Posted 7/18/2016 6:28 PM (GMT -7)
Sorry about the high risk diagnosis. I hope you understand that this is a time for specialists, and not your local doctor. Andriole is a great choice, and Barnes Jewish one of the best.
I've come to believe that for high-risk PC like yours, radiation is the best option because it treats areas outside of the prostate capsule where cancer may be lurking.
Did they see something suspicious on your seminal vesicles, or do they just suspect it because of the location of the known positive cores and the high PSA?
Some of the best cancer control outcomes come from combining external beam therapy with a brachytherapy boost to the prostate. Because of the high PSA, they will probably want to treat the pelvic lymph nodes as well. Hormone therapy for at least 18 months will help the radiation work better. Ask about hypofractionation too - they may be able to do it in fewer treatments.
If I recall correctly, Washington University/Barnes Jewish has a PET/MRI that they can do with C-11 Choline. If so, you might want to check for distant metastases with it. You don't want to pursue a cure using any radical treatment if the cancer has already escaped the local area.