Folks, at the end of the tests & procedures; it's make my mind up time.
Work medical in 2016 indicated PSA to be "of concern" (no number given) & I should see my GP. As a typical man, did nothing until being made redundant in October 2017, therefore missed the firm's annual medical, so no chance for another measurement. In March 2018 decided finally to see my GP about the 2016 result & then the process kicked-off. GP DRE - nothing significant, gland big but not knobbly; blood test - PSA 7.25; MRI scan - some dark areas; template biopsy - Gleason score 4+3; bone scan - clear; cystoscopy - nothing in bladder, constriction on urethra caused by swollen prostrate evident. Have had urinary problems for two to three years - frequency when vertical: no particular overnight problems, but have to pee frequently (often had to stop on the drive to work, or pee more frequently than the dog when out for a walk - no tree is safe!).
So I am being offered two courses of treatment & have to choose between them:
1. Radical prostatectomy - robot, keyhole. Have seen the surgeon to have the description. It was he who asked for the cystoscopy to check that there are no additional problems with the bladder. This seems a "safe" option in the sense that removal of the gland removes the problem. I am primarily concerned that the side effects will worsen my existing urinary problems, plus all the other ones on top of that (ED). The surgeon has indicated that it is possible that nerve damage would be minimised because the cancer is concentrated to one side of the gland.
2. Brachytherapy - permanent seed. Have had the consultation to explain, along with a pee test, further DRE & ultrasound to size the gland. Also proposed as part of the treatment are hormones for three months to shrink the tumour a bit & a TURP before the seed implantation to improve the peeing problem (?).
To sum up: both treatments should be effective regarding the cancer. However, I guess neither comes with a 100% guarantee.
Surgery seems a reasonable option, with a "once & for all" air about it, but with more extensive recovery & worse side effects (plenty of experience out there in this excellent community to at least have reservations about it).
Brachy seems to give me the impression (maybe undeservedly) to be too good to be true: less intrusive, short recovery, lesser side effects, ... the golden bullet! I may have missed it (& apologies if I have), but I can't seem to find any experience of brachy (plus the TURP) in the community: can anyone help, please?