@clevelandguy "I’m really surprised you had surgery, it sounds like your Prostate cancer has already left the barn. You said that the MRI and the PET scan did not show spread but the details in the pathology report showed lymphatic and/or vascular invasion plus PNI if I read that right."

But that pathology report is from his surgically-removed prostate. Pre-surgical needle biopsy rarely detects or reports LVI and the poster never suggested his did. Likewise, he didn't say if PNI was present on his needle biopsy, but even if it were, that has not been shown to be meaningfully correlated with advanced disease.

So if his pre-RALP MRI and PET showed no spread, surgery was an entirely reasonable treatment approach.

Speaking as someone who's been on the receiving end after RALP of similar comments like "I'm surprised you had surgery", I find that a rather obnoxious thing to say, doubly so when you don't have clinical basis for that judgment. The commenter made his treatment decision and having the peanut gallery second guess it now is not in any way helpful or supportive.