mhreed39, I definitely agree with surgery to remove your known aggressive cancer. I was diagnosed 2 1/2 years ago at 55 years old with Gleason 7 (4/3). I opted for surgery for several reasons.
First, surgery removes all known cancer, versus relying on imperfect imaging tools to direct treatment. I did not want to manage my PSA at a low level but rather have a more definitive PSA/Undetectable PSA test.
Second, I wanted confirmation of the cancer grade and aggressiveness with a physical pathology. So many men find they have more aggressive or additional cancer when the pathology is performed. Today's scanning technology is awesome, but I just did not want to bet my life on it.
Third, I wanted to reserve all future options in case the prostate cancer came back (thankfully, PSA undetectable thus far). From my research and referencing medical professionals, it is very difficult or impossible to have surgery after radiation.
I am very high on surgery based on my research and outcome, but surgery is not for everyone in all situation. You need to assess your personal expectations for life going forward and take into account other comorbidities and age. I was healthy, relatively young for prostate cancer (55), positive, and have an expectations for 30+ additional years of cancer free life to spend with my wife, son, and family/friends.
Best of luck and I pray all goes well with the treatment you move forward with!!
Jim
Hi, @hammer101 and thanks for the reply. Unfortunately my cancer has escaped the prostate and metastasized. So surgery is off the table, will be doing radiation and ADT.