Hello Gray Panther,
Welcome to the site. Sorry about the crummy news you have received. The advice you have been given is very similar to what I was told by the urologist who made my diagnosis. I did a good deal of research on the subject and treatments. I also got a second opinion from Mayo in Rochester. I would recommend that you also do the research and seek a second opinion from the facility of your choice.
At Mayo they believe that even in the advanced cases that surgery gives better results in the long term. But only if it is followed by radiation and possibly HT. There are a number of medical papers by Mayo doctors that propose this course of treatment. In my own research I found that the odds for cure were about the same for radiation of surgery in the case of localized disease. Key here is localized. Even so the data I found on advanced cases seemed to give a slight edge to surgery, radiation and HT vs just radiation and HT. In the end I went with IMRT and HT. Google Bola study for a good dissertation on radiation with adjuvant HT.
I also looked at proton beam at LL, Schands in Jacksonville, FL, and Anderson in Texas. It was (is) very expensive and a long ways from my home as well. I am uninsured so the cost was a major consideration. From what I could discern from my research the results were about the same as IMRT but the side effects were not as severe in most cases. My own side effects from IMRT have been very little. (thankfully) Proton can be given along with IMRT for an advanced case. The IMRT is used to radiate the pelvic region to try and get the lymph nodes.
There is a facility in Georgia (RCOG) that provides the brachy and IMRT combo and they claim very good results. Another that does this is Dattoli in Florida. Tampa I think. You can google both and read up on thier opinions and options. I spoke to both facilities and they took a lot of time to tell me about their treatments and results.
I also consider adjuvant chemotherapy with the IMRT and HT. This was a trial and my oncologist could have gotten me in but at the end of the day I decided not to pursue this track.
Best thing you can do is get educated on this disease, ask all the questions you and anyone you know can think of, and then make the decision and don't look back.
I wish you the best of luck with your treatment. It is a most perplexing disease with few clear cut choices for treatment particularly for the advanced cases.
Diagnosed 04/10/08 Age 58 at the time
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Lupron injection on May 15 and every four months for next two years
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 to be full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
PSA 02/08 21.5 at diagnosis
PSA 07/08 .82 after 8 wks of hormones
PSA 10/08 .642 one month after completion of IMRT, 6 months hormone
PSA 03/09 .38 six months post radiation and nine months into hormones
PSA 06/09 .36 or .30 depending on who did the test
PSA 09/09 .33 one year after IMRT and 16 months into hormone