I recomend two books.  One is Patrick Walsh's Guide to Surviving
Prostate Cancer and the other is Peter Scardino's Prostate Book.  The
latter is a bit more up-to-date and easier to read.   A good web site is
www.phoenix5.org.

I would recommend against relying too strongly on the internet.  It is
easy to get misled by particular points of view and come away without a
balanced idea of what is what.  In the end you will have to be guided by
what your physicians tell you.  If after some investigation you find
your doctors's explanations inadequate, you should change doctors.

Your history is a bit inconsistent.   The PSAs don't seem to have
changed all that much during the last couple of years and seems quite
consistent with benign prostatic hypertropy (BPH) which is relatively
common in men as they age.  It is also consistent with  your difficulty
urinating.  On the other hand the change from "non-aggressive" to
Gleason 7=3+4 seems rather dramatic.   One possible explanation is that
the previous biopsy just missed most of the prostate cancer by chance.
Perhaps the newer biopsy sampled better.

In any case, I think that even many skeptics about aggressive treatment
for prostate cancer would take a Gleason 7 seriously, particularly for a
man your age.   It is at the top end of what is is considered moderate.
 The likelihood of developing advanced metastatic cancer in your
lifetime is too high, I think, for a reasonable man to chance it, and
the prospects for a cure relatively good.  I speak personally because my
cancer was also 7=3+4 with PSA values similar to yours.  In my opinion,
"active surveillance" is no longer a reasonable choice for you.   In the
US, most urologists would suggest surgery, but radiation done by the
most modern methods may be just as good an option.  The important thing
is that radiation doses have to be quite high to be effective, risking
damage to surrounding tissues if not focused properly.  Either treatment
may have side effects such as urinary problems, incontinence, impotence,
or bowel problems.  To avoid impotence a surgeon should be skilled in
the so-called nerve sparing technique pioneered by Patric Walsh.   But
don't be deterred too much by the possiblity of side effects.  Many men
avoid them entirely, and the younger you are the better the chance you
will.  Also, side effects, including imptence can be treated.  In my
opinion, one treatment you should not consider at present is the use of
hormone suppresing drugs, except possibly as a temporary adjunct to
radiation.   They are more appropriate for treating advanced metastatic
prostate cancer, and despite some claims you may find to the contrary on
the web or elsewhere the great majority of experts don't believe they
can cure early prostate cancer like yours.

You do have time to educate yourself and make your decisions, so don't
panic.  Prostate cancer, even when aggressive, is slow growing compared
to most other cancers. But act within months rather than years.

Good luck.

On January 26, rosbif inquired, in pertinent part:

(snip)

Very little definite information has been supplied beyond the Gleason
score. Therefore, any attempt to advise rosbif about treatment would be
doing him a disservice.

A direct answer to his question is: for comprehensive and objective
information online, see the website of the Prostate Cancer Research
Institute at: http://prostate-cancer.org/index.html

A good place to start would be the "Resources" link, then on the page
that appears, the "Newly Diagnosed" link.

Good luck.

Steve J

"We must tailor the treatment to the nature of the disease. We must
listen to the biology."
-- Stephen B. Strum, MD

...

That wasn't Spouse's experience this morning, the only constraint was that
he didn't think to ask some questions. He had everything explained to him at
such length that he's forgotten a lot. It's your right to have all your
questions answered. They always have been for me.

I haven't seen such publicity - but we don't get newspapers and have no tv.

The medics he saw this morning weren't in a hurry at all - although they did
say that a PSA of 15 was high for a man of his age (66) and that if it
suddenly soared they'd call him for treatment sooner rather than later.

I suspect that as with all conditions and in all countries the treatment at
all levels is patchy. His experiences this morning have been very different
from those ten years ago in another hospital - but ten years is a long time
in medicine. He has no complaints, he's confident that he's in good hands
and that things are progressing. I just wish he'd taken notice of me and
sought advice before now - but that's men, innit!

We're in Leeds, Yorkshire, by the way.

Mary