Getting ready to make a treatment decision now that all my tests are in.
Age 64
Good health
PSA 4.8
MRI
Biopsy
Stage T2C
Gleason 6/7 (3+3 and 3+4)
Total body bone scan - nothing indicated
Genomic - high risk
Consulted with a surgeon and radiologist
Thoughts?
Experiences?
Thank you all!
Where do you live? Can you travel for treatment?
Why do you say "Stage T2C"? Was that based on a biopsy, or a DRE? What percent of your biopsy cores were positive?
Considering your high genomic risk, you are probably best off being treated as "unfavorable intermediate risk." That means that all of the following are good choices:
• SBRT
• HDR brachytherapy monotherapy
• Brachy boost therapy (external beam radiation+seeds)
Treatment will probably include about 6 months of ADT.
You have to meet with radiation oncologists who are specialists in each of those (not the generic radiologist you plan to meet with).
Surgery has inferior results for unfavorable intermediate risk. You can see what the expected cure rate is by filling out this nomogram:
mskcc.org/nomograms/prostat...
You may want to read this article:
Nearly 7 years after diagnosis - it's decision time.
Making a decision! 
Information overload and now decision time!
treatment decision 
Decision Time - After Xtandi
