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@di341. In my case my PSAs were hovering around borderline for a 68yo. After a third high reading in three months I went to a urologist who performed a 12 sample biopsy. That procedure was so simple and fast I honestly didn't even get undressed! "Pull down your pants and jump up on the table."
Results showed 4+4 Gleason 8, or advanced PC. It was decided that no matter which option I choose we'd need to shrink the tumors first so I started on Lupron and sent for an MRI. The MRI was to determine if the cancer had spread. Luckily it was still contained in the prostate so it seemed I was a candidate for either surgery or hormones/radiation. The radiation oncologist showed me a website developed by a panel of oncologists which actually had a flowchart where the doctor plugged in your data and it determined your best plan of action. Mine predicted the same results with either treatment. Then I saw a urologist/surgeon who confirmed the same outcome BUT recommended against surgery because of my hypertension. Turns out you're tipped backwards for about 2.5hrs during the surgery and that's hard on your heart. So 20 radiation treatments and 2yrs of Lupron it is. One more Lupron to go. PSA is undetectable at this time.
Talking to men who have had surgery v hormone therapy I wish I'd been able to have surgery. While Lupron seems to have controlled the cancer the side effects have been hard on me.
Best of luck to you and continue to reach out to groups like this

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Thank you for sharing your experience with me. It’s all very helpful.