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Thoughts on treatment options
A quick rundown of my situation:
57 yo, 188 lbs 5’10”, active, good overall health and diet, working out, no booze, smoking or drugs, good relationship, Buddhist meditator, etc
2020s - elevated PSA
Nov 2024 - biopsy, two spots that 3+3 = 6, Group 1, active surveillance
Nov 2025 - biopsy, spots are now 3+3 = 6 and 3+4 = 7 with only 10% in the 4 range, Group 2, treatment recommended.
Feb 2026 - MRI, I don’t have the details of what this showed yet
It took a few months to get back in to see urologist, the combo of the biopsy and MRI has him recommending treatment: surgery, radiation or HIFU.
I’m leaning towards radiation just to minimize potential side effects and cost for now, kicking the ED and incontinence can down the road so I can take steps to mitigate over the next few years or so. The time commitment for treatments is acceptable for me, I work from home and have a fairly light schedule.
Curious to see what others think before I contact my urologist and get started on one of the options?
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@lagnafinc Thank you for the information and the related suggestion(s). I'm not at all familiar with the "cyberknife" approach, and have no idea whether its something that either my urologist or oncologist would recommend? I just have to be patient for another couple of days, until I can meet with both, and know their respective thoughts on things. However, in the meantime, I will certainly begin looking into it, and I greatly appreciate your sharing your thoughts.
Cyberknife is just a technology, not an approach; it's a brand name for a specific technology to administer SBRT using high-dosage radiation. Developed at Stanford, been FDA approved since 2001. Among other things the Stanford developers were able to determine that the prostate is capable of receiving higher dosages of radiation than other parts of the body....which allows it to do what it does in only 5 days at higher doses.
Word of caution: many urologists/oncologists have their own, very expensive radiation machines in their own clinics. As you might guess, that's what they typically recommend...so hopefully the people you are seeing are independent and not necessarily referring you to a source of their own income. Get multiple opinions...I think I had six when I first started.
@toomany
Cyberknife is just SBRT radiation. It’s been used for over 18 years, clinical trials started in 2007. I know people that have had it 15 years ago, he’s never had a recurrence.. My brother had five sessions of it at UCSF, He’s doing fine three years later. I know almost as many people that have had that as have had IMRT radiation.