Time to decide what treatment is best

@ginger38314 Hope he gave you % and margins based on images which is a big part of that decision (imo).
My first consult just said “he’ll do his best”
Retzius may be worth considering too if they feel a posterior approach works for your situation

@brianjarvis 2 cores 3+4 10% and 40% component .8cm lesion pet scan was negative and mri didn't show any invasion. The .86 decipher score is what worries me down the road even though now it shows it being contained so ralp seems better in my situation if there was reoccurance.

@ginger38314
Hi, If it was me I would go with robotic surgery 1st then if needed in the future you still have some form of radiation as backup. The one incision procedure gets good reviews from folks. No need for nasty ADT with the surgery.
Dave 3+4

I assume your PET scan being negative means that the cancer has not spread outside of the capsular prostate? That was the case with my PC last year (3+4 Gleason, 2mm and 3 mm lesions at time of biopsy). I was 61 at the time. I chose robotic assisted laparoscopic proctectomy (RALP) last December. My margins were not clean of cancer and my pathology post surgery showed 4+3=7, Grade group 3 with 3 masses of cancer. My surgery was 6 months post biopsy. In my case, my cancer had progressed to the point if I had waited another 6 months, I may not have had as successful of surgery. My decision was to get rid of the cancer BEFORE it spreads. I have not had any long term issues post surgery (ED and incontinence). My PSA at 9 months post is .2 ng/ml and is rising so I am in discussions with my Urologist and surgeon. Salvage radiation my be in my future. At least I still have the option of radiation. If I had started with radiation and that did not remove all cancer, it would most likely be too late for surgery. If you haven't already, get a copy of Dr Patrick Walsh's Guide to Surviving Prostate Cancer. Good luck with your decision.

@gfeaglefan Question, were you able to find out WHERE within the prostate your tumors were located? Close to Colon wall, mid section or other? Sometimes location dictates go or no go on surgery. My tumor was real close to the colon wall so the decision for RP was a no brainer.

@gfeaglefan Question, were you able to find out WHERE within the prostate your tumors were located? Close to Colon wall, mid section or other? Sometimes location dictates go or no go on surgery. My tumor was real close to the colon wall so the decision for RP was a no brainer.

My main concern was the high decipher score if reoccurance would happen.

@ginger38314
I imagine you are glad you made your decision to have surgery as your treatment. I don't know if you decided on ADT or not.
I had RALP and then BCR occurred. I had a higher decider score (.96) plus many high risk features. My RO was on the fence about adding ADT to the salvage radiation therapy. However, I was also in the luminal b subgroup, and the randomized trial NRG GU 006 showed the benefit of ADT was restricted to Luminal B patients, so we agreed on 6 months of ADT. Your doctor can get the Decipher test back up sheets and grid that will show your subgroup--you probably just got the summary sheet like I did.
(NOTE: subsequent to our decision, a PET scan showed lymph nodes involvement, so I ended up on the patch and Abiraterone/Prednisone, all three for a 2-year period. )