@shelby29

Because radiation with aggressive cancers sometimes does not give full result.

My husband was diagnosed with 4+3 and cribriform and IDC , Decipher 1 , PSA 5.6 before surgery and was recommended by both, the surgeon AND the radiologist, to have RARP as initial treatment.

RO said those words : " You have aggressive cancer and it is best to have "aggressive" approach in those cases and the most aggressive approach is surgery."

After RARP it was discovered that his gleason was actually 4+5 !!! So - if he was treated as having 4+3 which would require just 6-12 mos of ADT and "regular" RT , you can bet it would NOT be successful treatment ! Besides, PSMA is never all telling.

My husband is extremely happy that he had RARP, recovered very fast and is living a normal, very active life, already skiing and hiking full speed and working 3 jobs. If anything was "left" it would be something that is of lower grade and would be easily zapped with RT if necessary since it is not hidden inside the gland and possibly resilient and mutating even further O_O !

Every case is different and aggressive cancers require very specialized approach.