Brothers update

Ok he met with the surgeon, said it hasn’t left the prostate, said 20 yr survival rate is almost 100 percent and if it does come back it’s easy to treat???
He recommended radiation over surgery even though he’s a surgeon

The survival rate for a 68 year old man at 20 years is no more than 50% so I suspect his surgeon’s comment was a slight exaggeration meant to reassure your brother.

The G7(4+3) as you described previously is a real cancer and requires a thoughtful treatment plan. Hopefully he will get with a RO who is a little more pragmatic and can advise him of the “risks and rewards” of different treatment schemes.

cvc: it's an entirely personal choice. At 68, he's getting to the age where surgery starts becoming riskier. That being said, there are lots of surgical patients older than him. It's all about risk tolerance and effort required. Surgery is over in 24-48 hours....but it takes weeks, if not months to recuperate from. Radiation usually takes multiple treatment sessions (from 2 for HDR to 5 for SBRT to 30-40 for EBRT). Surgery gives immediate results, and full pathology of his prostate. Radiation takes months to years to determine effectiveness and knowledge of cancer control.

So....he needs to talk to the RO's (His Urologist is suggesting radiation--that's significant, I think), and get info about the multiple available options, and then make a decision.

It is probably significant that his urologist is recommending radiation as halbert noted, probably the MRI shows something unfavorable in conjunction with the G7(4+3) pathology that pushes him in that direction. Could be age and general health also.

Radiation comes in many flavors and in various combinations with hormone therapy. This is why he needs to find a good radiation oncologist that does prostate treatment regularly to evaluate his situation and propose treatment schemes. He may have to find a couple of RO’s since there are different types of equipment and expertise needed for the different methods that are not always in one location if he wants to learn about them all.

He will just have to seek out the best radiation providers he can find locally or look to NYC or Buffalo if he wants a more expert group to review his situation. A lot will depend on his attitude towards his disease. If he just wants it done as soon as possible, he gets a RO referral from his urologist, schedules a visit, and gets treated. If he is more careful, he would read a lot, visit forums, and get more opinions to help make the final decision. He does not have years to think about it but he can take the next month or so setting up meetings to get educated about the treatments available and one will rise to the top in his mind.