Just diagnosed with PC at 60 years old. Gleason 3+3, PSA 14.92.

Hi, External beam radiation will destroy the cancer and you ( may never ) have to worry about it again !! Always the possibility of recurrence. The hardest thing to do is drinking fluids before each treatment and holding it until you have to pee so bad ✌️ Each treatment only takes a few minutes ✌️I went 44 times but you probably wouldn’t have that many treatments. Shouldn’t interfere with your sex life unless they put you on testosterone lowering meds for awhile !!

Sounds like you are in a good spot PC wise. I had RALP done yesterday. Was diagnosed 1 year ago. With regional metastatic PC I was told that ADT was only good for a couple of years. I spent the last year doing tons of research and decided to go the surgery route and then follow up with spot radiation later if necessary. And use ADT as a backup. Feel great this am . Soar belly but great pain meds.

Diagnosed with Gleason 3+3 in Sept 2022. PSA 10.5. Similar circumstance to you. Recommend you read Dr. Walsh's "Surviving Prostate Cancer". All options will become much more clear. I decided on Proton Beam RT at Mayo Rochester. Completed treatment in January 2023. Minimal disruption to daily life. No impact to sexual activity other than a reduction in seminal fluid production. I also experienced temporary increase in urination frequency which went away after a few months.
Hope you find the best solution and achieve desired results.

Prostatectomy (RP) or Radiation plus ADT are the 2 treatment choices. I infer that active surveillance (AS) was not suggested to you.
Walsh's book, as already noted , is an excellent place to begin gathering information.
Prostate Cancer Foundation (PCF.org) free Patient Guide can be downloaded or received as a hard copy.
Someone posted elsewhere these priorities to consider: (1) address the cancer; (2) manage continence; (3) manage sexual function.
My choice at 72 was RP. I wanted my chance at complete elimination. RP went very well; continence has not been an issue; sexual function coming along, but a work in progress.
RP retains radiation therapy as a 2d treatment if necessary; surgery virtually eliminated as an option if prostate radiated as initial tx.
Note: Many men choose Radiation w/ ADT and have been pleased with their choice.
Treatment decisions can be overwhelming initially.
Best wishes.

Well, with the clinical data such as age, GS and PSA, there is a piece missing which may help the forum provide you some assessment and feedback:

Have you had imaging, if so, when, with what, results? You say no spread to other organs and with GS 3+3 that may very well be the case. Still, there is micro-metastatic disease too small to be seen by imaging, even the more recent and more sensitive ones. Did it show PCa in the prostate, a MRI may do that.

Have you had previous PSA tests, dates, results...? I ask because that would show PSADT, a valuable data point.

My initial read of your post and the GS 3+3 had me thinking active surveillance. Then the PSA said maybe not.

With GS 3+3, imaging with shows no spread (what you don't say is did it show PCa in the prostate) and if PSADT is greater than 12 months, consider AS.

If you and your medical team determine that treatment is warranted based on the clinical data, no rush...

Kevin

Since sexual function is of great importance to you, I think it is imperative that your treatment decision be made with your partner. As my wife said, it's her penis too!

As one of your radiation choices, you might want to check out the Mridian Machine from Viewray. Their website is viewray.com. This is the only machine that has both a built-in MRI and radiation, automatic, shut down and real time dynamic mapping and I was treated in January of this year with five treatments Gleason 3+4, and 10.5 PSA. No adt.
You might want to have your biopsy used for the Decipher test, which helps understand how aggressive your cancer may be. doctors do use this test to help them make a better decision.
I would also suggest getting more than one opinion from your biopsy, and the imaging from doctors outside whatever institution you are currently using. Doctors are dedicated, but not infallible.

Sounds like you are in a good situation with GS of 6 (3/3). I did a significant amount of research on how to address my GS 7 (4/3) prostate cancer. I was 57 when diagnosed in 2022 and ended up going with a radical prostatectomy at Mayo-Rochester in November 2022. For me, it was imperative to go with a treatment plan that had the lowest chance for BCR. Imaging tools do a great job identifying cancer , but are not 100% perfect. Based on my experience, I would recommendation having a RP (with nerve sparing at center of excellence) to eliminate the known cancer from your body. With a GS of 6, chance of BCR is very low.

However, everyone is unique and treatment plans must align with life expectations. For me, I wanted the best chance for living a long life without dealing with PC and its painful & life changing side effects (my priority: life, continence, sexual function). I recall watching my uncle die from what I was told was bone cancer. When I talked to his daughter after my diagnosis, it turns out he died from PC that had metastasized and went to his bones.

I know thjs decision is difficult, best of luck with your treatment plan.

There are lots of choices and options with PC. My wife and I talk and talk about what I should do. Finally, we agreed our priority: life, continence, and sexual. My PSA 4.2 was low; however, my cancer was not confined. My surgeon had to “cut wide”, and biopsies located cancer in one lymph node. My life has gone on, continence obtained after 10 months and sexual after 18 months. I’ve kept my PSA at an undetectable level with AS and a Mediterranean Diet. Good luck with your decision.

73 and 10 months 4-3 Gleason in two cores from a 120 gm prostate and 2.9 PSA that has been in that range for 5 years previously. Had a 30 core mri fusion guided biopsy because my prostate was so large. Just finished the 5 proton treatment at Mayo Phoenix and my three-month PSA on 7/17/2023 as undetectable. I did not take a Lupron shot because I have been on TRT since 2008 and just stopped taking it before radiation and my testosterone level dropped to 12 ng/dl without the shot. My oncologist did not believe me when I said it would happen as I have experimented on my own during normal blood draws. I had next to no side effects from the proton radiation other than two five inch tan circles one on each hit. I even asked on the patient portal if they were sure they gave me enough radiation. Good luck.