Wayne's advise is right on. I'm 76 and was diagnosed with prostrate cancer 2.5 years ago. My Gleason score was 4+4 and was told by my urologist that it was an aggressive form. However, there was no discussion about genomic testing, nor was there any mention of an MRI to determine if the cancer had spread outside of the prostrate. Where I lived the two options were surgery or Photon radiation. I consulted my GP and a friend who was a doctor and neither could help on best option. I felt like you. What am I supposed to do? The decision was being left upto me.
As I was trying to decide, my wife talked to a friend who mentioned that he knew someone with good success with Proton Beam radiation therapy and was cancer free for 17 years. I checked into the research and determined it was a better option than Photon, but it was only available at limited locations, including the Mayo Clinic. I didn't want surgery so chose Proton Beam therapy treatment at the Phoenix Mayo Clinic. At Mayo I talked to other patients who had the same experience and even had doctors put them down for choosing Proton Therapy. They chose it based on their own research and not doctors' recommendations.
When I got to Mayo I learned there's a lot more to doing a thorough diagnosis then a biopsy. The first thing they did was to put me through a number of scans to rule out any progress of the cancer to my bones or other organs. Fortunately, it was contained in the prostrate. I know men who didn't have this check and later found the cancer had progressed to other organs and bones resulting in the need for severe forms of treatment.
My treatment consisted of 3 "hormone" shots over 18 months and 20 sessions of radiation. Two years later my PSA is negligible. I had not heard about the combination of hormone shots and radiation, but it is the recommended treatment for more advanced forms of the cancer. It improves your chance of survival by 20 %. There's now a form of the Antigen Deprivation Therapy that is in pill form that acts faster and the side effects recede faster. It was approved by the FDA last fall. The shot slowed down the progression of the cancer by shutting off the production of testosterone. It also shrinks the prostrate to make radiation easier and kills any stray cancer cells in your system. It's not a picnic but is necessary.
When I was doing my treatment I heard about the 5 treatment option. It's a stronger form of radiation and Mayo was studying the toxicity of the treatment. They concluded it was safe. I believe the number of treatments is based on how well they think the patient can handle different levels of radiation. At Mayo they had patients with 20 upto 48 sessions. They have a group of specialists who recommend the level of treatment. I also learned about the genomic tests after my treatment. They tested me to see if there could be a hereditary link to my cancer. There wasn't but I learned that they have isolated certain gene mutations that can cause the cancer. They have developed remedies to repair these genes to cure the cancer. The same is true for breast cancer.
I hope this isn't too much information, but this was my journey. I wish it was easier, but take Wayne's advise and get as much information as you can. There are other treatments as well that others have used and are documented on the Mayo Connect. This can be a stressful time so stick together and you can make it through it together. At the end of the treatment they have you ring a bell to signify you are cancer free. My wife and I rang it together because we both went through this together. It's like a huge weight has been lifted from your shoulders.