I am also newly diagnosed: Gleason 3+4, 1 out of 18 cores positive, 14.5 PSA and a GPS score of 47. Per NCCN guidelines, I fall into the unfavorable, intermeidate risk category because of my PSA is greater than 10. In addition, the GPS genomic score of 47. suggests a very aggressive form of cancer which could have spread to lymph nodes: even though my PSMA PET scan did not show metastitis in April. (These scans are great but are not always perfect)

After having my patholgy report re-read and re-confirmed, I consulted with both surgeons and radiologists so I could decide between surgery and radiation which - in expert hands with the latest tools - have roughly equivalent long term cure rates, but with different side effect profiles. Surgery is in some ways the most invasive form of treatment, but I learned my pre-existing urinary symptoms due to enlarged prostate were likely to be greatly exacerbated with radiation treatment. I was left with one option: surgery which is scheduled for this coming Tuesday.