Newly diagnosed with prostate cancer and still gathering information

I am new here, my husband have only one plug 4+3 and only 3 more plugs of 14 total with 3+3, HOWEVER that 4+3 is what is going to result in him having surgery. It is not only 4+3, it had intra-ductal involvement and cribriform cells present. His Decipher test also came back showing high risk for spread and in this particular case RP shows better result than RT.
So sorry that you have to deal with PC diagnosis, it is terribly emotionally tasking event : (, but many, many members here have good results with all kind of treatments and that is very comforting to know. Honestly, if I did not find this forum and did not have so much understanding and support from many members here , I would never be able to gain so much knowledge in such short period of time.

I had exactly the same diagnosis. Gleason 4+3 unfavorable. I chose surgery at age 64 ( your age is VERY important in deciding on treatment) just in case the cancer came back.
Five years later it did and I just completed salvage radiation and ADT.

If you are still in the 'deciding' what to do stage I strongly urge you to look very closely at removal
of the prostate. I had cyber knife radiation 12-13 years ago and the long term side effects are still showing up and they are not pleasant.

Not from experience, but you should see a couple of radiation oncologists. As you mentioned the surgeon that perform surgery do so because they think it is the best treatment. I think the radiation oncologist(s) will recommend radiation. You might watch this video on the five fraction treatment.
https://www.youtube.com/watch?v=ZpK3JhVUNDk His other videos are informative as well. You might want to watch the PSMA/PET video.
Is anyone talking about ADT.

@brucemobile
I had RARP 7 weeks ago and I am doing okay. no ED and no incontinence. It is a tough decision to make but it helps to read and ask questions.
https://pubmed.ncbi.nlm.nih.gov has a lot of published medical papers that helped me educate myself quite a bit in making my decision to go with surgery.

@brucemobile & @jayhall I have been in this support group for more than a month. My impression, based on the many postings I have read, is that for those diagnosed early (in the 50's or 60's), surgery is a good option. For those in their 70's and over, radiation may be better. I was 68 when diagnosed. My first option was robotic assisted radical prostatectomy, but after considering my family's concerns about surgery at my age, I reconsidered and I am now scheduled for SBRT April 9 - 21 for five treatments. I hope it goes well for me, and for the gentlemen (younger or older) who choose surgery.

Hi Vircet. Thanks for sharing your process. I think it’s a great example of how we make decisions that are right for us - and we’re all different. I wish you the very best in April and look forward to hearing updates of your successes!

(With somewhat similar numbers - PSA of 7.976, Gleason of 7(4+3), localized, 65y/o - I chose proton beam radiation that I had during April-May 2021) + 6 months of Eligard + SpaceOAR Vue.)
Urologists usually favor surgery (because they’re almost always surgeons); get referrals to a radiation oncologist and a medical oncologist.
Always get a PSMA PET scan. Also, ask them for a biomarker (genomic) test and a genetic (germline) test. Those results will all factor into your treatment decision.
You’ll always have options no matter what the outcome of all those tests. The doctors will provide you advice and recommendations, but the ultimate decision will be yours.
One of the understandings I had with my doctors was that quality-of-life and successful treatment were equal priority for me. That set the basis for us working together and agreeing on a treatment plan. In every decision, that “equal priority” was front and center.
The proton radiation treatments were relatively uneventful. Now 4 years later, PSA is remaining low (between 0.35-0.55). It’s as if nothing ever happened - just walked in a revolving door, got treated (28x), and walked out the door…..it’s practically back to the way it was before the prostate cancer journey started. (My wife later told me that if she hadn’t known I was undergoing radiation treatments, she wouldn’t have realized it from any change in me.)

Good luck with your decision.

I think the decesion on what type treatment has to come from the individual after researching and becoming an informed patient. Many times like me and many others we get second and third opinions. Not that we dont' trust our urologist and R/Os but that we want to have multiple opinions and if not the same why.

I was 76 when I was diagnosed. My urologist referred me to R/O. My first consulatation with Mayo R/O did not rule out anything but went over all options including surgery and types of radiation treatments. I did not experience the same I see from other posters that surgeons want surgery and R/Os want radiation.

I was given all optioins and the pros and cons of all. I also appreciated at the time my original R/O recommending Deciphter test as at the time was not familiar with it Decipher test and now see how imporatant beneficial test it is. I also had the bone scan and PSMA tests.

I chose 30 rounds of proton radiation after two different consulations with two different medical facilities. My PCP went over all with me and we agreed on what was best for me.

Very happy for you!! Hope things continue to go great for you long term like 12-13 years out.