Newly diagnosed questions

Prostate Cancer Foundation (pcf.org) now has a Patient guide for the newly diagnosed - free by download and hard copy.
Also Patrict Walsh, MD'S book "Surviving Prostate Cancer ".
Primary pathways are treatment (either surgery or radiation with ADT hormone therapy) or active surveillance.
Other tests, including a PSMA PET scan, may be appropriate.
My suggestion is read the PCF guide and/or Dr Walsh's book and prepare for Thursday.
Best wishes.

You have two biopsy that are cancer on one side, and a precursor on the other side. Most places at the get go offer the most aggressive treatments possible, and hardly mention the issues of those treatments. Some people are ok with that as they just want it out and be done, others want to see what else is available, but usually most centers/places you go never mention anything but the most aggressive treatments. Hard to say for sure, but that is the typical story, and with me. Even at Mayo you might be advised that, though they have some doctors doing focal and multi-focal treatments, almost always what is advised is the most aggressive. Prepare to have to go to 2 to 5 additional places, doing a fair amount of calling around, but often times there are dead ends. Let us know what they tell you, and how comfortable you are with the main two treatments RP (surgery) and RT (Radiation of some kind). I think more people are opting for RT of some kind, but prostate size and so on factors into that.

If your doctor mention the focal and multi-focal therapies that is a real plus for your doctor. There is also active surveillance in some cases, then there is a re-grading of the biopsy in some cases. It used to be people had slides mailed to Hopkins for re-graded but the main person is gone from there, so suggest Mayo or other if you want a re-grading.

If you want a direct discussion of PIN, try this link. But the PC found sounds like the big dog in your fight.
https://www.health.harvard.edu/blog/what-is-prostatic-intraepithelial-neoplasia-pin-2009040440

Good luck and God Speed
bob

You have two biopsy that are cancer on one side, and a precursor on the other side. Most places at the get go offer the most aggressive treatments possible, and hardly mention the issues of those treatments. Some people are ok with that as they just want it out and be done, others want to see what else is available, but usually most centers/places you go never mention anything but the most aggressive treatments. Hard to say for sure, but that is the typical story, and with me. Even at Mayo you might be advised that, though they have some doctors doing focal and multi-focal treatments, almost always what is advised is the most aggressive. Prepare to have to go to 2 to 5 additional places, doing a fair amount of calling around, but often times there are dead ends. Let us know what they tell you, and how comfortable you are with the main two treatments RP (surgery) and RT (Radiation of some kind). I think more people are opting for RT of some kind, but prostate size and so on factors into that.

If your doctor mention the focal and multi-focal therapies that is a real plus for your doctor. There is also active surveillance in some cases, then there is a re-grading of the biopsy in some cases. It used to be people had slides mailed to Hopkins for re-graded but the main person is gone from there, so suggest Mayo or other if you want a re-grading.

Lorkem258: I had 3+4 and 10.2 psa. I went to multiple radiation oncologists. Active surveillance does not mean they will catch an issue before you have to make decisions regarding treatment later on that can change your entire quality of life forever because the cancer has grown in between the times they are checking your blood. I chose treatment and specifically the MRIdian linac radiation machine. 2mm margins vs 4-6 mm for other types of radiation. Protect your healthy tissue. Finished 5 treatments in February.

Here are some other research thoughts:

Nccn.org
Many doctors follow their guidelines, and it is there for doctors and patients
Decipherbio.com
Takes a slice of the biopsy which helps evaluate aggressiveness and modes of treatments
Viewray.com
MRI/Radiation machine combination unit
Mevian.com
Proton therapy radiation machine

Ok I will definitely takes notes of what is said. Can’t do mri because of pacemaker from birth defect so I wonder how that will play into things as well . I’ll let you know Thursday. Thank you for all the information!!