and some had surgery. A couple had things like HIFU. There's a whole lot of treatment options. It's basically pick the side effects you're comfortable with. If I had to do it again, one thing I would have asked that I didn't is "how much experience does your dosimetrist have?" The dosimetrist is the person who takes the doctor's prescription and programs the computer to deliver the radiation (the doctor still approves the final plan).

See the many discussions on Tulsa Pro here for a good option.

As others have mentioned, we can't tell you what you should do; we can just share our own experiences.

Neither option is a slam-dunk; they just come with different pros and cons, and have similar overall-survival outcomes in the aggregate (though your oncologist might know why one or the other is better for your specific case).

I had 20 rounds of SBRT/CyberKnife (60 gy total) in spring 2022, which is close to the maximum. I have stage 4, so a cure is extremely unlikely, but I remain in full remission 2½ years after the radiation (over 3 years after disgnosis) with the help of that radiation therapy and ongoing medication.

SBRT side-effects are usually mild and disappear in a few weeks or months, but in rare cases they can emerge a year or more after treatment and stick around. That's what happened with me: I was one of the unlucky ones, with apparently permanent mild radiation damage to my lower bladder and rectum that emerged a year after treatment.

Would I do it again? Heck, yeah! I can live with a bit of occasional burning in the bathroom in exchange for, well, living.

First thing I would recommend is to get a second opinion on your biopsy at a center of excellence; I would recommend Sloan Kettering in New York City.
Began with Gleason 4+4 = 8. I live in Raleigh NC and recently went to Duke Cancer Center and was very disappointed and unimpressed.
However, my 2nd opinion by Sloan Kettering experts downgraded my Gleason to 4+3 = 7 and ordered the decipher genetic test to determine aggressiveness.
Duke Cancer Center did none of that. I saw three different doctors at Duke. The first was a urologic oncologist who told me the only thing he could do for me was prescribe testosterone block therapy. I next went to a radiation oncologist who spent about 15 minutes with me wanted to cook my prostate with SBRT. My cancer would have been cured but my quality of life would’ve been wrecked for life. So I asked if focal therapy was possible at Duke and they assigned me to a junior physician who was still an intern just a few years ago, so I said F U very much to Duke and went to Sloan Kettering in NY. Night and day difference. Be willing to travel to get the best treatment. There are actually studies that document the further away one is willing to travel for treatment increases the probability of a better outcome.
Best to you as you work through this.

I also was a Gleason 7 (4+3) I did a ton of research (talked with 7 doctors). I did not want to have any quality of life issues. I chose Tulsa Pro at Mayo in July. My PSA went from 8.6 to 0.68. 45 cc prostate. I have had zero side effects. Only had a catheter for two days. I had zero pain and didn’t even take a Tylenol. Medicare and my BCBS supplement covered all but $6 of cost.

@pops1
I think you can see you will get a lot of opinons and experiences of others. But that is what MCC is for.

Bottom line you need to do research, and if possible get second opinon. Do what you think is best for you from what you find out from your own research, asking questions of your providers and specialist, and from experiences of others.

Did your medical providers go over the difference between proton and photon radiation and the many different types of treatments? Has anyone gone over the side affects and complications of surgery and radiation to you? Both have side affects you need to know trying ot make decisions. Have you been told you need hormone treatments? If you have not been told the answer then asked questions and know these.

I would mentioned that there are additional tests I would consider. You can research them also but you will hear a lot about them on MCC.

Decpiher test. Will help determine the aggressiveness of your cancer and help determine applicable treatments. After my Decipher my intermediate threat was reduce to low threat.
PSMA: Helps determine if cancer had spread.
Bone scans: Not sure if bone scan needs to be done if PSMA is done.
Second Opinions: Some of these can be done by medical records and tests sent to the other provider. I think hearing a second opinion really helps you determine if what is being proposed for you is echoed by another expert.

A recent study found the photon versus proton Difference made no difference. Results were essentially identical, whether you had one treatment or the other.

I didn’t save that study, but I’m sure you can find it with a quick search.