The debate as to whether to use HT alone or not is relatively shot down in several studies unless there is confirmed metastatic disease. If there isn't confirmed mets, the use of HT alone is not a good idea. Here is a link in today's Prostate Cancer InfoLink news feed:tinyurl.com/394us88
There is consistent mounting data that HT is a bad idea for local prostate cancer, and that RP consistently outperforms radiation therapy in all risk groups. I can probably site a dozen retrospective studies that agree with this post at the InfoLink. But the Sitemaster at the InfoLink asks a valid question: Is it necessary to do the more invasive procedure to get those results. I posted a reply to his post that will show up tomorrow. I think that it is important to look at age and life expectancy and also the aggressiveness and stage of the disease. In this post, Temenos is 68 years old. If he is genetically tied to a family that lives into the 90's, and he is otherwise healthy, then he should take the prostate cancer specific mortality rates more seriously. If not then it is possible that will do well with radiation therapy of any kind, or possibly even not treating the disease if his health is poor. I'll let Temenos clarify that. But combination therapies have more side effects, and adding HT is going to be the potentially worst one.
I do not know of any circumstance where HT alone is a best procedure except in stage 4 disease or where life expectancy is very short.
John T, you and I will debate that forever. EPE or positive margins alone are not a basis for eliminating a surgical intervention as an effective therapy. In the link above Michael Zelefsky is the Editor in Cheif of Brachytherapy magazine and even he acknowledges that.