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I had pain in my bladder area and been for ultrasound, everything is fine.
As far as treatment is concerned all depends on first psa value if its <.2 then I will wait for 2 months for recovery and then start radiation however if its more than that then radiation in 3-4 weeks that will give more time to recover from surgery or if more time is needed adt injection.
However all based on psa due in 2 weeks time (6 weeks in total).
Your question is a good one. You can go to: https://www.mskcc.org/nomograms/prostate/pre-op. You will find that you have around a 99% chance of having extra capsular extension with your gleason 9. So the real question is, Will surgery improve survival? Studies have shown that you improve your survival apx 3% if you have surgery first. You have to decide if that 3% is worth it given the chances of additional side effects. You will very likely require radiation and hormone therapy down the road to maintain control of your cancer.
Your urologist should have told you this and I am disappointed that most don't.
One of my pet peeves is urologist saying that they are treating you with surgery "with curative intent". What does that mean if 99% of gleason 9/10 guys recur.
Keep in mind that you can still live a long time with the addition of systemic therapy.