I have had two consultations this week. As you may remember I'm T1c, psa 2.4, gleason 3+3=6, and 2 cores out of 12, 65/75%. The two consultations were with a surgeon and medical radiation oncologist. Of course, both tried to sell me on their treatments...one did so very aggressively, one did it very gently and supportive. First, I was convinced I should just get this cut out and be done with it...hopefully never to have to worry about it again. Now I'm thinking the radiation would be easier, less evasive, less long term complications and as effective as surgery. At least the oncologist said, as did my urologist, with my stats, any treatment I choose will probably have a 95% success rate in eliminating the cancer, so choose what side effects I can live with and choose that treatment. I hope this is true. Any thoughts?
The Prostate Cancer Results Study Group is a group of prominent doctors with expertise in prostate cancer from all over the country who came up with criteria for identifying, selecting and comparing high quality studies that have been done of various therapies for patients with low-, intermediate- and high risk levels. They have displayed their results in easy to view color and symbol coded graphs of success (freedom from recurrence) according to how long the average patient has been followed for each report ("median" follow-up). A brachytherapy site, the Prostate Cancer Treatment Center, is maintaining their report.
Take a look at their work, which is updated as new studies that qualify are reported. Here are a couple of things to bear in mind. The outstanding brachytherapy results reported are from centers of excellence, not community practices; community practice results have a somewhat lower success rate, more like proton beam or very well done EBRT. It's important to read the introductory comments. Cyberknife (SBRT) is still new enough that it's possible not even the Christopher King series - the longest running - yet meets the criterion for minimum follow-up. I have not verified that.