@rickdent
At 77 surgery is not the greatest idea. Radiation would take care of this for you and would be just as effective, and last a long time. If you had surgery, it might come back soon and you’d have to have radiation then.

I’m 78 and had my diagnosis at 62. Had surgery because my father died of prostate cancer and had radiation, It came back after 3 1/2 years and I had to have radiation. It has come back three more times, but the drugs they have today work very well And keep me undetectable.

My brother at 77 had five sessions of SBRT radiation. He’s 80 now and doing just fine.

I know people that had Gleason nine and had radiation and it didn’t come back for 15 or 20 years. Rick, The guy who runs the ancan.org Advanced prostate cancer meetings had Gleason eight and had SBRT radiation 17 years ago and is Having no reoccurrences.

I don’t think there’s really a lot of decisions to make, Radiation will work just fine And give you plenty of years.

@rickdent I have been there. At 77 I don't think you'll have a surgery. Gleason 8+8 is high and your medical team, I guess, will try to block the testosterone to slow down the cancer. Lupron has some side effects but it is is the most efficient known to block the levels of testosterone.
If this helps you, I have the surgery 9/19/2015. The cancer came back on 8/17.
Since then, I have been with cancer; stage 4 since 6/2019. I am 80 now.
Good luck

@rickdent Similar situation at 76 YO. Doctors do not recommend and really didn't want to discuss. I spent way too much time researching the surgical option because articles, including those from leading sources, rarely mention age related treatment limitations.

@rickdent Did you have a PSMA PET scan? At a Gleason 8 there is a high probability of micro metastasis in the prostate bed which would give you a recurrence after surgery. The Decipher is also not good. Recovery is also worse from surgery the older you get. Many surgeons will not even consider a patient at 77. For all those reasons radiation with ADT was probably recommended. If there are no metastasis on the PSMA PET the ADT should be 6-12 months. If Orgovyx is covered it is usually easier than Lupron on the body. Has an ARSI been discussed in addition to Lupron? All of this depends on what was found in the biopsy. How many cores were positive? What percentage of these cores? were there other aggressive conditions found?

@rickdent
Me? No choice. Radiation only choice. 28 workdays straight.
Surgery considered as first option not recommended for me (age over 70), low platelet count, and in my case, prostate attached to my skin.
The good news, nothing glowing on post radiation PSMA test (gold standard).
We all walk in our own shoes, on our own paths.
Godspeed in your journey!

@rickdent

At 83, 12 of 12 showed cancer, PSA near 100. Opted for chemicals and radiation. Took a couple of years. Now in remission for about three years. Had to have follow-up surgery to abalate lesions in rectum due to radiation. Piece of cake. ED is given. But at 87 its probably not that inconvenient. Aids like Viagra and injections were not very helpful.

Check with your Dr. - surgery is not always a cure all. My radiation Dr. said she sees a lot of prostate cancer patients where surgery was the first choice, but is back.