Your RO is right. That's why brachy boost therapy has a much better record of cure for high risk PC.
It is unusual to have an MRI a month after
a biopsy - there is still blood that causes artifacts. MRIs do not confirm Gleason scores - only biopsies do that. The data on staging (organ confined) using MRis are even worse than your RO thinks. In this study, MRI failed to detect 28% of the cases where extraprostatic extension was subsequently found on a prostatectomy:/www.ncbi.nlm.nih.gov/pmc/articles/PMC4480330/
Even if no EPE is found, there is still a danger that microscopic cancer cells have infiltrated outside of the prostate. That's why radiation can kill them where surgery can't. Radiation after surgery makes the side effects worse than either alone.
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
•SBRT 9 yr onc. results
•SBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.1,no lasting urinary, rectal or sexual SEsmy PC blog