Just informed of positive biopsy

Hello Frankie,

Welcome to the forum!

Glad you found us but sorry you found yourself needing to look. Hope we can help.

If you look at the list of topics on the forum you will see one at the top with a push-pin/sticky-note icon beside it called Newly diagnosed with PC? -- Read this thread first.. It has quite a bit of information for newly-diagnosed guys such as yourself.

"Seeds" -- also called Low Dose Rate (LDR) Brachytherapy -- is generally a full-gland treatment. They insert enough seeds to irradiate the whole thing.

We have had a couple of guys who've had some sort of "focal" therapy and are happy with the result. But the results in the published research are not particularly good -- cure rates are lower than more aggressive therapy options and the side-effect story isn't as happy as one might wish.

With two positive cores of Gleason 6 disease you have lots of time to make up your mind what you want to do -- probably years -- and you shouldn't commit to the first doctor you speak with. Be sure to talk to your uro about "active surveillance" -- a better considered form of "watch and wait" that involves lots of testing to stay on top of things and avoid surprises.

FrankieB said...
specifics:
white male 56 years old, No family history known, PSA 4.7, gleason 3+3, tumor involves 65% of 2 cores. total cores taken 14. Linear extent 10mm located in anterior zone. Now...options? I don't think I am ready to remove the prostate. would I junk my truck if the transmission went out? no. only 2 cores contained cancer, so my thought is, it is confined to a small location. is the "Seed" the same as Focal Therapy? Is the seed term just a laymen's term? I have an appointment in 3 weeks with a decision of what option of treatment I want to go with.

Sorry you have to be here, but this is a good site to get reliable (evidence-based) information.
For starters, I will say that you don't need to make a decision now, or in three weeks. There are a lot of options to treat your cancer and you have ample time to get educated and make a decision.
We generally recommend talking to several (!) specialists. It turns out that, even if you choose radiation, there are several ways of doing that. For instance, there is brachytherapy with seeds or high-dose rate brachy, SBRT, IMRT/IGRT etc. Moreover, it is important that you choose a specialist with a lot of expertise.

And yes, as the previous poster already mentioned (4 minutes ago), active surveillance is another option worth considering.

I hope that others will chime in in due time...

Active Surveillance should top your list of options (unless you are African-American). You may be a good candidate for focal therapy depending on where the cores were. No one really knows how well it works in the long run. Here's an article you can read about the unanswered questions:

/pcnrv.blogspot.com/2016/12/focal-ablation-unresolved-issues.html

If you decide that's for you, I think you should only do it on a clinical trial. Insurance will not cover it, and it has a 20-30% "re-do" rate.

Surgery, SBRT and both kinds of brachytherapy all have about the same cure rate for your very low risk PC - 95+% They have different side effects, however.

The great thing is that you have a lot of time to make decisions. Certainly not in three weeks. You may start AS and find you never have to treat it. I do agree that with what you know surgery is far too invasive to treat a low grade low risk cancer.

The thing is that you have to go separately to each of the different treatment specialists. Do not let any one doctor tell you about treatments that doctor doesn’t perform. I visited three surgeons, two radiation oncologists and one medical oncologist before deciding on a treatment method and course. You are much lower risk but you still have to go to deifferent specialists for their specific assessment before deciding.

Sorry about your diagnosis and that you have to join this club. Keep doing your research and follow the great advice above. The fact that you are researching already puts you in a better position. I wish you well on your journey. Take care. —JR