I am a Gleason 4+4 at stage cT3a and with Cribriform Pattern 4. My urologist, Dr. Abdul-Muhsin, Haidar, recommended RP which is scheduled 12 days from now. He also recommended I meet with Dr. Sarah James, Radiation Oncology, which I did yesterday. She told me that while radiation would normally be recommended in my situation, however,
I have BPH issues with urination and she informed me that radiotherapy will cause swelling in the urethra that could make future urination difficult if not impossible and I could possibly even need a catheter. She also told me that since I have coronary artery disease, and an adjunvant treatment of 18 months of HRT would be part of the radiation treatment in order to achieve the similar efficacy to RP, and HRT has, among many other potential negative health impacts, possible negative impacts on the cardiovascular system, and as a result of these issues, she recommended I proceed with RP and keep radiation for future salvage treatment if necessary. Dr. James listened and answered questions fully and I was quite pleased with her information.