Deku - OK you have prostate cancer . the up side is your 51 and hopefully in decent shape . Start now getting ready for treatments . This is not a death sentence BUT , you have to meet this head on and start learning . Create a binder , EVERY document, Dr visit notes, images , PSA test , Blood panel tests , narratives about your case go into this mobile binder ! This will be helpful for you and other doctors . Here in Canada you will be surprised how one hospital does not talk to another Image department hospital . So you will have your mobile profile there . Over the last 5-8 years so many advances in Cancers like this ! You will likely die of something else than protate cancer at 85+ years of age - to be VERY frank . It appears with the high PSA the PC has travelled a wee bit . Why did you not get yearly physicals ? Or did you ? Have you been monitoring the PSA rise or ? From what I see in the Biopsy ( which can be misleading ) you have some extra-capular extensions to this PC likely the seminal vesicles , maybe the close by Lymph nodes - but im not certain . Here what you need to do . Get in the best shape of your life for potential surgery , know that yoru age is on your side for healing and recovery , make sure ALL yoru friends and family know you have this challenge in front of you and encourage them to get PSA check now and every 12 months ! ( dont hide it re - people with breast cancer tell the world usually , hence more dollars and attention to this cancer) , consider with yoru Dr a PSMA-Pet scan , contrast MRI , Bone scan, Ultra sound of abdomen , an Dany other diagnostics that the Dr's think would be good . One advantage of surgery is you can get the Pathology details . Also , make sure you ask hospital to freeze your Prostate for further testing , as Gene therapy and other cures/helpful treatments are comming every month it seems now . Remain VERY positive - this helps with healing . Make sure EVERYONE KNOWS , and how to get a PSA test and track the yearly results - it may save someones life , this is nothing to be ashamed of - thats what got the PSA up to 72 likely in the first place . This is now a life project for you , great it as such . Do you have any urological symptoms ? Any other health issues ? Speak right away with a Urologist ( URO ) and a Radiation Oncologist( RO) as soon as possible . We are here for you - so many great minds here and medical experience . Be proactive to the Max ! About me - I was diagnosed early at 58. Very fit . PSA was 4.2 . Steep family history , hence going to GP and URO for 5 years yearly prior to diagnosis . Im 61 now . Had surgery , 3 years ago , Pathology report saw no tissues infected with PC other than Prostate ( But micro pieces/cells can escape prostate at any time. Lesson was small in size , but near wall of Prostate and 2mm extrusion of cap of prostate that Dr's feel just happened , as no tissues were infected close by outside of prostate , but still a major concern of mine. No invasion of seminal vesecls, predominately , 3+4= 7 Gleason . My 3 type was 60% of session my 4 type was 40% of session. No type 5 present . Type 3 is usually not treated these days . A type 3 cell will not turn into a type 4 cell and so on, my Urologist told me . This is a key feature of PC surgery is you get the prize, the Prostate after surgery to get all the material facts - remember to get them to preserve it for future DNA and other testing( usually routine these days , but check your region) . After surgery my PSA did not bottom out at 0.008 . It was like 0.07 for the longest time , so two years ago I spoke with my RO . RO said we could do Salvage radiation . I was at 0.14 PSA at the time . He said no need to wait for 0.2 or 0.3 he said . So at 0.14 , I got External Bean Radiation Therapy ( EBRT) , also known as salvage radiation. This knocked PSA back eventually . I went from 0.14 , and after about 10 months PSA started to decrease . Last PSA test was 0.041 from what was o.14 prior to radiation. Dr's were quite sure any "good or bad cells still remain in pelvic region" . Anyway I gather they were right as PSA came down , after about 8-10 months . Radiation and operation has about the equivalent PSA Efficacy for 'normal' PC . Different recovery curves though- with surgery taking longer . Start reading up on both primary treatment types . We are here for you . You are not alone . Please keep us informed of yoru progress . I am not a dr ( rather an airline pilot) so my medical knowledge is very minimal , but I can tell you of my experience . Its also best you join a Prostate support group that meets monthly or whatever . You can learn a lot , plus the guys are very nice to bond with . God Bless Sir ! James on Vancouver Island .