Prostate Cancer Treatment

[Dunc53]

I am a young man of 55 and have been diagnosed with mid-grade prostate cancer with gleason score of 7 and psa level of 6.42. Attempting to do all the reseach I can I've had consultations with a seed implantation-radiation center and another consultation with a urologist who performs robotic prostatectomy. I am still searching for what is the best treatment which always seems to depend on which doctor your talking to. Are there any independent studies that have been done that may give me more insight? Searching the internet has greatly increased my knowledge of prostate cancer (before I did not even know what function the prostate had} but unsure if all the claims that I am reading have much merit. I am presently scheduled for robotic surgery in November but still researching if this is the right choice.  
Thank you for any feedback.

[Ash Tewari, MD, M.Ch.]

The choice of treatment in your situation is largely dependent on individual patients' preference and should be made after all the risks and benefits of all treatment options have been explained and are understood.  Seeking multiple opinions is a good idea but can sometimes confuse patients on the best treatment.

That said, opinions of which option to chose vary in the urologic community as the absolute “best” treatment option for all patients is controversial– it is a decision best made on a case-by-case basis.  If you do chose to have the operation, you should know that it has been shown that surgeons with more experience have better functional outcomes.

Independent studies show that all three definitive treatments for prostate cancer have overall, similar survival outcomes. However, as I mentioned, functional outcomes can vary widely and but are associated with the specific nature of the patients disease and surgeon experience.

Results of prospective trials comparing the treatment options should hopefully be published in the coming year or two.  These results should provide more insight into your question. Until then, I would suggest weighing the risks and benefits of each treatment independently and basing your decision on which best fits your preferences with the consultation of your physician

[Dunc53]

Thank you Dr. Tewari for your response. I'm sure many other men are going having the same thoughts. The doctor doing the surgery here in Atlanta presently has performed over 1900 of these operations and has pretty much set the ladder very hight form my outcome. Of course much of that depends on my willingness to follow through with the exercises and mental adaptation.  I have one more consultation with another type of treatment utilizing high intensity focused ultrasound. This treatment is considered non-invasive but the side affects appear in line with the other procedures. Will discuss that in future feedback.  Thank you again..  

[keyzersoce]

I am not a doctor but a close friend went through the same process you are experiencing. He gathered all his information and consulted a medical oncologist, who has no dog in the hunt and merely gives his opinion based on your records. I would consult a medical oncologist for an opinion.

Additionally, I remember one of the community members, Artdude, was from Gainesville, Georgia and has been through this ordeal. Look up his posts and/or contact him for futyjer help.