You can get quite a few varied opinions on this from surgeons, I actually had the therapy before surgery thinking that I might go with radiation instead of surgery, the rad onco assured me that the therapy would not preclude me from surgery if I decided that way. When I informed the surgeon I chose to do the surgery(DaVinci) he was supportive and didn't think that it would cause any complications. He did say that it took a little longer than usual for the surgery to be completed but that it wasn't a big deal.
There are some positives and negatives that came from the therapy. My path report denoted that the tumor had been shrunk substantially meaning that if there was more therapy needed it was obvious that Casodex and Lupron would work very well. I also had the peace of mind knowing that during the lag time from diagnosis to surgery that there would be no further cancer growth which was a huge load off of my mind. It also gave me time to look into all of my options and not feel rushed to make a decision.
The negative was since the medicine did such a good job on the tumor they could not get a defenitive Gleason score on the path report. I had three reviews of my needle biopsy so I had a pretty good idea what we were dealing with.
The statement that this therapy is akin to "salvage therapy" is way off base. There are a few guys on this site who have gone the same route as me and had good results.
Remember, each case is different and we can only give you our personal experience. No one has all of the answers.
Biopsy- 12 cores, 4 positive highest 4+4=8
Bone scan, CT scan and Chest X-ray clear 4/16/08
Urologist suggested surgery 4/16/08
MRI on 4/24/08 clear no suggestion of lymph node involvement.
4/24/08 -Started on Lupron and Casodex preparing for HDRT and IMRT in late July. This treatment will not preclude me from surgery if I change my mind.
Decide to have DaVinci surgery after another consult with surgeon.
6/19/08- DaVinci surgery at University of Washington.
6/25/08- Path report, clear margins, no noted extension
9/12/08- PSA <0.02
12/05/08-PSA <0.02 Six months after surgery