Posted 9/24/2017 9:21 AM (GMT -6)
I don't think I can add much to what has already been said. I'm in a similar situation, RP with good results, but high Gleason and EPE. My surgeon says I can get adjuvant or wait to see if PSA rises and get early salvage. He doesn't see much difference between the two, and maybe I'll never need RT. I've seen two ROs and they both recommend RT, but say no harm in monitoring PSA for a while. After a while, however, the benefits of adjuvant or early salvage will be lost. I.e., if psa does not come back until 4 years later, RT isn't likely to help me.
I'm getting another couple of opinions and will sit on the decision for a few weeks. I'm leaning toward RT, but it's really a close call.
Your pathology report is a little different than mine, and I'm not conversant in your particular features. I do agree that Gleason 9 is nothing to take lightly. The chances of permanent urinary problems with RT are low, and while chances of ED are somewhat higher, there are work arounds. Permanent ED with no solutions results from death.