Prostate cancer treatment options?

Yes. Upon removal and examination the medical staff upped my Gleason score and changed my cancer medication. This reevaluation would not have happened but for the surgery and examination. This was a hidden benefit for me for surgery rather than radiation.

Being brand new to this, I’m still trying to wrap my head around this. I really appreciate you replying to me. What do you mean by “they upped my Gleason score? Is it better, worse?

Worse. they changed my Gleason score from 8 to 9 which resulted in increased cancer medication for a longer period of time. The cancer had spread locally to the seminal vehicles and was graded as aggressive and advanced Gleason score 9. It did not please me but I was glad that they caught it and are treating it. Two years ago my surgeon gave me a prognosis of 4-5 years and that still alarms me but I am hopeful. The research that I have done indicates a life time prognosis of 60 months from the cancer discovery and 41 months of event free survival. I am now 76.

Best wishes. Stay healthy!

We all go through emotional phases . First there is denial, then an OMG phase that “This Is Actually A Cancer that is in My body” then there is “this is my situation and I have to deal with it as best as I can” I am in the last phase. We all go through something like this. Good luck

bens1 has given you excellent factual information. Read it carefully and understand. My 10 Gleason was treated at Mayo Phoenix with proton radiation. A sound choice on my part. Proton treatment is extremely local, meaning there is little to no damage outside of the selected area. This means you may still have unaffected prostate tissue remaining to take over and repair.
I was treated with Lupron. It has good points and some very bad points. If you are healthy and physically active it then appears your Lupron effects can be zippo. On this group you will find some with no Lupron issues whatsoever. BE PHYSICALLY ACTIVE to minimize the negative effects of Lupron. Best of luck to you, understanding that luck has little to do with your outcome.

The PCF website mentions that the Patient Guide has been divided into two guides: Early dx/tx (newly revised) and later tx (under construction).
Treatment techniques and protocols are changing regularly, and Proton tx has evolved from experimental to more mainstream. Similarly, ADT therapy protocols have evolved.
My personal view is that all the mainstream radiation txs at major tx facilities are comparable.
I had IMRT salvage radiation at Johns Hopkins in Baltimore and a friend is receiving proton salvage radiation at Sibley Memorial, a Johns Hopkins facility in DC.

Diagnosed in 2021 and was similar to your situation. Gleason 4+4. I was 71 and healthy. Surgery was never an option as I never spoke to anyone that had a successful outcome. After much research I decided to do proton radiation.
Spoke to an oncologist at Mayo Rochester and was told I was a good candidate for 5 treatments of proton at a higher dose with a Space Oar procedure done prior to protect the rectum. Also did Lupron for 14 months. Side effects for me were minimal - mainly sleep.
Side effects lingered for almost six months after my last shot, but I feel as good now as before the diagnosis. My recent PSA was < .10 so my cancer is in remission.
After the initial shock of knowing I had cancer, I found what I felt was the best treatment for me. Best wishes to you as you do your research and for a successful outcome.

What was your Gleason score before your prostectomy? My dr said it is rare for it to get much higher upon doing the prostectomy biopsy from what it was before doing it. Assuming you do it within three months or so from biopsy.. He said if it’s a 3+4 , possibly 4+3’s but would be rare to go to all4”s or higher. I believe all options are equally effective and it’s really up to the individual to weigh out the after effects for their lifestyle and for the comfort level they feel is “enough” of a treatment for them. I do believe urologists suggest the removal more often because they truly believe in their field and oncologist radiologist suggest all the radiation treatments because they truly believe in their fields as well. So it comes down to the patient to decide what’s best for them. As someone else said, there are no wrong answers.

Thanks for your reply. Health and happiness.