Connect
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?
Like
Helpful
HugInterested in more discussions like this? Go to the Prostate Cancer Support Group.
Connect
radiation- prob 10-15 sessions and then 6 mos ADT. I dont think I would go thru the surgery for what you describe. you dont have high risk at the moment and prob radiation will destroy what you have and ADT will suppress any spread. I doubt either will upset your life too much at all. Just my opinion.
-
Like -
Helpful -
Hug
1 ReactionIn brief, diagnosed Gleason 4+3 at 59 in Dec 2025. Retzius, single incision RALP Jan 2026. I chose the surgery for a few reasons. I am working and radiation would be most disruptive for work and I would need ADT with my risk being higher at 4+3. Wanted to avoid ADT. Otherwise, I would likely have had radiation. Surgery was very successful. Currently undetectable. No real lack of continence, except a bit of stress incontinence which resolved in less than two weeks after catheter. Natural return of erectile function progressing 7 mos post surgery. Utilize Trimix for sexual intercourse. I have zero regrets and am very grateful 🙏🏽. There is no right way, but this was best for me. Hope this helped a bit.
-
Like -
Helpful -
Hug
1 ReactionCurrently waiting to see Urology surgeon on Sept 28th, saw oncologist last week waiting for decipher test to make decision diagnosed with 2 cores 3+4 taken from .8cm lesion, oncologist recommended 5 sbrt treatments with a 90% cure rate or 95 % with adt, to me the extra 5% is not worth taking it. Would rather do radiation but not with high decipher score, will see what happens.