Perhaps the thinking has changed on this but in July 2009 I consulted with doctors at several of the large national centers (Cleveland Center, Sloan Kettering) and they advised me that the combination of HT + External Radiation + Seeds was as viable an alternative as RP for my situation. I also spoke with several radiation doctors in this area and they were quite surprised that with a Gleason 9 and Stage T2C surgery was even recommended by my urologist. I believe the thinking on this was that with my conditions chances that the PCa was confined to the prostate were less than 10%, so what good would surgery do since the great odds were that I would have to also do radiation later, and HT along the way.
My take on this is that seeds were once considered only for low and intermediate risk patients with Gleason 6 or 7 and PCa in only one lobe. Today it seems that many doctors consider HT + External Beam Radiation + Seeds a viable treatment for localized but advanced high risk PCa.
In the end I decided to go to a large center in Florida and have the seed implant done by an experienced radiation oncologist who was one of the early users of the real time seed implantation technique developed at the Sloan Kettering. After that I had the IMRT here in the area at the Carolina Cancer Center on Farris Road in Greenville. My radiation oncologist in Florida recommended the CCC highly because I could be treated with a Novalis machine which is able to apply the radiation with very great precision. At the time the CCC had the only Novalis machine in the state of SC, probably still true.
In retrospect and with a little more knowledge at the time I might have chosen HDR brachytherapy and had it done at the Gibbs Cancer Center in Spartanburg as they have a very experienced doctor there who was highly recommended by several external sources.
It may sound to you that I think I applied good reason in coming to a decision, but perhaps that is not really the case as I must admit that my decision was very emotional in that I simply had a great fear of the potential side effects of RP.
Anyway, this does not have anything to do with your original post in this thread and I only joined in to wish you well and suggest that HT may not be as bad as you fear.
Age 66, PC diagnosed 7/2009 at age 65
Stage: T2c, Gleason: 9 (4 + 5), 6 of 6 cores positive
Bone, CAT and MIR scans negative
Treatment: brachytherapy (103 palladium), 100 gy, 11/2010 + hormone therapy (Lupron + Casodex) + IMRT on Novalis, 45 gy, 3/2010.
PSA: 7/2009, At time of diagnosis -- 11.9, 10/2009 -- 5.0, 12/2009 -- 0.56, 5/2010 -- 0.15, 8/9/2010 -- 0.06
Post Edited (Sancarlos) : 8/27/2010 2:02:48 PM (GMT-6)