This forum is for the discussion of anything to do with Prostate Cancer. There are only four rules:
No fundraisers, no commercials (although it is OK to recommend choices of treatment or medical people based on your personal research; invitations to participate in third-party surveys are also acceptable, provided there is no compensation to YANA);
No harvesting e-mail addresses for Spam;
No insults or flaming - be polite and respectful at all times and understand that there may be a variety of points of view, all of which may have some validity;
Opinions are OK, but please provide as much factual evidence as possible for any assertions that you are making
Failure to abide by these simple rules will result in the immediate and permanent suspension of your posting privileges.
Since this is an International Forum, please specify your location in your post.
Beth:
I agree with those who have posted that time is, indeed on the side of your father. I think that many urologists who see a man with clinical factors such as your father would not refer to CT scan or Bone scan because the chance of gross metastasis is so small. To address your question directly, for those men who are curable, radiation OR surgery, performed by the very best practitioner (KEY ITEM) can be equally successful. If there were a clear and obvious advantage to one, then that is what everyone would choose. Surgery has risks that radiation does not have, and these risks accumulate with age at treatment. Continence and potency are both affected by each treatment. With the G score and doctor opinions you mention then it is certainly likely that your father will not die of prostate cancer. Repeat: statistics show that men in the position of your father are most likely to die of other causes.
My situation was fairly different from your fathers on several counts - my age (40) being the biggest variable - so I can't point to any specific advice on best treatment plan but I have a couple of thoughts based on my own experiences.
First, yes, get the sample reviewed by another pathologist - Dr Epstein at Hopkins is probably the name most often mentioned - I sent my sample to him but it was also reviewed by the two top surgeons (or their own pathologists) who I met with.
Second, like everyone says, don't panic. I took my time (4 months) making a decision (having a Gleason 3+3 and 6% positive in one core I felt comfortable with that). It's important to remember that every specialist has his own preference - surgeons will want to perform surgery, radiation oncologists will want to perform radiation, etc. To compound it further, open RP surgeons will play down robotic data and robotic surgeons will advance their own claims of recovery rate and side effects. Probably the most important thing is to find the best team of doctors for treatment and feel confident in their ability to effect a cure.
