New and looking for info

@webs4298 I agree with the Decipher test. I have attached a word doc of sources I have collected with summaries of issues and solutions that may help your husband.

see above comment

Hey Wife, Don’t get flustered by medical mumbo-jumbo! What you have described is pretty simple: it is a more aggressive, highly dense form of prostate cancer. It’s there and must be dealt with.
Surgeons will recommend surgery, radiologists - radiation therapy if some kind( there are many!). As others have said, hubby needs a Decipher score (gotten from biopsy) which will tell you how aggressive (if its the metastatic kind) it is, and a PSMA PET scan to see if there has been any spread.
Once you have all this info you can get consults and proceed with the treatment that makes the most sense to you and your husband. No matter which you choose, the outcomes (successes and failures) are about equal. Your husband may also require hormone therapy (ADT) to slow down and weaken his cancer before/during/after treatment.
I am not an expert but don’t think that things like HIFU, TULSA PRO and other focal therapies (which claim to be less invasive) are an option for treatment due to the widespread disease inside the gland. Also, be certain your care team is the A-Team! No small rinky dink hospitals or DRs who are not experts in their field. Large university hospitals and centers of excellence like -Mayo, Sloan, Cleveland, Anderson, etc are where you want to go.
Of course, this forum is an invaluable place to get any information you might need - especially in understanding all the technical stuff. Just post a question about whatever topic you like and you will receive a barrage of comments, advice and support from men who’ve been there and done that!
Best
Phil

1 - Dr Walsh's book Surviving Prostate Cancer (as has been suggested) is well written easy to understand and comprehensive.
2 - Patient Guide free from the Prostate Cancer Foundation pcf.org by download or hard copy.
Best wishes

Good morning. I wanted to add my experience and suggestions as I was diagnosed with G8 at age 68 3 years ago.

G8-10 are considered high grade, aggressive cancers. Men with G6 and some G7 cancers have many months (or longer) to research and make decisions about treatment options. Although your husband's cancer treatment is not an emergency, you should proceed as quickly as possible and decide on a treatment option. I am not suggesting you need to do something in the next few weeks but just move the process along.

In my opinion, it is critical to have a consultation with not only a urologist but a Radiation Oncologist as well. Your husband really has 2 options: surgery (radical prostatectomy or RP) or radiation therapy treatment. You may also want to seek the opinion of a medical oncologist but need to pick one that specializes in genitourinary oncology (kidneys, bladder and prostate). The field of prostate cancer is evolving so rapidly that it is very difficult for a general oncologist to keep up with treatment of all types of cancers.

From my extensive discussions and research about treatment options for G8, radiation and surgery have about equal long term survival rates. You will hear/read people advocating for one or the other; usually people that have had that particular treatment and therefore believe it is best, or those that have had side effects or complications and wish that had had an alternative treatment. Individual stories are of no benefit to you or your husband. It is the large numbers and clinical trials that should guide you.

Your doctors may want your husband to have a PSMA PET scan. This is a relatively new test that has the best chance of identifying any spread outside the prostate. There are different treatment options if: 1) the cancer is confined to the prostate (surgery is a good option), 2) if the cancer has spread outside the prostate but remains localized within the pelvis, 3) if the cancer has spread/metastasized outside the pelvis (usually to bones or lymph nodes). If the cancer has spread outside the pelvis it further divided onto high volume disease and oligo metastatic disease. Most progressive, knowledgeable medical oncologists treat these two differently.

Seek second opinions. Start making the appointments now because it may take weeks/months for him to be seen in a busy practice. Go to a Center of Excellence, even if it means you need to travel. I travelled from Georgia to Johns Hopkins in Baltimore and it may have saved my life. Your husband needs treatment by an expert with both cutting edge knowledge and experience.

Surgery has side effects. It can result in incontinence (usually, but not always, temporary) and erectile dysfunction. These side effects depend on age, extent of disease, skill of the surgeon and your husband's presurgical condition. Radiation also has side effects; some are more acute but some are delayed. The Radiation Oncologist can explain these in detail.

Be careful what you read. Much is out of date. The survival from even aggressive prostate cancer has changed significantly with a myriad of treatment options over the past couple of years. More are on the way.

Good luck to both of you.

I certainly agree regarding the dating of information. I try limit my reading to journal articles, symposia presentations, etc. that are perhaps a year, or maybe two years old. This is not to say the there isn't useful older information out there. But, I figure most of it has been superseded by or incorporated into more recent writings/presentations.