Did I make a mistake ?

What was your gleason score from your biopsy?   Not that that would cause me to feel competent to suggest what you should do, but it might assist others in making suggestions.

With recent more extensive screening, many men are now diagnosed as early stage gleason 6 cancers, with the resulting debate about over diagnosis and over treatment of miniscule amounts of cancer.

Dr Epstein and Johns Hopkins have several studies, and published criteria for "insignificant" cancers, which was defined as PSA density below .15*, no more than two biopsy cores with cancer, no biopsy with more than 50% cancer and no high-grade cancer.

*PSA density is PSA figure divided by the gland size. A larger gland naturally produces more PSA.

Biopsy readings are subjective: what looks like cancer to one person might appear more normal to another, which is why biopsy slides should be sent for a 2nd reading.

12% in one core of 13 does not indicate a high volume of cancer. If your gleason scores are not in the high risk category, it's worth waiting for now to further consider your options if you're doubtful. Best to feel sure you've made the right choice and have selected the best doctor available.

Whether you would want to use active surveillance medium to long term is another question. Not everyone can handle that approach, and many want to have it out yesterday.

Hey Fatcat, you pushed a lot of buttons with your post.  It is for sure the biggest question we all had after diagnosis.  My cancer was pretty isolated, but it was a Gleason 8 so my only question was which treatment.

I think the post by Selmer is one of the best thoughtout,  and evenhanded on the subject of should I or shouldn't I.  Good luck with your decision,

At an early stage you have time on your side, but when you do decide what to do--or not do--the cancer will still be there.  Is it aggressive? Is it slow-growing?  Will it spread outside the prostate? How soon?  

The answer to these questions is unknown. I personally chose to use the window of opportunity I had to make a decision that was right me.  It was not by any means an easy choice, but I don't regret making it. 

Take care and hang in there...Tim

Hey Fatcat

I echo a lot of what has been said.  I too was having lots of doubts surrounding my choices of surgery, seeds, or just waiting.  My cancer was suspected to be very small.  I decided on the surgery, and am glad I did.  As you can see, my pathology report was worse than expected, and I've had to go through additional therapy.  Many have a small amount and surgery or seeds takes care of it.  Others change their lifestyle and live with it.  It would be great if there was a sure fire test to see exactly how much cancer you have and map it out to see if it was approaching the margins, but there isn't.  The needle biopsies do a good job, but even with thirteen darts, you're not going to hit all the numbers on the dart board.

I agree to get additional opinions on your cores.  Then do a lot of soul searching and make your decision that you feel will best suit you.  Good luck.

The lumpectomy approach sounds intriguing, however I would be concerned with leaving the prostate intact. PCa is multi-focal, and a focus of cancer cells too small to be mapped could be missed. Even if all of the cancer were removed, the genetic and/or envronmental factors, which caused the cancer in the first place, could strike again somewhere else in the remaining prostate. Obviously, age and concern of side effects from other treatments must be weighed, and I am biased due to my personal choice of surgery.