I used this six years ago, and it was great. One session, no hospital stay. No pain - I didn’t even take one Tylenol after the procedure. My PSA is near zero. And the equipment works maybe better than it did before.
Science the hell out of it, and interview any surgeons or doctors you might use. Unlike so many maladies, you have time to make a good decision.
My late wife developed metastatic tumors in her brain. We had 3 different ~5mm tumors zapped over 18 months via Cyber Knife.
Truly a magic tool. A couple visits, no side effects, and the tumors were erased, never to locally return.
Absent other considerations, if a pro said my problem was addressable by CK, I’d totally choose that.
Best of luck
what a relief! I am so glad you have good, informed family support for the coming decisions.
You’re doomed. You’ll never make it past 120, 125 years tops😉*
*rough equivalent of “break a leg”.
So I got a text today that I signed up to get texts from MSK.
I got a call to tell me that I would get two bills, but not what they would be.
Then the real kick in the ass, I got a call after 5pm that they still didn’t get my records from my urologist. They might have to move my appointment.
So in a panic I called the urologist office. I got lucky a got office worker. She told me it was all faxed over this morning.
So I called my contact at MSK again and let them know. She said, after she called, she found the records were fax over. Oof.
I hope the treatment is easier than this.
Why are we still faxing? Please go digital and improve things greatly.
MSK = Memorial Sloan Kettering.
So unexpected option. Apparently the one Biopsy core that showed the 3+4 Gleason Score was only 5% of the core. Base on everything else, I need to consider just Active Surveillance instead of treatment.
This will probably put off treatment for 2-3 years, but sometimes much longer.
It would involve a future biopsy in about a year and lots of PSA testing. Might be the way to go.
If I opt for treatment, the treatment the oncologist recommended is the MSK Precise. (similar to Cyber Knife)
- 10 min procedure to put Fiducial Markers in the prostate and add a spacer between the prostate and rectum.
- Get a special MRI up in NYC for designing the treatment. About 2 weeks later can begin treatment local.
- Over a 2 week period go in every other weekday for a total of 5 radiation treatments.
- PSA Blood Checks every 3 months for maybe a year and then back to twice a year.
I’m so glad to learn you have reasonably good options! This seems like a pretty tolerable outcome for what you’re dealing with. Yayyyy!!
All things considered, this is not a bad place to be. Hope you’re feeling relieved. I know all your fans here are! 
Overall it is very good news. I’ll turn the torture of getting to New York City for another MRI into a hopefully fun day with my wife if I go the treatment route.
The fact that no treatment yet is on the table sounds good, but wondering if it is the right move or not.
At least it seems like you have some time to consider all your options. And I know you’ll make the best decision.
I’m consulting my unofficial medical team* now and I’ll probably PM @Qadgop_the_Mercotan also. Or he can opinion here.
The big question is should I put it off or should I get the treatment now.
I’ve heard from everyone how good it is that it was caught early, so it seems like waiting is not the best strategy, though I know the counter is Prostate Cancer is usually very slow growing.
* My 2 sisters & Niece (all nurses) and my BIL, a Doctor, though not oncology.
It’s great you have so many resources! You’ll have a consensus soon, I’m sure. Whatever you decide, I know it will be well thought through. 
Without trying to confuse your case with someone else’s, I’ll cite this other post for your consideration.
And this one:
My late wife had breast cancer, which is admittedly a quite different beast than prostate. After her initial surgical + radiation treatment we entered a series of years of maintenance meds and active surveillance.
Problem was the surveiling was not highly effective with the result that the first anyone knew anything was amiss she had disseminated metastases here, there, and a few other places for good measure. Her cat was well and truly out of the bag.
At which point we were screwed. A lot of effort gave her a number of good years after that, then some less good, and then finally 2 shitty ones, then it was game over. She was 65.
Overtreatment of incipient cases is most certainly a risk. And side effects of that treatment, whatever they are, are real.
For myself I am of the general view that “surveillance” needs to be real active and real frequent to avoid an escape like we had. probably more active than is practical for most patients. Again prostate is generally pretty slow moving, but she had one of the slowest moving BCs they’d seen. But once it was out on the loose, there was no turning back the clock.
I don’t yet have a PSA problem. My Dad did have active prostate cancer before he was my current age. So I am actively watching this in myself for my sake, and fully intend, if / when active cancer is found, to take the more aggressive treatment approach and forgo the active surveillance. Is that smart? Hell if I know. But speaking only for me, it “feels” right.
I’m a DYI guy and was a small shop programmer analyst, so my gut reaction is fix it, not watch it until it is worse.
One other thing to put on the scale is that in a few years there might be better treatment options. I am not qualified to say if that makes sense in the specific.
Damn, that’s a good point.
It’s so easy to second guess whatever decision you make. This was the worst part of the experience for me.
My doctor told me treatment wasn’t a big rush, with a very strong likelihood that waiting a year or two would not be a problem. But he also said at my age (about the same as you), it was likely I’d need treatment at some point (i.e., I’m not old enough to let it go forever).
So I decided to get treatment then, figuring recovery will be easier the younger I am. I don’t know if it was the right* decision, but two years later I’m happy with it.
*The concept of a “right” decision is kind of bogus. Each one has its pros and cons.
Thanks, I initially didn’t know what “MSK” stood for.
I will just say one thing. Sloan Kettering holds a very special place in my memory, My brother’s wife was diagnosed with lung cancer about ten years ago. She and my brother live in NYC. She was told by whatever oncologist was seeing her at the time that her case was terminal and inoperable. Not willing to give up, my brother pursued every option.
Long story short, they went to MSK and they saved her life through advanced robotic surgery. The kind that I don’t think was available anywhere else at the time. I know your case is nothing extreme like this at all. I’m just saying, you’re in good hands.
As a side note, the surgeon who saved her life was a pompous ass, but he was a very, very skilled pompous ass, and that’s all that mattered!
Yes. If there was one unambiguously right decision, your doctor would recommend it. The fact that you are being given a lot of options suggests that it’s a bit of a crap shoot. You don’t know how disruptive treatment will be, or know with certainly whether the cancer will spread.
I’m sure you will make a good decision. It’s good that you have a lot of support in this. But don’t make the perfect the event of the good. Research your options, pick one that seems like a good choice, and then move on.
Best wishes.
Another +1 for not beating yourself up over the whole “right” answer. And a reminder (if you ever re-read this thread years later) that you’re almost going to certainly second guess yourself with 20/20 hindsight no matter WHICH decision you end up making!
As @puzzlegal just said, if the experts can’t give you a clearer best option, they’re all full of pros and cons. I’m still amazed, as a slightly younger fart, how much medicine has changed even in my lifetime, that while still stupidly expensive and unfairly applied, we have so many more options than radical surgical or brute-force radiological therapies for cancer, much less many other conditions.
If anything, the good news of the recent review means you have more time to decide which is the best option, with somewhat less pressure to pick immediately. Figure out which set of pros vs. cons works best for you, along with which are going to leave you most comfortable mentally (I share your tendency to want to just FIX it and move on). But figure you have friends, family, and presumably doctors that all want you to have the best solution - you’ll figure it out together.