Hi All

I'm in the process of deciding on which type of treatment is best for
me (PSA 6.7; Free PSA 19%; Gleason 6; Stage T1c). My urologist
referred me to Sunnybrook Hospital in Toronto to see if radioactive
treatment would be a better option than surgery.

Saw the radiologist today at Sunnybrook to discuss treatment options.
He felt that mortality and morbidity rates for the radioactive
treatment options are about the same as those of surgery – but
admitted that he did not have hard data to support this conclusion.
Together, after exploring the alternatives, we decided that surgery is
a better option in my case. The size of my prostate (60 grams -- as a
result of benign prostate enlargement or "BPH") is a major
complicating factor.

This is too large for "seeds" and the methods to shrink the prostate
beforehand were not acceptable to me. For the same reason, HDR
brachytherapy was not recommended. That left external beam radiation
treatment (Sunnybrook uses the 3D conformal method) and the doctor
felt that this approach would be effective in treating the cancer and
had a very high chance of completely curing it. The "however", and
it's a big "however" for me, is that EBRT would not reduce the size of
the prostate and would thus leave me with all the symptoms I have from
the BPH. In fact, he felt that the radiation would make the symptoms
worse for a period of time during and after the treatment as the
non-cancerous prostate tissues are irritated by the radiation. These
symptoms are very annoying and I certainly would like them corrected.

So the bad news is that radioactive treatments are not the best option
for me. But he did have some good news…

He examined me (via DRE), reviewed my file and advised that the PCa
was at an early stage. Said I could probably go on for 10 years before
noticing any symptoms. Of course, the BPH symptoms would still be
there. He definitely did not recommend "watchful waiting". But I do
have time to make a considered decision.

He also said that the symptoms I am experiencing are definitely from
BPH and not from the cancer. That certainly was a relief! I had really
worried that the increasing severity of the symptoms was the result of
the cancer growing.

Even tho I don't have much choice of treatment, I find that to be good
news. No possibility of worrying about having made the wrong choice.

So, there it is. Now I need to determine if my urologist has the
skills and track record to do a good job for me. I think he is the
right guy. But I am meeting with him next week to answer those
questions.

Regards to all. Without all your comments and experience I would never
have had the facts to have such a good conversation with the
radiologist today!!

Bruce