Where in Florida are you? Please don't limit yourself to the large hospitals as there are many excellent organizations that treat cancer and practice urologic oncology that are world renowned.
Moffitt Center, Datolli, Mayo, Florida Oncology and many others may be nearby. My brother-in-law lives in The Villages and found an excellent specialist nearby. He was similar in age and dx as you a few years ago. He used radiation treatment and is cancer free and has absolutely no negative side effects.
In your shoes with a G8 in the mix I would certainly explore my possibilities now. That may include AS, but you also have great non-invasive treatment options as well. Again in your shoes I would be consulting with Datolli in Sarasota. All they do is prostate cancer and have always been leading edge. Personally, I haven't consulted them because I had great centers here in Atlanta, but I did research them as a possible option.
As to multiple treatment modalities, surgery should be off the table at age 75. I wouldn't waste my time speaking with any surgeons. The best known surgeon at Johns Hopkins that developed the nerve sparing procedure, Dr. Patrick Walsh always has a strict cutoff at age 70. In his book he states that if a man over 70 wants surgery, he must bring both parents to the consult before the doctor would consider the procedure. HIFU has proven to be ineffective and cryo will nearly always guarantee incontinence and complete ED.
Your approach will be AS or the various effective radiation therapies. Of those Brachytherapy (permanent seeds or high dose rate temporary) and SBRT external beam offer the best results. Traditional IMRT is also very effective, but will take 35-45 procedures versus 5 for SBRT and one for brachytherapy.
The three main factors to pursue are effective cancer control, low expected side effects and treatment convenience.
PSA 59 on 8-26-2010 age 60. Biopsy 9-8-2010 12/12 positive, 20-80% involved, PNI in 3 cores, G 3+3,3+4,and 4+3=G7, T2b.
Eligard and Jalyn started on 10-7-2010. IMRT to prostate and lymph nodes started on 11-8-2010, HDR Brachytherapy December 6 and 13, 2010.
PSA < .1 since February 2011
Post Edited (JNF) : 5/27/2017 6:54:50 AM (GMT-6)