I'm also inclined to go with "luck of the draw." My personal opinion is that PCa comes in many varieties that are not summarized by just staging, Gleason, or per-treatment PSA. Whatever original treatment you choose, some are more aggressive than others, and medical science just doesn't know enough yet to say in any reliable way which are more aggressive than others other than through crude and inexact measures such as staging, Gleason, etc.
The best we can do is to make the best informed choices we can. But I suspect that a cancer that is more aggressive is going to be less responsive to whatever treatment we, as patients, choose. And a cancer that is less aggressive will respond better on average regardless which treatment we choose.
I know it's not much consolation, but I think it's a crap shoot, and for the most part we and our doctors make the best choices we can based on what we know so far. Beyond that it's out of our control--and not worth second guessing.
-DX March 2002 - PSA 9.4, needle biopsy PCa 75% left lobe.Small focus right.
-RP April 2002. Pathology PT3B N0 MX Gleason=7 (3+4), seminal vesicle involvement. No lymph node involvement.
-Post-surgery PSA low of 0.01; slow rise to 0.4 (August 2009).
-SRT Jan/Feb 2010. Enlarged lymph node near prostate bed targeted. Casodex 3 months during SRT
-PSA 0.00 for 2 years
-PSA 0.01 April
Post Edited (Bohemond) : 9/12/2012 8:35:06 PM (GMT-6)