Per the NCCN guidelines, the treatment options for High-Risk prostate cancer are surgery, beam radiation, or a combination of beam radiation plus radioactive seeds. Hormonal therapy (with Lupron for example) is usually given along with the radiation for two to three years. But patients certainly wonder if one of these three treatment options is better than the other two. A study published recently in the October 2016 issue New England Journal of Medicine compared surgery and beam radiation prospectively in men with mostly Low-Risk prostate cancer. It showed equivalent survival rates. A prospective study for High-Risk prostate cancer, however, is unavailable. Only retrospective studies are available.

Eight years ago, at the age of 55, I learned I had prostate cancer. At that time, ignoring three separate doctors’ recommendations, I decided to forego surgery. One of my doctors, a urologist, gave me the name of a patient who was on active surveillance. I contacted Brad Cole and our conversation gave me the courage to try it myself.

Choosing the right specialist is a decision that will have a significant effect the rest of your life. So I repeat, take your time. And make sure that the doctor you choose gives you confidence that the treatment he recommends will be successful.

Maybe it’s shabby of me to immediately think: It’s all about money. The pot of gold at the end of the prostate cancer rainbow. Well, the first dip into that pot is billing for all those PSA tests, DREs and biopsies. Standard screening procedures, right? Only it’s not that clear cut. More and more these days, I tend to consult with Dr. Google. Turns out there is disagreement in high places.