Cancerfight, did you make a decision yet? Here are my thoughts:
First, as should be obvious, this forum is a great resource with some very informed guys to help. Hopefully it's not too much
One thing I've learned in my journey is that you just don't get enough time with your docs to ask all the questions you may have, so if you're a research type of person, this is a good place to learn. Also, I've become a believer in searching out the best doctors with the best equipment and learned some important things just doing a couple telcons/zoom sessions with specialists in other cities.
I was 3+3 (later upgraded to 3+4 from a 2nd opinion at John Hopkins - Dr. Epstein) and with high volume. For me surgery and potential SE wasn't something I wanted to do and I stumbled onto a friend of a friend who was my age and had recently had SBRT (Cyberknife). I researched it and liked the technology aspects of a tight beam that is programmed to kill the cancer via many, many angles where it crisscrosses and thus minimizes damage to other tissues. No surgery except a procedure to implant 5 gold fiducial markers for alignment of the machine, then 5 one-hour painless sessions where you lay on a table and watch the very large robot move around your body.
Except for some discomfort for a couple days after the 5th session I have no SE. Recently my PSA has risen and then dropped so I may be experiencing a PSA 'bounce' (long story), we'll see.
I've been asked several times if I had it to do over again would I still chose Cyberknife and my answer was yes, although in researching follow-up procedures in case this isn't a bounce I would probably consider HDR (High dose brachy) or even LDR as a first therapy. If my PSA does go back up then I'll most likely go with HDR from Dr. Martinez in Detroit who has a very good reputation. He was recommenced to me from JNF on this forum.
One thing to consider with the radiation therapies is that once radiated, if you have a recurrence then you're in a 'salvage' situation due to damage of the tissue planes. At that point surgery is much more difficult and SE are almost guaranteed, especially incontinence if I remember right and most UROs will not/can not do it.
There was a brief note from one of the responses about
cost and if you are on a medicare advantage plan. I'm sure you've researched this. I'm on traditional medicare with a supplemental policy and my treatments totaled up to about
$600k or more MSRP. My out of pocket I think was about
$1K. A medicare advantage plan will be more restrictive I'm sure.
Good luck and please keep us informed.