I was 48 when I was diagnosed with Prostate Cancer. I was Gleason grade 7 (3+4). I had robotic surgery to remove the gland. Now I am 64. I decided after surgery that if cancer returned, I would not seek any further treatment. I was followed by my Urologist after surgery and watched as my PSA slowly climbed from 0.03 to 1.5 within a few years. My Urologist recommended salvage radiation. I moved to another state for work and didn't find a new Urologist for follow up. I had my primary care physician order PSA tests instead and I tracked the results myself. I was very happy with my decision for the last 12 years. No treatment and no side effects. Last summer my PSA went from 4.0 to 7.0 and my doctor urged me to see a Urologist again. I didn't want further treatment if it was not going to lead to a cure. It seems that now with new therapies available it might be worth looking into my options again.

I had a PSMA pet scan that did not show cancer, but there was an undefined spot in the bladder. A biopsy confirmed that there was a lesion (Gleason 9 4+5). My Urologist has hopeful that with a treatment plan that included IMRT and ADT plus a second-generation Hormone agent there was still a high likelihood of a cure. So, I decided to give it another shot.

I don't believe you are wrong to want to avoid any treatment. I almost made that decision myself. I am hopeful that I could be cured, and I chose to take a risk because the side effects from cancer not being treated are worse. I think if you decided not to seek treatment you would have 15-20 years of survival, but who knows. It depends on a lot of things like your age, how large is the tumor and any other health conditions you may have.

Today there are so many more treatment options that it can all be overwhelming. I would recommend that you start with "active surveillance." This approach allows you to keep an eye on your cancer and decide on a treatment when you are ready for that next step. You can research focal therapies that target the tumor but spare the surrounding structures. You may be a candidate for SBRT (a shorter course of radiation) or Brachytherapy (radioactive seeds implanted permanently or temporarily) or other types of focal therapies. Talk to your doctor. Seek a second opinion. There are many sources of information online that can guide you in your search.

I am attaching a video I hope it is helpful.