I'm sorry about
your diagnosis. The first order of business is to get a second opinion on your biopsy slides from Bostwick or Epstein. You want a treatment suited to as accurate a diagnosis as you can get.
Mojo58 said...
RO didn't think seeds would be enough.
Given your numbers, that may be more a reflection of the RO you spoke to. Often, ROs who do HDR don't do LDR - it's a different skill set. I think if you talk to one of the LDR brachy superstars (e.g., Grimm, Zelefsky, etc.) you will get a different story.
Mojo58 said...
The RO recommended prostate MRI for mapping. the surgeon more for staging.
You may want to wait. different specialists will require different MRIs. If you go with HDR, you will need an MRI with fiducials, for example.
Mojo58 said...
But it seems like if you fry the prostate, you'd still have a chance of incontinence. Probably didn't ask the right questions of the RO.
You are not "frying" the prostate with radiation (that would be thermal ablation). You are inserting hydroxyl radicals into the cancer's DNA, which it cannot repair or survive, while healthy tissue often can. With your low volume of cancer, you will have a lot of healthy prostate tissue after radiation. Incontinence is almost never a problem after any kind of radiation. The urinary and rectal SEs tend to be irritative and temporary. With LDR brachy, the opposite problem - retention - is a frequent side effect, but even then, it is usually mild and transient.
Mojo58 said...
Both said the outcomes are about the same. Dud they mean for incontinence and SE?
He meant oncological outcomes - lasting cure rates. With your "favorable intermediate risk" PC, all treatments have about
the same (excellent) chances of lasting success.
As you talk to experts in surgery, HDR brachy and LDR brachy, I also recommend you talk to an expert in SBRT (see link in my profile). SBRT and HDR, in addition to low rates of SEs, also have the lowest rates of associated ED (around 20-25%).