Gleason7(3+4) - treatment options recommendation

Given that radiation and surgery have similar survival outcomes, if sex is very important to someone I think it's entirely reasonable to choose the option that's likely to cause less sexual dysfunction. With cancer, holding on to some things can feel very important, even if the things themselves seem trivial.

I referred other members to review the U.K. Protec T trial results which were released in 2023 .
This was the largest 15 year study of Radiation , Surgery and Active Surveillance for prostate cancer . To my knowledge , Focal Therapy did nor form part of the trial .

The study is pretty clear. It doesn’t matter which treatment you had results are about the same. This was started 15 years ago and they are many new techniques and even new treatments besides surgery.

It would be interesting to see what the results are now, because the new techniques may have more successful results. In the past radiation and surgery, at times, both left some cancer cells untreated, leading to future spread. The new radiation techniques have probably reduced the amount of untreated cells. The Mridian radiation is a big advancement.

The study started before use of SBRT and Cyberknife SBRT. Apparently IMRT was the radiation treatment. Again, I wonder what the results would be with the latest technology.

My surgeon and radiation oncologist both said if you have radiation first RP is off the table.

It’s not an RP, it’s called a salvage prostatectomy.

Look it up for details.

I ordered the test kit on 9/28 and on 9/30 got shipping info, so I guess they don't contact my docs first. Should have the kit Saturday.

I do not know the answer to your question . I noted in Dr. Patrick Walsh's 5th Edition " Guide to Surviving Prostate Cancer " : There was no mention whatsoever about NanoKnife , yet it is gaining ground worldwide and showing positive results for low to intermediate Prostate Cancer . I personally know 5 individuals who have undergone the procedure : 2 in Germany and 3 in Toronto, Canada . Another is awaiting a procedure date .
I am on Active Surveillance . I am reviewing my options : NanoKnife , SBRT Monotherapy and HDR Monotherapy Brachytherapy .
Canada is one of the few countries who does not have a Proton Radiation Facility -- We are behind the times on this one . Lack of funds -- Billions for illegals .

That is not true for all physicians and facilities. Doing surgery (usually called salvage, an unfortunate term) after radiation is more difficult, and many physicians don't want to mess with it. But there are surgeons in Mayo Rochester Urology who do the salvage procedure for appropriate patients. I am sure that is true at other major cancer treatment facilities.

I am not doubting you at all. Just passing along my doc’s counsel.

Nanoknife is a FOCAL therapy similar to laser, cryo in that it only targets cancer cells.
But targeting cells is tricky stuff even with the best scanning technology. Only tumors of a certain size will show up on scans. What about tiny clumps of three or four cells which have not grown to a viewable size?
I applaud any treatment that can spare an individual from the side effects of RP or radiation but I am also concerned that treatment might not kill all the cancer present in the entire gland.
Just my opinion and not an endorsement or criticism of any treatment.